Authors (including presenting author) :
Lai K.M.(1), Liu S.L.(1), Lo Y.C.(1)(2), Yan H.K.(1), Leung K.K.(1), Chan O.N.(1), Siu H.L.(1), Cheung Y.P.(1), Choi K.L.(1), Wong C.S.K.(1), Chan K.W.(1), Chan T.J.(1)
Affiliation :
(1) Orthopaedics & Traumatology, Prince of Wales Hospital (2) Specialist Outpatient Department
Introduction :
Leg ulcer is one of the most common wound problems in clinical practice which cause one’s physical and psychological distress. The prolonged healing time and high recurrence rate with repeated hospitalization have put a strain on the healthcare system. These ulcers most frequently lead to bacterial infection and require hospitalization.
Oversea studies (Wilson, 1986) suggested leg washing before wound dressing to remove debris can create an optimal healing environment for chronic leg ulcers. A literature review (Lee et al., 2019) has conducted in the community nursing services (CNS) of Kwun Tong district highlighted foot bathing before wound dressing would not increase the infection rate and outline the benefit of foot bathing including clear wound bed for examination, better leg hygiene and increased patient’s satisfaction. However, there is no related practice guideline on leg washing in Hong Kong.
Therefore, this study is to focus on the effectiveness and feasibility of leg washing in local clinical settings.
Objectives :
(1) To examine the effectiveness of leg washing before wound dressing; (2) to improve local patient’s quality of life and (3) to improve the quality of care.
Methodology :
Purposive sampling method was employed. Subjects were (1) adult patients with leg ulcer, (2) alert and conscious, (3) ADL grossly independent patients.
Patient was assigned to the control group and intervention group according to the time of admission.
Outcome measures were categorized by (1) wound size, (2) wound bed condition, (3) wound exudate, (4) patient’s satisfaction and (5) staff evaluation.
Result & Outcome :
Results:
From 11 July to 30 September 2022, 22 patients were recruited.
The wound size showed statically signification reduction in intervention group (p=0.042). The mean healing rate in the intervention group (-4.53%) was higher than intervention group (-3.52%). And patient satisfaction showed positive feedback on improving personal hygiene; staff evaluation showed the majority agree leg washing before wound dressing was simple and effective method to enhance patient’s skin hygiene.
Conclusions:
Leg washing before wound dressing could provide a benefit for patients with leg ulcer in terms of better wound size reduction and healing. This practice would help to shorten the in-hospital length of stay and reduce the unplanned readmission. It is a good practice to be promoted.
