Authors (including presenting author) :
Yip KYL(1), Leung SH(1), Chan BY(1), Li CCD(1), Ho CK(1), Wu WSF(1), Yu PK(1), Leung MF(1), Wong SM (2), Li YC(1)
Affiliation :
(1) Department of Family Medicine and General Out-patient Clinic, Kowloon Central Cluster
(2) Central Nursing Division, Queen Elizabeth Hospital
Introduction :
General out-patient clinics (GOPCs) provide public wound care service in primary care setting in Hongkong. Leg ulcers contributed 14.5% of total wound services in KCC GOPC wound clinic during Dec 2018-Dec 2021, while which required longer healing time and more dressing service attendances. Venous leg ulcer accounts for 70% of the leg ulcer (Olin et al., 1999). Three-layer compression bandaging therapy is one of the treatment to promote wound healing of venous ulcer with less cost, higher compliance (Bale and Harding, 2003) and patient tolerance (Weller et al., 2012). In this study, the effectiveness of early application of Three-layer tubular bandage in GOPC general dressing service will be evaluated in terms of clinical outcomes, including ankle circumference, wound size, pain level, and treatment compliance in four-weeks study period.
Objectives :
To evaluate the effectiveness of early application of Three-layer tubular bandage for patients with venous leg ulcers in GOPC general wound care service
Methodology :
During the 2-year recruitment period, 70 new cases of venous leg ulcer attending one of the 10 KCC GOPCs general wound care service would be recruited by triage nurses, if fulfilling inclusion and exclusion criteria with written consent obtained. Patient education on three-layer tubular bandage application and related daily care information will be given by GOPC nurses after routine leg ulcer wound care in GOPC general dressing service. Recruited patients were instructed on self-care on daily application of three-layer tubular bandage. Clinical outcome parameters were assessed and measured in week 0, week 2 and week 4. On the half way of the whole patient recruitment period in July 2021, 31 cases had completed data collection and were analyzed to inform an interim report.
Result & Outcome :
A total of 31 recruited cases included 13 (42%) male and 18 (58%) female patients. 74.2% were non-smokers, 64.5 % received primary or lower education level, 25.8% were employed. Most of cases had chronic comorbid diseases, including 64.5% had hypertension and 87.1% had varicose vein. Paired sample tests were performed on 4 Clinical outcomes between week 0 and week 4. The mean ankle circumference difference was decreased by 0.71 cm (p=0.022); the mean wound size (length x width) decreased by 2.36 cm (p=0.001), while mean pain score decreased by 2.93 (p<0.001). Patient compliance did not show statistical difference in Week 2 and Week 4. The preliminary study results suggested that with application of the three-layer tubular bandage, clinical outcomes in terms of ankle circumference, wound size and pain score among patients with venous leg ulcers were significantly improved, while patient compliance were maintained over the 4-week study period. In conclusion, early application of the 3-layer tubular bandage in primary care setting could be beneficial to patient outcomes, promoting patient engagement in self-care as well as alleviate clinical service attendances.
