Authors (including presenting author) :
CHAN KKS(1), PANG YK(2), WAN YP(3), CHONG C(3), PUN MK (3), NGAN HL(4), LAM J(4), KWAN K(4), NG KK(4), LEE A(5), SHIT F(6), TONG SY(6), PANG CH(7), WONG J(7), NG SC(8), PANG SY(9), LEUNG YP(9), SZETO R(9)
Affiliation :
(1)Wound and Stoma Care, QMH&HKWC, (2)Wound and Stoma Care, QEH&KCC, (3)Wound and Stoma Care, TMH&POH, (4)Wound and Stoma Care, UCH&KEC, (5)Wound and Stoma Care, TKOH, (6)Wound and Stoma Care, PWH&NTEC, (7)Wound and Stoma Care, YCH, (8)Wound and Stoma Care, PMH&KWC, (9)Wound and Stoma Care, RHTSK&HKEC
Introduction :
Venous leg ulcer (VLU) is a known chronic wound condition leading to healing difficulty. Compression therapy regards as the gold standard for VLUs management. Positive clinical outcomes in management VLUs are reported by using appropriate compression bandaging system which requires skilled clinicians to perform. In light of addressing the increasing volume and cost in local healthcare system, an initiative of exploring the use of 3 layers’ tubular bandage (3LTG) as an alternative for compression therapy in VLU management was carried out by the Specialty Advisory Group (Enterostomal Therapy).
Objectives :
To evaluate the efficacy and safety of using the 3LTG when compared to standard compression bandaging (CB) in healing patients with VLU with chronic venous insufficiency. The project will help to answer whether the application of 3LTG system will achieve similar clinical outcomes as the conventional long stretch compression bandaging system (LSCB). With gathering the local evidence, further standardized and generalized practice on using 3LTG would be possible with extension to the community/ primary care setting.
Methodology :
The recruited candidates will initially receive 2 weeks of conventional compression bandage. The participants will be assigned in sequence afterwards to receive either a) 3LTG; or b) continuation of conventional compression bandage until 12 weeks is due. The participants will be followed up 1-3 times per week. The outcomes (e.g. wound size reduction, healthy tissue proportion, resources consumed, participants’ satisfactory level, presence of complication etc.) will be recorded.
Result & Outcome :
Data was collected in nine Hospital Authority (HA) wound care centres among seven clusters. 72 cases were recruited; 32 in the intervention group (3LTG); 36 in the control group (LSCB) and 4 dropped out from the project. The healing rate of the intervention group had slight difference to the control group (65.6% vs 69.4%, overall 67.6%). Average time to heal was 35 vs 33 days respectively. The LSCB (control) appeared faster (18 vs 22 days) in achieving 50% of wound size reduction than 3LTG (intervention). However, the level of satisfaction was better in 3LTG (intervention) as less pain was perceived (71% vs 50%) and reflected by Global Rating Scale of improvement (62% vs 45%). The average nursing time spent was less in intervention group (28 vs 33 minutes). No severe adverse reaction was reported during the project period. In conclusion, the application of 3LTG for VLU management is safe and non-inferior treatment modality to conventional long-stretch compression bandage.
