Epidemiological studies have shown that vascular diseases and specifically venous
diseases are the cause of lower leg ulcers, that venous diseases are the cause of 70% of
lower leg ulcers in the United Kingdom and 70 to 90% of all ulcers in North America and
England. In North America 10 to 15% of ulcers are the result of a combination of venous
and arterial insufficiency.
Two treatment modalities are available for venous lower leg ulcers:
¿ sustained compression and
¿ intermittent pneumatic compression.
The aim of this study was to compare the usefulness and effectiveness of intermittent
pneumatic and sustained compression with each other.
To attain this objective:
¿ the profile of patients with venous lower leg ulcers was described.
¿ the effectiveness of sustained versus intermittent pneumatic compression modalities
regarding wound healing were compared.
¿ the effectiveness of sustained versus intermittent pneumatic compression modalities
regarding pain were compared.
¿ The factors that influence the feasibility of the two treatment modalities were
identified.
This study consisted of two components. In the first place a descriptive study was
undertaken of the patients with venous lower leg ulcers who visited the out-patient
department of a Tertiary hospital in the greater Bloemfontein area. The second
component was an experimental study in which the effectiveness of the two treatment
modalities were compared.
The patients in the experimental study were allocated to the experimental and control
groups by means of a random list. Patients in the experimental group were treated with intermittent pneumatic compression for twelve weeks, while those in the control group
were treated with four-layer compression bandages for the same period. The study lasted
for 27 months until the desired sample size was reached.
Data confirmed the information available in the literature regarding venous lower leg
ulcers.
Outstanding characteristics of the profile were the majority of the patients were obese and
hypertensive.
The misuse of topical antimicrobic drugs became clear from the patientsâ history.
It also appeared that many of the patients lacked knowledge of and insight into the causes
and nature of venous lower leg ulcers, as well as their prevention and treatment.
It became clear that the ulcers of more patients treated by means of sustained
compression were healed than those with intermittent pneumatic compression. This
difference in wound healing was, however, not statistically significant.
The pain levels of the patients of both groups decreased with treatment between the first
and last assessment. However, the difference between the pain levels of the experimental
and control groups was not statistically significant.
The most import factors that influence the feasibility of the two treatment modalities were
the following:
¿ A shortage of nursing staff and doctors were experienced due to the labour intensity
of the study;
¿ Communication problems (it was necessary to use an interpreter at times);
¿ A shortage of wound dressings and bandages due to unforeseen circumstances;
¿ The Department of Health under-estimated the cost implications of the treatment
modalities;
¿ Intermittent pneumatic compression as a treatment modality was available only to
patients in the greater Bloemfontein area.
Volgehoue versus intermitterende pneumatiese kompressie as behandelingsmodaliteite in
pasiënte met veneuse onderbeenulkusse
35
¿ Sustained compression â patients from outside the greater Bloemfontein area missed
a treatment session if they missed the ambulance that transported them to the
hospital.
¿ Patients experienced transport problems due to high taxi fares and transport was not
always readily available on public holidays or over weekends.
¿ The continuity of sustained compression had, in some cases, to be broken for some
patients if the patient presented with clinical signs and symptoms of infection.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:ufs/oai:etd.uovs.ac.za:etd-01182007-073229 |
| Date | 18 January 2007 |
| Creators | Gerber, Johannes Benjamin |
| Contributors | Prof M Mulder |
| Publisher | University of the Free State |
| Source Sets | South African National ETD Portal |
| Language | en-uk |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.uovs.ac.za//theses/available/etd-01182007-073229/restricted/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University Free State or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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