OUTCOMES OF PATIENTS WITH VENOUS LEG ULCER TREATED WITH COMPRESSION BANDAGING – EXPERIENCE OF A MEDICAL CENTRE IN SINGAPORE

Abstract

BACKGROUND: Venous leg ulcer (VLU) is a common type of lower limb ulceration caused by venous insufficiency. Significant challenges are faced when there is delayed healing. Healing rates with compression therapy are varied and better understanding of the myriad of factors causing delayed healing within the local context can improve healing outcomes. AIMS: The aims of this study were to describe the type and duration of treatment, frequency of outpatient attendances and inpatient admissions and to identify the association between demographic variables (age, gender and race) and clinical variables (co-morbidities, smoking status, ambulatory status, body mass index, ulcer characteristics and type of compression therapy) with delayed healing of VLUs among patients on compression therapy in Singapore. METHODS: Retrospective, descriptive correlational design was used. Medical records were extracted from 397 VLU patients. Patient and ulcer characteristics were recorded using standardised data collection sheet. Chi-squared statistic and Pearson correlation were performed to find the association between selected variables and delayed healing. RESULTS: The average age of patients was 65.13 years, where 55.9% were female. The common co-comorbidities were hypertension (n=216, 54.4%), diabetes mellitus (n=137, 34.5%) and lack of mobility (n=103, 25.9%). The majority of patients were treated with compression therapy (n=387, 97.5%), over an average of 6.37 months. Patients regularly attended outpatient follow-up appointments (n=309, 77.8%) and had inpatient admissions (n=163, 41.1%). Age, gender and race had ix no significant association with delayed healing. Clinical variables (diabetes mellitus, ulcer duration, infection, type of compression therapy) were significantly associated with delayed healing of VLUs. CONCLUSION: This study is a benchmark for comparison with other VLU studies in Singapore. Two-layer compression bandaging is a viable alternative. Diabetes-specific protocol and ulcer chronicity monitoring can be implemented into healthcare practice. Future research can be done on interventions, infection, other demographic variables, nurse-led services, and role of cultural factors on VLU healing.