The Frustrating 15: What’s Missing?
March 17, 2008
Dot Weir, RN, CWON, CWS
Caroline Fifes’s commentary on the state of healing of venous leg ulcers over the years evoked several questions. She described the “frustrating 15%,” describing the relatively small change in healing rates of this population of patients through the years. This begs the question, how can this be? Our diagnostic skills regarding recognition of atypical ulcers that masquerade as venous ulcers have improved and we have many more advanced and “active” topical approaches in our treatment armamentarium. As Caroline more than adequately noted, wound care professionals know and understand the necessity of adequate compression and many sophisticated options for providing that compression are available.
What is missing in the care of that frustrating population (the 15%) of refractory ulcers? Although the following ideas might not change outcome statistics, at least five factors must be understood in order to impact refractory ulcerations:
1. Patient participation
2. Recognition of the impact of bacteria
3. Recognition of atypical ulcers
4. Use of advanced treatments
5. Defining closure versus healing.
For a preview of this article in TWC’s digital edition, visit
InPerspective
Subscribers can log in to view the entire issue.
Comments
Got something to say?
You must be logged in to post a comment.
