Venous Leg Ulcers and Bandaging Regimens - Case Study Example

Venous Leg Ulcers Introduction The study undertaken is aimed to present an understanding of research evidence in relation to venous leg ulcers. Thecases of venous leg ulcers is the main focus of the research due to the frequency of encounter with such cases during the period of practice spent with the district nurses. Due to the personal experiences with patients that incurred the venous leg ulcers, the realization of the need for attention on such cases came up. This is in addition to the fact that significant percentage of the population can incur the disease. The main objectives of the study are to discuss the efficacy of the different interventions and management types of venous leg ulcers. To be able to present and discuss the venous leg ulcer, primary evidences gathered by prior empirical research processes had been included as references. The data and concepts presented are then analyzed and compared. Description of Venus Leg Ulcers The study is focused on the cases of venous leg ulcerations specifically in the management of such cases. Venous leg ulceration is one of the types of leg ulcerations that can affect a significant percentage of the population. Based on statistical evidences, the venous type of leg ulceration can affect a larger number specifically 76% of the people with leg ulcerations. Management of the cases of leg ulceration is the most important aspect in the treatment process due to the negative aspects of the disease such as pain and the procedure for healing itself. Another issue that is needed to be considered is the proper diagnosis of cause due to the possible dangers in case the real cause of ulceration is arterial because the main intervention can worsen the case (Closs, Nelson and Briggs, 2008, p.638). The cases of venous leg ulcers are commonly treated and managed through compression bandaging. In the research undertaken, the analyses of other forms of treatment and management as well as the different techniques that can be used are taken into account. Analysis of Related Research Data There are three researches included in the study undertaken. All of these were involved in the analysis of the procedures and techniques that are related to the management and treatment of venous leg ulcers. Use or Non-Use of Compression Bandaging One of the studies that are included in the research undertaken is focused on the use of one of the most important treatment intervention in the management of venous leg ulcer. This is based on the fact that although the use of compression bandaging had been accepted and proven to cure the venous leg ulcers, there are cases wherein the said procedure is not applied by the district nurses and other medical professionals. The main objective of the study is to explore the reasons why the said procedure is not being used. This is undertaken through the use of qualitative and descriptive research procedures undertaken specifically through interviews (Annells, O’Neill and Flowers, 2008). There are different points that are needed to be given attention in the analysis of the study. These are the significance, validity and the applicability of the results. Significance can be related to the importance of the rationale. Validity can be related to the research methodology and the gathered results and data. Applicability then is related to the main benefit of the gathered information which can be related to the possibility for other effective treatments in cases wherein the most important treatment is not used. The rationale of the research is to be able to determine the reasons of the medical professionals for not using the compression bandaging to be able to perceive alternative perspectives regarding the treatment for venous leg ulcers. The said rationale is important for the patients in the said localities for certain reasons. One is in relation to the quality of healthcare that they are receiving. If the said procedure is the most effective, then the reasons for finding the less effective intervention are needed to be analyzed. Another reason is the possibility for better alternatives that the healthcare professionals find more beneficial to the patients. The method used in the research process is another aspect of the analysis. The research procedure that had been used is qualitative descriptive or exploratory (Annells, O’Neill and Flowers, 2008). Although the use of quantitative analysis can be considered more objective, the focus of the study faces subjectivity since it concerns the preference of either the district nurses and other healthcare professionals or the patient himself/herself. Thus, the method used can be considered suitable. In terms of validity, the process of choosing the possible sample population can be considered acceptable since randomization process cannot be applied completely. The inclusion and exclusion criteria though produced stratification for the sample population. Also, due to the ethical considerations, blinding had not been employed and the participants are fully responsible for their opinions and points of view. In terms of the interview method, it had been used to achieve the main objective of the study which is to determine the reasons of the interviewees, which are the district nurses for using or not using the compression bandage technique. The interview process can be considered reliable and ethical on the basis of the rules on confidentiality. The process had also been undertaken with full documentation and in a structured manner. Validity can be achieved by undergoing two types of interviews namely the individual and the focus group interviews. The process of data analysis undertaken can also be considered important. Methods for descriptive and qualitative data analysis had been employed to ensure the validity of gathered information (Annells, O’Neill and Flowers, 2008). Based on the results gathered by the research, there are important reasons for using compression bandaging. Although the said procedure can be considered as one of the most effective ways of treating and managing venous leg ulcers, the applicability is considered the main priority. This means that for a district nurse to apply such practice, the needed resources should be present, the personnel should be very familiar and the diagnosis is accurate. When these factors had been considered it is fundamental that there is mastery in the use of the compression bandage. These factors can be considered to be in the control of the district nurses. But there is another factor considered fundamental by the interviewees. This is the willingness of the patient to be treated using the compression bandaging procedure. This is considered as the most important factor in the research process that can affect the application of the compression bandaging as well as the management and treatment of the ailment. The results of the study are important in the recognition of the attitude of the patient toward the treatment and the manner of management and intervention relation to the venous leg ulcer cases. Comparative Analysis of Bandaging Methods In relation to the prior research that focused on the use of the most effective procedure in the management of venous leg ulcers, the comparative analysis of interventions and procedures are important in cases when there are limitations in resources or hindrances in different aspects. The second study in focus is the comparative determination of the efficacy of the cohesive short-stretch versus the four-layer bandaging techniques for venous ulceration. The main rationale of the study is to analyze the efficacy of an alternative procedure to the more conventional and generic type which is the four-layer bandage. In this manner, the said technique can be gauged and be recommended in the future either for further study or for application on a generalized manner specifically in the community level where such procedures are needed (Franks et. al., 2004). The research is based on empirical data, thus, the results are first hand in nature which is considered as an important source specifically in the field of healthcare and medicine because through such studies the improvement of medical care can be achieved. The 12-centre prospective randomized trial is important in terms of the validity of the results that can be generated in the study. Stratification on the basis of severity of the leg ulcers had been undertaken. Screening of the sample population had been based on the exclusion and inclusion criteria. Randomization had been applied in the specific set-ups for testing through factorial design (Franks et. al., 2004). These procedures endure the validity of the data. The ethical considerations had also been satisfied, thus, the research process can be considered acceptable. Statistical methods used include consideration of the set-ups used, the sample population size and the analysis of the data. In terms of the set-up used, the randomization technique employed insures validity. In terms of the sample population size, 200 patients in total had been considered as statistically acceptable to describe significance in the study results. For the analysis of the data, different methods were used to standardized and validate the results. Thus, based on the satisfaction of the prerequisites for validity, the results can be considered significant (Franks et. al., 2004). Based on the research results, there is no significant difference in the efficacy of the cohesive short-stretch and the four-layer bandaging techniques for venous ulceration. This can mean that both methods can be use for the treatment of venous leg ulcers. It is important to consider that in the recognition of alternative procedures for the treatment of venous leg ulcers more patients can be benefit and at some point they can even make a choice on the procedure that they want. More alternatives in terms of interventions are always beneficial to healthcare and medical practice. Comparative Analysis of Bandaging Regimens In relation to the analysis of two bandaging techniques, another research in focus is the determination of the efficacy of two bandaging regimens. The main focus of the study is the determination and comparative analysis of the efficacy of compression enhance healing through the two regimens namely the brands Tensopress and Elastocrepe. The said brands were tested due to the possibility of better healing when external and greater compression can be applied (Meyer et al., 2002). The research process employed a randomized empirical trial thus the validity is upheld. Stratification procedures on the basis of preset criteria had also been used. With regards to the set-up, they were given same treatments such as zinc-impregnated paste bandage, only the bandages differ. The sample population were also chosen by applying randomization techniques. With regards to the sample population size, 112 patients, it can be considered acceptable although a higher number of participants can increase the reliability of results on the basis of statistical rules (Meyer et al., 2002). Statistical methods in analysis of the data had also been used which include techniques such as Mann-Whitney U test and the Mantel-Haenszel (Meyer et al., 2002). These are used to be able to generate an analysis for the empirical data gathered. Based on the analysis of the research undertaken, the effects of the two regimens did not vary significantly. In addition, the research had concluded that there is no significant improvement in terms of higher compression in elastic bandages applied in the venous leg ulcer cases. Basically, such study is one of the important explorations that can improve the process in treating and managing cases of venous leg ulcers. Also, the difference in regimens (e.g. brand type or name) cannot be the basis for the efficacy in terms of the healing process. The research is another contribution to the medical and healthcare practice. Conclusion The research undertaken on the management of venous leg ulcerations explored the methods used to be able to gather methods and concepts to improve the medical and health care practice. Specifically, the first research presented the importance of the patient’s willingness. The second research showed new alternatives for the treatment of venous leg ulcers with efficacy similar to the conventional treatment used. The third research included presented the equal efficacy of two different regimens in the market and how increased compression can affect the healing process. By knowing the results of these kinds of empirical and exploratory studies, healthcare and medicine will continuously improve. Bibliography Annells, M. O’Neill, J. and Flowers, C. (2008) ‘Compression Bandaging for Venous Leg Ulcers: The Essentialness of a Willing Patient’. Journal of Clinical Nursing, 17: 350-359. Closs, S.J., Nelson, E.A. and Briggs, M. (2008) ‘Can Venous and Arterial Leg Ulcers be Differentiated by the Characteristics of the Pain they Produce?’ Journal of Clinical Nursing, 17: 637-645. Franks, P.J., Moody, M., Moffatt, C.J., Martin, R., Blewett, R., Seymour, E., Hildreth, A., Hourican, C., Collins, J., Heron, A. and Wound Healing Nursing Research (2004) ‘Randomized Trial of Cohesive Short-Stretch Versus Four-Layer Bandaging in the Management of Venous Ulceration’. Wound Rep Reg, 12: 157-162. Meyer, F.J., Burnand, K.G., Lagattolla, N.R.F. and Eastham, D. (2002) ‘Randomized Clinical Trial Comparing the Efficacy of Two Bandaging Regimens in the Treatment of Venus Leg Ulcers’. British Journal of Surgery, 89: 40-44. Read More