Introduction
First of all, it is necessary to mention, that efficient management of venous leg ulcers symbolizes an important medical matter and a key consumer on imperfect monetary reserves. The investigation has shown that the mainstream of ulcers can be persuaded to cure by the request of sufficient stages of continued adapted compression though this method is never designated for the curing of ischemic sores.
Bandages differ very much in their aptitude to offer continued density owing to dissimilarities in their arrangement and the content of elastomeric fibers. Another component, such as limb perimeter and form, will also have a significant impact on the heaviness manufactured below a compression bandage.
The offered article explains a categorization scheme in which bandages are classified according to their purpose and performance, to facilitate the option of a suitable result.
Impasse or injury to the venous system will originate disturbance to standard blood flow, which may reveal itself in several various means by the size and degree of the injury. If the regulators in the shallow scheme are injured, a venous return will be damaged and blood may collect in the veins making them turn out to be swollen, leading to the structure of varicosities (varicose veins).
If the purpose of the perforator regulators is damaged, the function of the calf muscle thrust will tend to reason blood to flow in the overturn direction into the exterior system rising the opportunity of injure to the superficial vessels.
Following a deep vein thrombosis that outlines in the total or incomplete obstacle of a deep vein, the unalleviated strain manufactured by the calf muscle pump on the perforator regulators may cause these to turn out to be ineffectual. If this happens, there will be a great rise in the heaviness in the apparent system, which may force proteins and red cells out of the capillaries and into the nearby tissue. Here, the red cells break down discharging a red pigment which leads to staining of the skin – an early pointer of possible ulcer creation.
Methodology
The methodology offered in the article may be described as one clarifying the essence of bandaging requirements (not rules of bandaging itself, but the necessity of it with taking into account different stages of affection). The realization gained by this research will support preparation by district curing associations to advance the rate of proper firmness bandage use for venous leg ulcers through the specification of suitable reserves, support, and instruction, as compulsory. Also, the results will notify nurses how to charge patients experiencing venous leg ulcers properly, then wisely plan and employ approaches for patient-satisfactory and continued best treatment care. Consequently, the probable for venous leg ulcer curative in an opportune mode will be exploited with improved results for patients.
The biggest merit of the article is the offered information on research methods and samples on the mattes of research the problem of venous ulcers. The fact is that compression bandaging is the most important part of treatment. The aim is to counteract the raised pressure in the leg veins. This offers the best possibility for the ulcer to heal. The general method is for a nurse to use 3-4 layers of bandages over the cloths. When the bandages are put on, the stress is put highest at the ankle, and regularly less towards the knee and thigh. A compression supplying over the cloths is occasionally used as a substitute, but not to be equivalent to bandaging.
The bandages are re-bound every week or so when the ulcer covering is changed. It is superlative to put the bandages on after the patient has raised the leg for a few hours or during the night.
Regarding methodology, it is also would be rather useful to emphasize, that the greatest positive component of the article is the interviews with the patients, who had been subjected to bandaging. These interviews give clear realization on the actuality of the issue, and the real difficulty of curing such patients.
As it is appropriate for any research article, the offered results chapter is one of the key moments of the paper. As it is suggested, explanation of data resulted in conceptualization of eight groupings, compression bandaging is selected, a keen patient, a not keen patient, schemes to encourage, an option is selected, and allied care. Though, six of the groupings are either appropriate or accompanying two sorts that are key regarding responding to the investigate issue. These two categories turn around the construed central matter of patient enthusiasm and are about an eager patient and a not willing patient. Consequently, these two types are accounted for in detail and illumined by supporting exact quotes from information, with the other six types abridged.
As for the data collection tool, the only thing worth mentioning is the discussed above collection of the opinions by patients. These are quite useful for young practitioners and inexperienced doctors, who are starting their career and aim to further educate.
The majority of venous ulcers can be productively cured conventionally and do not necessitate surgical treatment. External, measured compression (stretchy bandages or stockings, compression drains) to overturn venous hypertension and assemble edema is the keystone of venous leg ulcer curing. Conducting venous hypertension and edema support in decreasing the long-term results of persistent venous deficiency and promote healing and preservation of skin reliability in the affected leg.
Regarding the issues of validity, credibility, trustworthiness the fact that needs to be highlighted is that the paper is based on prior researches, and with the account of the latest observations. Thus, the paper pretends to be highly credible and trustworthy, as besides the mentioned above factors the paper is accredited by the “Journal of Clinical Nursing”, which is regarded as rather authoritative in certain research and scientific circles of the scholars.
Data analysis in the paper is the only negative moment and an essential demerit of the paper, as it provides any kind of essential analysis for the gained data except for the whole image, which is outlined only in the results chapter. In spite of the fact, that some pieces of information are outlined throughout the chapters, the most essential analysis is in the final chapters of the paper.
The specificity of the paper is that there is no place for serious discussion to take place. It is mainly aimed to state the facts of using the bandaging procedure in curing the venous ulcer damages. Thus, all the observations are used here just to give information on the latest data. Though the separate chapter for discussion is given in the paper, it is more claimed to summarize the paper, and sum up the previous observations and researches.
Conclusion
Some restrictions to this study are considered to exist in the general practice of Venous Ulcer curing. First of all, the consequences cannot be asserted to be generalizable as only one background of care was researched in one territorial region of Australia in one community nursing association. Another restriction is that ‘hypothetical sampling’ was not used but an expediency example of registered nurses who were typically principal constituency nurtures at an analogous stage of accountability.
As such, partakers included in important events and situations for an appropriate investigation that could be classified through the attendant invariable comparative information research, could not be looked for and interviewed. As the instance was self-choosing – they were invited who consented to take part – they were probably more relaxed about, devoted to, or anxious about using compression bandaging than other nurses.
References
Backhouse C.M., et al., Controlled trial of occlusive dressings in healing chronic venous ulcers.Br. J. Surg., 1987, 74, 626-627. Web.
Burke, Mary M., and Joy A. Laramie. Primary Care of the Older Adult: A Multidisciplinary Approach. St. Louis, MO: Mosby, 2000.
Chase, Susan K, et al. “Living with Chronic Venous Leg Ulcers: a Descriptive Study of Knowledge and Functional Health Status.” Journal of Community Health Nursing 17.1 (2000): 1-13.
Ebersole, Priscilla, and Patricia Hess. Toward Healthy Aging: Human Needs and Nursing Response. St. Louis, MO: Mosby, 1998.
Fletcher A., The epidemiology of leg ulcers. In Leg Ulcers, Nursing Management, A Research-based Guide, Cullum N., and Roe B (eds) 1995, Scutari Press, Middlesex.
Loudon, Irvine. Medical Care and the General Practitioner, 1750-1850. Oxford: Clarendon Press, 1986.
Moffat C., The organisation and delivery of leg ulcer care. In Leg Ulcers, Nursing Management, A Research-based Guide, Cullum N., and Roe B (eds) 1995, Scutari Press, Middlesex.
Negus D., Leg Ulcers; A Practical Approach to Management, 1991, Butterworth Heinmann Ltd, Oxford.
Nelson A., Compression bandaging in the treatment of venous leg ulcers. Journal of Wound Care, 1992, 5(9), 415-418.
Strange, Carolyn J. “Second Skins: A Serious Burn Is One of the Most Horrendous Traumas the Body Can Suffer.” FDA Consumer. 1997: 12.