Affiliation:
1. Gdański Uniwersytet Medyczny
2. Gdański Uniwersytet Medyczny Klinika Chirurgii Onkologicznej, Transplantacyjnej i Ogólnej, Centrum Medycyny Inwazyjnej
Abstract
The homelessness crisis in Poland poses a serious challenge to the state, with the number of homeless individuals exceeding 30,000 in 2019. In this paper we highlight one of the most common surgical issue of people experiencing homelessness – venous leg ulcers – and present current treatment guidelines. Homeless individuals, particularly exposed to inadequate living conditions, poor hygiene, and circulatory disorders, are at high risk of developing them. Venous ulcers are chronic wounds with prolonged and complex healing processes.They arise due to venous hypertension associated with chronic venous insufficiency and thrombosis. Often, specialized treatment is necessary, which is a challenge for homeless individuals due to difficulties in accessing regular care.The treatment of venous leg ulcers involves a multi-stage process. The gold standard for managing venous leg ulcers is compression therapy, which reduces edema and venous reflux. The TIME strategy outlines the approach to chronic wound management, emphasizing the importance of initial wound cleansing (surgically, enzymatically, or larvotherapy), infection prevention, maintaining proper moisture and wound edge preparation. This requires the use of suitable antiseptics, dressings, and wound hygiene.People experiencing homelessness face specific issues that necessitate a holistic approach, which includes health education, nutrition, and rehabilitation.
Subject
Industrial and Manufacturing Engineering,Surfaces, Coatings and Films
Reference27 articles.
1. Bartoszewicz M., Junka A., Leczenie miejscowe rany przewlekłej objętej procesem infekcyjnym w świetle obowiązujących wytycznych, „Leczenie Ran” 2012, nr 9.
2. Bartoszewicz M., Banasiewicz T., Bielecki K. et al., Zasady postępowania miejscowego i ogólnego w ranach/owrzodzeniach przewlekłych objętych procesem infekcji, Forum Zakażeń 2019, nr 10.
3. Burak A., Ferenc A., Defining and measuring of homelessness. Poland,"„Social Policy Issues” 2021, nr 52.
4. Chamanga E.T., Understanding venous leg ulcers, „British Journal of Community Nursing” 2018, nr 23.
5. Comerota A., Lurie F., 'Pathogenesis of venous ulcer', Seminars in vascular surgery, Elsevier 2015.