Community nursing care for chronic wounds: a case study of optimal home treatment of a venous leg ulcer

Abstract

Europe's aging population presents an increasing number of chronic diseases, including vascular diseases that can lead to chronic wounds. These chronic wounds carry a significant health burden for individuals and economic burden for healthcare systems. Of chronic ulcers in the lower limbs, 80–85% are venous leg ulcers (VLUs). VLUs can be treated using a combination of compression therapy, modern wound dressings and wound-bed preparation based on tissue management, inflammation and infection control, moisture balance and epithelial advancement. This approach should improve the patient's quality of life in a way that is fast, cost-effective and minimises pain. Optimal treatment should involve holistic, comprehensive care for the individual patient, supported by multidisciplinary teamwork and patient education for self-care. An aging population also increases the need for community nursing care in patients' homes. Access to home wound care differs between European countries, particularly whether it is provided by registered nurses, as part of the healthcare system, or by homecare assistants, as part of the social care system. In countries like Slovenia, community nurses play an important role in the multidisciplinary treatment of VLUs, as they care for patients in the home environment and can best assess their condition. The GP first makes the initial wound assessment and diagnosis before authorising the community nurse to provide wound care in the patient's home. A case study is presented of a 91-year-old male patient with a VLU, alongside reduced mobility and multiple comorbidities. The treatment method provided optimal healing and is described and illustrated in detail.