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The article focuses on a study on the use of compression therapy in the assessment and management of the venous and arterial aetiologies underlying leg ulceration as part of a holistic care plan, which was presented in an expert panel discussion held in October 2023.

The article provides information on lymphatic insufficiency and stiff compression in venous leg ulceration.

Objective: The impact of hard-to-heal wounds extends beyond traditional clinical metrics, negatively affecting a patient's health-related quality of life (HRQoL). Yet treatment outcomes are seldom measured from the patient's perspective. The purpose of the present study was to perform in-depth qualitative interviews with patients diagnosed with varying types of hard-to-heal wounds to identify outcomes important to them. Method: Participants were recruited from wound care clinics in Canada, Denmark, the Netherlands and the US, and were included if they had a hard-to-heal wound (i.e., lasting ≥3 months), were aged ≥18 years, and fluent in English, Dutch or Danish. Qualitative interviews took place between January 2016 and March 2017. An interpretive description qualitative approach guided the data analysis. Interviews were audio-recorded, transcribed and coded line-by-line. Codes were categorised into top-level domains and themes that formed the final conceptual framework. Results: We performed 60 in-depth interviews with patients with a range of wound types in different anatomic locations that had lasted from three months to 25 years. Participants described outcomes that related to three top-level domains and 13 major themes: wound (characteristics, healing); HRQoL (physical, psychological, social); and treatment (cleaning, compression stocking, debridement, dressing, hyperbaric oxygen, medication, suction device, surgery). Conclusion: The conceptual framework developed as part of this study represents the outcome domains that mattered the most to the patients with hard-to-heal wounds. Interview quotes were used to generate items that formed the WOUND-Q scales, a patient-reported outcome measure for patients with hard-to-heal wounds. [ABSTRACT FROM AUTHOR]

The article comments on the impact of public policies and legislation on the U.S. wound care community and patient access to treatment and care in 2023 and outlines wound care advocacy initiatives for 2024 covering cellular and/or tissue-based products, antimicrobial dressings, lymphoedema compression and surgical dressings.

Objective: The aim of this case series was to retrospectively assess the impact on volume control and patients' quality of life (QOL) when a night-time garment was added to their previous compression regimen for a full 24-hour interval compression plan. Method: Patients who had a history of chronic oedema presented to one of two oedema management centres in the US for treatment for oedema exacerbation and/or suboptimal performance of their current garments. Objective data examined were circumferential limb volume (cm3) measurements and QOL measured with the Lymphoedema QOL Tool (LYMQOL-Leg and LYMQOL-Arm). Subjective comments on functional abilities and perception of improvement with a compression plan that comprised a 24-hour interval were documented. Results: All three patients presented in this case series had a reduction in limb volume and improvement in QOL when their daytime regimen of garments was updated and new night-time garments were added. Their subjective comments indicated improvement in activities of daily living and ease of controlling daytime oedema with a 24-hour interval compression plan. Conclusion: This case series illustrates the need for clinicians to create a partnership with the patient to promote concordance and adherence as part of their individual 24-hour interval compression plan. This partnership allows the plan to be uniquely changed and adjusted to allow each patient to feel in control of refreshing their mood, their skin and their garments. [ABSTRACT FROM AUTHOR]

Compression, skin care, manual lymph drainage and exercise form the mainstays of treatment of chronic limb oedema. The compression aspect of the regimen is often prescribed and used without conscious concern for the patient's ability for self-adjustment and skin hygiene. This article will focus on the action of compression therapy using a new concept of encouraging patients to apply and reapply an adjustable compression garment or multiple garment types during a 24-hour interval. The benefits of this focus on interval compression therapy on all aspects of care will be explained and case studies presented. [ABSTRACT FROM AUTHOR]

The article presents a case study of a male patient with a three month history of static left medial malleolus ulceration.

The article presents a case study of a male patient with venous leg ulceration and compression hosiery that had not been changed for 2.5 years.

The article presents the case of a 61-year-old man with 3-month history of static left medial malleolus ulceration requiring multiple courses of oral antibiotics for recurrent infection to discuss left medial malleolus ulcer.

The article presents the case of a 62-year-old male who was presented to his doctor with 2.5-year-long venous leg ulcers, eczema, and hosiery to discuss his conditions and possible treatments.

The authors reflect on a Norwegian study which examined the effectiveness of objective structured clinical examination (OSCE) in assessing the clinical skills of students in advanced nurse practitioner (ANP) education.

The article discusses facts about the chronic condition called lipoedema, some new developments on its pathophysiology, its effects on mental health, as well as some expert consensus on its treatment.

The article projects an era in lymphoedema insurance coverage in the U.S. in 2024 driven by the Lymphedema Treatment Act, grassroots effort by the Lymphedema Advocacy Group, and the coverage plan for compression garments and supplies proposed by the U.S. Centers for Medicare and Medicaid Services (CMS).