Wound management for 287 patients with chronic leg ulcers demands 12 full-time nurses: Leg ulcer epidemiology and care in a well-defined population in southern Sweden

Abstract

Objective - To study the prevalence, aetology and tretment of chronic leg and foot ulcers, and to estimate the nurse's time in wound management. Design - A structured questionnaire with 19 questions about chronic ulcers and wound management was sent to all district and community nurses in the county during 1 week in March 1998. A similar questionnaire has been administered regularly since 1986. Setting - Primary and community care in the county of Blekinge, Sweden, with a population of 151610. Patients - 287 patients with chronic leg and foot ulcers were identified during the week studied. Main outcome measures - Prevalence of leg and foot ulcer, ulcer aetiology, treatment of ulcers and wound management time. Results - The estimated prevalence of chronic leg and foot ulcers was 0.19%. Venous ulcers were the most common (38%), of which 87% were treated with some form of compression therapy. Seven percent of the nurse's workload was devoted to ulcer care. During the period 1986 to 1998, ulcers with missing or unknown aetiology descreased from 31% to 6% and ulcers with a duration of more than 2 years from 44% to 27%, while treatment time per ulcer descreased from 2.1 to 1.7 hours/week. Conclusion - Monitoring standards for ulcer aetiology through repeated questionnaires seems to ensure more accurate diagnoses. Thorough and detailed information about treatment time documents the workload for wound management.