Leg and foot ulcer patients. Epidemiology and nursing care in an urban population in South Stockholm, Sweden

Abstract

Objective - To study the prevalence, demography, perceived aetiology, level of care, treatment and nursing care of patients treated for leg and foot ulcers. Design - Prospective survey of leg and foot ulcer patients, using a structured questionnaire consisting of 20 questions directed at nurses and doctors in 193 units, including both primary health care and hospital. Setting - South Stockholm Medical Area, Stockholm, Sweden. Patients - Two hundred and ninety-four patients with leg and foot ulcers were identified during the six-week study period. Main outcome measures - Demographic data of population, prevalence of leg and foot ulcers, level of care, economic aspects, treatment of ulcers, level of compression, characteristics of the ulcers, pain and analgesics. Results - With a population of 241804 in the area, the prevalence of leg and foot ulcer was 0.12%. The majority of patients (92%) were older than 65 years of age, median age 79.2 years. The commonest cause of leg ulceration, as estimated by the staff, was venous insufficiency (42%). The majority of patients were treated within the primary health care system, and only a minority were treated in hospital. Many different local wound dressings were used (n=51). The majority of dressing changes were performed by auxiliary nurses (54%). Compression was practised in 86% of all cases diagnosed as venous ulcers. Pain was reported by staff in 47% of all patients with venous ulcers. No pain relief was given to 29% of all these cases.