Today's Wound Clinic - Winter 2008 - (Page 34) inperspective problems threaten the wound care professional’s ability to provide the most basic compression; regional Medicare carriers quibble over how and when such compression can be provided to the growing number of patients who need it.10 Utilizing new technologies in the care of compromised patients is exciting. Still, the future challenge for venous ulcer management may be how to provide the same care that was available in the past. ■ REFERENCES Applied correctly and consistently, compression can heal up to 85% of patients, a success rate that has held steady for 20 years. diagnosed on the day of consultation or, as suggested by Falanga,9 within 4 weeks of care when they fail to meet projected healing milestones. 1. Margolis DJ, Berlin JA, Strom BL. Risk factors associated with the failure of a venous leg ulcer to heal. Arch. Dermatol. (1999); 135(8):920–926. 2. Fletcher A, Cullum N, Sheldon TA. A systematic review of compression treatment for venous leg ulcers. Brit. Med. J. (1997); 315(7108):576–580. 3. Steed DL, Hill DP, Woodske ME, Payne WG, Robson MC.Wound-healing trajectories as outcome measures of venous stasis ulcer treatment. Int.Wound J. (2006); 3(1):40-47. 4. Burton CS:Venous ulcers. Am J Surgery. (1994); 167(1A): 37S–41S. 5. Cullun MN. Evaluation of treatments for wounds in clinical trials. J Wound Care (1996);5(1):8–9. 6. Duby T, Hoffman D, Cameron J, Brown D, Chewy G, Ryan T. A randomized trial in the treatment of venous leg ulcer comparing short stretch bandages, four layer bandage system and a long stretch-paste bandage system. Wounds. (1993);5:276-279. 7. Falanga V, Margolis D, Alvarez O, et al. Rapid healing of venous ulcers and lack of clinical rejection with an allogeneic cultured human skin equivalent. Arch. Dermatol. (1998); 134(3):293-300. 8. Mostow EN, Haraway GD, Dalsing M, Hodde JP, King D. Effectiveness of an extracellular matrix graft (OASIS Wound Matrix) in the treatment of chronic leg ulcers: a randomized clinical trial. J. Vasc. Surg. (2005);41(5):837–843. 9. Falanga V, Sabolinski M. Wound Repair and Regeneration.Vasc Surg. 1999; 7(4)201–207. 10. Fife C. Walker D, Thomson B, Carter M Limitations of daily living activities in patients with venous stasis ulcers undergoing compression bandaging: Problems with the concept of self-bandaging.Wounds. (2007)10(19):255–257 Fla:Taylor & Francis Group 2005:423–437. BRINGING BACK THE PAST No other intervention in the field of wound care may have a greater evidence base for use than compression in the treatment of venous ulcerations. Applied correctly and consistently, compression can heal up to 85% of patients, a success rate that has held steady for 20 years. Recent scientific advances allow clinicians to expediently identify patients with limited healing potential and provide them with advanced technologies aimed at correcting their specific underlying healing barriers. However, the great irony of healthcare in the 21st century is that reimbursement 34 Winter 2008 Today’s Wound Clinic http://www.ethex.com
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