Authors (including presenting author) :
LO YM(1), LI KY(1), LEUNG SS(1), HEUNG LW(1), YIP TH(1), CHAN MWM(1)
Affiliation :
(1) Community Nursing Service, Princess Margaret Hospital
Introduction :
Venous leg ulcer is the major type of leg ulceration. Chronic leg ulcer is defined as open lesion between the knee and ankle joint that has not healed within 4 to 6 weeks. The prolonged healing time and high recurrence rate of venous leg ulcers contribute to a considerable cost in management and negative impact on patient’s quality of life. Foot bathing before wound dressing in community is one current practice to create an optimal healing environment for venous leg ulcers by removing debris. However, local guidelines focus on wound cleansing method and do not suggest the feasibility and methods of foot bathing. Hence, a literature review was performed to search for the relevant nursing practice in community setting.
Objectives :
(1) To identify the evidence-based practice on foot bathing before wound dressing of chronic venous leg ulcers (2) To address the risks and benefits of foot bathing
Methodology :
A thorough literature search was conducted according to PICO components of Johns Hopkins Hospital. P - Problem: Chronic venous leg ulcer I - Intervention: Foot bathing before wound dressing C - Comparison: Without foot bathing O - Outcome: Patient satisfaction, wound condition and healing time of leg ulcer The CINAHL complete, Cochrane Library, EMBASE, Joanna Briggs Institute EBP Database, Medline, Nursing Reference Center and PubMed were searched for English articles from 2009 to 2019. Grey literature search was also conducted by performing internet search for local and international guidelines, reviewing reference lists and bibliographies of retrieved articles.
Result & Outcome :
Three level IV and four level V evidence were identified with critical appraisal of evidence conducted. While no high-level of evidence had studied the effect of foot bathing, experts highlighted that foot bathing would not increase the infection rate and the healing time of chronic venous leg ulcer. Advantages of foot bathing include clear wound bed for examination, good leg hygiene and increased patient’s satisfaction. Soaking was recommended as the foot bathing method.
Conclusion: In order to promote the best possible outcomes of venous leg ulcer management in community, development of practice guideline on foot bathing with collaboration of key stakeholders, staff training and a study exploring the risks and benefits of foot bathing wound be conducted.
