Mette Niemann Johansen, Gregor Borut Ernst Jemec, Matias Greve Lindholm
{"title":"慢性腿部水肿、溃疡和心力衰竭:一种潜在的致命且经常被忽视的组合。","authors":"Mette Niemann Johansen, Gregor Borut Ernst Jemec, Matias Greve Lindholm","doi":"10.12968/bjcn.2024.0149","DOIUrl":null,"url":null,"abstract":"<p><p>Chronic leg ulceration may often be accompanied and exacerbated by the presence of oedema, a common health problem that can cause ulceration, which if left untreated can require amputation. Current clinical consensus indicates compression as the recommended treatment for oedema. While cardiac function is also known to influence oedema, it is rarely considered a parameter of wound management. This article presents a case study of a patient with oedema and ulceration, who avoided a scheduled amputation when lesions healed following the optimisation of cardiac function. The patient had right-sided heart failure with preserved ejection fraction. After fluid drainage, the ulcers began to heal. The case raises the question of cardiac optimisation of leg ulcer patients. This case highlights the potential role of cardiac management in leg ulcer treatment and raises an important question: should cardiac optimisation be a greater consideration in the care of patients with leg ulcers? The prevailing emphasis on compression therapy may benefit from reassessment, with particular attention to the role of cardiac function in wound healing.</p>","PeriodicalId":35731,"journal":{"name":"British Journal of Community Nursing","volume":"30 Sup4","pages":"S14-S17"},"PeriodicalIF":0.0000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Chronic leg oedema, ulceration and heart failure: a potentially deadly and often neglected combination.\",\"authors\":\"Mette Niemann Johansen, Gregor Borut Ernst Jemec, Matias Greve Lindholm\",\"doi\":\"10.12968/bjcn.2024.0149\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Chronic leg ulceration may often be accompanied and exacerbated by the presence of oedema, a common health problem that can cause ulceration, which if left untreated can require amputation. Current clinical consensus indicates compression as the recommended treatment for oedema. While cardiac function is also known to influence oedema, it is rarely considered a parameter of wound management. This article presents a case study of a patient with oedema and ulceration, who avoided a scheduled amputation when lesions healed following the optimisation of cardiac function. The patient had right-sided heart failure with preserved ejection fraction. After fluid drainage, the ulcers began to heal. The case raises the question of cardiac optimisation of leg ulcer patients. This case highlights the potential role of cardiac management in leg ulcer treatment and raises an important question: should cardiac optimisation be a greater consideration in the care of patients with leg ulcers? The prevailing emphasis on compression therapy may benefit from reassessment, with particular attention to the role of cardiac function in wound healing.</p>\",\"PeriodicalId\":35731,\"journal\":{\"name\":\"British Journal of Community Nursing\",\"volume\":\"30 Sup4\",\"pages\":\"S14-S17\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"British Journal of Community Nursing\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.12968/bjcn.2024.0149\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Nursing\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"British Journal of Community Nursing","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.12968/bjcn.2024.0149","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Nursing","Score":null,"Total":0}
Chronic leg oedema, ulceration and heart failure: a potentially deadly and often neglected combination.
Chronic leg ulceration may often be accompanied and exacerbated by the presence of oedema, a common health problem that can cause ulceration, which if left untreated can require amputation. Current clinical consensus indicates compression as the recommended treatment for oedema. While cardiac function is also known to influence oedema, it is rarely considered a parameter of wound management. This article presents a case study of a patient with oedema and ulceration, who avoided a scheduled amputation when lesions healed following the optimisation of cardiac function. The patient had right-sided heart failure with preserved ejection fraction. After fluid drainage, the ulcers began to heal. The case raises the question of cardiac optimisation of leg ulcer patients. This case highlights the potential role of cardiac management in leg ulcer treatment and raises an important question: should cardiac optimisation be a greater consideration in the care of patients with leg ulcers? The prevailing emphasis on compression therapy may benefit from reassessment, with particular attention to the role of cardiac function in wound healing.
期刊介绍:
British Journal of Community Nursing (BJCN) is the UK"s leading peer-reviewed journal for district nurses, containing the most up-to-date clinical coverage and research on primary care nursing. The journal promotes excellence in clinical practice with an emphasis on the sharing of expertise and innovation in district nursing. Articles are written by nurses from across the community nursing spectrum, and peer-reviewed by leading authorities in primary care to make sure that the journal addresses all aspects of the profession in a way that is relevant, intelligent and accessible, and so useful in daily practice.