NURS 3055 Assignment 2: Literature review

1. Introduction (250-300 words)

The process of evidence-based practice is essential in accessing relevant research literature that could provide valuable insights into factors associated with the healing of venous leg ulcers. In order to accomplish this, an analysis of various research articles will be conducted using frameworks specifically designed to determine its credibility. Through the verification of the results the factors that corelate with the healing process of venous leg ulcers will be identified.

Venous leg ulcers are a common chronic wound problem, affecting about 2% of the population at some point in life. There is considerable interest in identifying factors that are associated with healing of venous leg ulcers, as this information can help healthcare practitioners improve their management of patients with these ulcers. In general, ulcer size, duration, and location, as well as patient age, comorbidities, and overall health status, are known to play important roles in determining the healing trajectory of venous leg ulcers. Other factors that have been associated with better healing outcomes include good wound care practices, the use of compression therapy, and lifestyle modifications such as exercise and weight management. Understanding these clinical factors can help healthcare professionals tailor their treatment plans and improve the likelihood of successful ulcer healing.

The clinical relevance of identifying factors associated with the healing of venous leg ulcers is significant for healthcare professionals, patients with the condition, and healthcare systems. Understanding these factors can aid healthcare professionals in developing more effective treatment plans and prevention strategies. Patients can benefit from improved healing outcomes and potentially avoid complications associated with delayed healing or non-healing of venous leg ulcers. Additionally, healthcare systems can benefit from reducing the costs associated with prolonged treatment and hospitalization for non-healing venous leg ulcers. Overall, identifying factors associated with healing of venous leg ulcers can improve patient outcomes, lessen financial burden, and aid in the advancement of clinical research.

2. Body: Discussion (approx.2500 words)

Search Plan: [150-200 words]

2.1. Develop the PICO or PICo (delete which table does not apply).

2.2. List the key concepts, similar concepts, synonyms, and different forms.

2.3. Present your advanced search using AND and OR (delete what does not apply). Include Boolean truncation.

Article Summary and Critique: 2000-2200 words 650-700 per article

Describe IN YOUR OWN WORDS (do not copy and paste the abstract), in sentence format, each article in terms of the aim, design and methods (i.e., what was done), and results (what was found). Include a summary of the critical appraisal of each study using the appropriate frameworks and tools provided in NURS 3055.

Article 1

Title: Factors that influence healing of chronic venous leg ulcers: a retrospective cohort

Aim: The aim of this article was to identify therapeutic and clinical factors that have an impact on the healing of venous ulcers.

Design and methods: A study was conducted on patients who had venous ulcers. Researchers measured the size of the ulcer at the first visit, after 6 months and after 1 year. They looked for outcomes where the ulcer area reduced by at least 50% at both 6 months and 1 year, considering various factors such as the patient's clinical condition, demographic information, and treatment methods used.

Results/findings: A group of 168 patients who had their first visit between 2000 and 2010 were chosen, but 74 of them were excluded for various reasons such as missing data, ulcers of unknown causes, or ulcers due to other medical conditions. The remaining 94 patients (with a total of 137 ulcers) had a reduction in ulcer area of at least 50% either after six months or 12 months. Complete healing occurred in 16.8% of patients at six months and 27% of patients at 12 months. Patients with long-standing ulcers, poor adherence to compression therapy, and infection episodes had lower ulcer area reductions at six months, while those with longer use of topical antibiotics and systemic antibiotics had lower reductions at 12 months.

Critical Appraisal tool used: The critical appraisal tool used for this article was a qualitative research using the critical appraisal skills programme.

Critical Appraisal summary:

Article 2

Title: Factors Associated with Poor Healing and Recurrence of Venous Ulceration

Aim: This article aims to look back at a significant number of cases of venous ulcers and analyze the factors that contribute to these ulcers not healing or reoccurring.

Design and methods: The study looked at patients with chronic venous ulcers that were at least 2 centimeters in size. The patients were examined for venous disease, including reflux and obstruction, in superficial, perforating, or deep veins. The treatment included compression, venous ligation, stripping, thermal ablation, sclerotherapy, and local wound care. If the ulcers did not heal after 6 months of treatment, they were considered nonhealing. The data was analyzed to compare differences in patient and ulcer characteristics and the clinical course of nonhealing ulcers. Statistical analysis was done using Sigma Stat and SPSS with a significance level of p < 0>

Results/findings: In their study, the authors found 153 ulcers in 127 patients. They discovered that certain factors such as advanced age, higher body mass index, history of deep venous thrombosis, not following compression therapy, and having a larger ulcer area were associated with ulcers not healing. Out of the 153 ulcers, 131 or 85.6% healed within six months, and ultimately, 147 or 96% of the ulcers healed on their own without needing plastic surgical intervention.

Critical Appraisal tool used: The critical appraisal tool used for this article was a qualitative research using the critical appraisal skills programme.

Critical Appraisal summary:

Article 3

Title: Prognostic factors associated with healing of venous leg ulcers: a multicentre, prospective, cohort study

Aim: The aim is to determine which clinical characteristics can predict the healing of venous leg ulcers, along with the sociodemographic and psychological factors associated with them and their healing within 24 weeks.

Design and methods: This study looked at patients with venous ulcers over a period of one year. At the first visit, and then again at 6 months and 1 year, the area of the ulcer was measured. The main interest was in seeing if there was a 50% or more reduction in the ulcer area at both 6 months and 1 year, considering clinical, demographic and treatment factors.

Results/findings: A group of 168 patients who had their first appointment at a medical facility between 2000 and 2010 were chosen for study. However, 74 of them (44.04%) were not included for various reasons. For example, 17 patients had ulcers that weren't followed up after 12 months, while others had ulcers due to a variety of causes, such as peripheral artery disease and burns. Among the patients who were included, many were elderly and had large ulcers. Most of the participants were female and the ulcers had been present for anywhere from 12 months to 39 years.

Critical Appraisal tool used: The critical appraisal tool used for this article was a qualitative research using the critical appraisal skills programme.

Critical Appraisal summary:

Recommendations for Practice: (300-350 words)

Suggest two (2) strategies that will assist the integration of the findings from the literature review into nursing practice. Discuss the strengths and weaknesses of each strategy.

Strategy 1:

Strategy 2:

3. Conclusion - 200 words

Summarise the main points of your literature review and the implications for nursing practice.

4. References (please also include the 3 articles you reviewed)