Authors: (including presenting author): :
Ma PM, Tong MH, Chim CK, Kwok ML Angela, Ho PY Becky, Leung KW Maria
Affiliation: :
Community Outreach Service Team, Prince of Wales Hospital
Introduction: :
Background:
Chronic edema and lymphoedema cause prolonged tissue inflammation and tissue changes. Some patients will progress to develop significant secondary tissue damage with presenting in recurrent cellulitis, wound healing retardation. Consequently, they may experience a significant impact on pain, reduced physical ability and lowered quality of life. Those conditions are required long-term medical and nursing management which causes burden on health services involving both hospitalization and community health care.
Studies supported the use of Manual Lymphatic Drainage (MLD) in treatment of patient with complicated lymphedema. NTEC COST conducted a pilot program by using a handy negative pressure massage devices (LymphaTouch) to facilitate conducting Manual Lymphatic Drainage (MLD) in home setting as new model of care and advanced nursing practice.
Objectives: :
Objectives:
1. To develop new nursing practice in managing patients suffered from leg ulcer with edema or lymphedema condition in communities.
2. To reduce edematous or lymphedema condition.
3. To improve the wound healing process.
4. To reduce pain.
5. To improve the quality of life.
Methodology: :
Methodology:
Patients suffered from chronic leg ulcers with severe edema or lymphedema were recruited. Individualized MLD care plan would be designed. 2 weeks and 4 sessions MLD with device assisted treatment for each patient would be conducted by qualified lymphedema trained nurse. Outcome evaluation included Pre- and Post- intervention related to wound conditions, pain level, physical ability and patient satisfaction survey.
Result & Outcome: :
Results:
From 1st May to 31st Dec 2023, 8 patients were recruited. Age median 75 (43-89years-old). Edema history ranged from 0.5 to 22 years. The result showed that 7 out of 8 patient’s wound sizes were reduced. 3 out of 8 patients with significant size reduction by 37.5% in average (pre-intervention range from 19.3 -300cm2, post 11.4-224cm2). 7 out of 8 wound exudations were reduced that dressing frequency reduced from once daily to 2 times per week. Pain level was markedly reduced by 57%. All (N=8) calf circumferences were reduced by 6.3%, 2.5cm in average. As a result, their physical abilities were also improved. All patients (N=8) agreed the project greatly helped in pain reduction and activity daily of living (ADL) after treatment.
Conclusion:
The results demonstrated the new model of care was able to accelerate wound healing, reduce pain and improve ADL. MLD with device assist is feasible, applicable and acceptable to help community nurse in managing complex patient condition in community.
