Page 153 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

128 Chapter 5. Different Wound Type

has healed and the perception from health care professionals
that no further support is required. There is therefore a need
for psychological support for those both with an active ulcer
and those with a potential for re-ulceration.

Venous Leg Ulcers

Leg ulceration affects a large number of people within the
UK and worldwide, predominantly as a consequence of
chronic venous insufficiency (Green and Jester 2009 ). Annual
costs to the NHS, of the reported 70,000–190,000 sufferers
are estimated to be some £200 million (Posnett and Franks
2007 ). Despite both the prevalence and the personal and
psychological cost of leg ulcerations on patients, it continues
to be misunderstood, often being overlooked and underes-
timated (Rich and McLachlan 2003 ). Research surrounding
chronic venous leg ulceration demonstrates, unequivocally,
the long- term suffering patient’s experience that fundamen-
tally impacts upon their quality of life (the importance, of
which, will be discussed later in the book; Franks and Moffatt
2001 ; Maddox 2012 ). As discussed previously, psychological
consequences of living with wounds can include a variety of
issues stemming from the pain experiences due to the wound
or the isolation that a patient may experience due to living
with a wound. Research has highlighted a number of issues
associated with living with chronic venous leg ulcers, includ-
ing pain, leakage of exudate and associated odour, altered
body image, reduced mobility, and discomfort associated with
wearing bulky bandages. These physical problems can lead to
social isolation and psychological dysfunction (Ebbeskog and
Ekman 2001a , b ; Rich and McLachlan 2003 ; Hopkins 2004a ,
b ; Ebbeskog and Emami 2005 ; Jones et al. 2006 ; Edwards
et al. 2009 ; Green and Jester 2009 ; Maddoxs 2012 ; Jones
et al. 2008a , b ; Moffatt et al. 2009 ). Hence, it is important for
clinicians to understand the predominance of such issues in
order to account for such factors within their care procedures.
Green et al. ( 2013 ) suggested that VLU had a “pervasive and
profound effect” on the daily lives of their participants, with the
impact on physical, psychological and social functioning being