Management of Venous Stasis Ulcers in the Older Adult

The influence of sex, body mass and body mass index on plantar soft-tissue stiffness in healthy people in their 60s

Foot abnormality has become a public health concern. Early detection of pathological soft tissue is therefore an important preventive measure, especially in older people who generally have a higher risk of foot pathology. However, the interpretation of plantar tissue stiffness data - whether to normalize the data or to separate the data on the basis of sex- remains questionable. The objective of this study was to assess the influence of sex and physical attributes such as body mass (BM) and body mass index (BMI) on plantar soft-tissue stiffness, and to evaluate whether it is necessary to isolate the differences in sex, BM and BMI in the data analysis. One hundred healthy subjects in their 60s were recruited for the experiment. Localized force response was obtained underneath the second metatarsal head (MTH) pad at three different dorsiflexion angles of 0°, 20°, 40° and the hallux and heel at 0°. No significant relationship was found between the independent variables and plantar stiffness. From the experimental results, it can be deduced that BM and BMI are weakly associated with plantar tissue stiffness, and that there is no significant difference in stiffness between male and female participants. No difference was found between left and right foot measurements. This suggests that normalizing of plantar tissue stiffness by BM and BMI is not necessary in healthy people in their 60s. The data can be pooled and treated equally regardless of sex.

Knowledge, Attitude, and Practice in the Management of Mixed Arteriovenous Leg Ulcers

Leg ulceration is a chronic health condition that constitutes a significant disease burden. In this cross-sectional descriptive study, a sample of wound care clinicians were asked to respond to a web-based survey. Based on a review of literature and recommended best practices in the management of mixed arteriovenous (AV) ulcers, a questionnaire was developed to examine the knowledge, attitude, and practice pattern in the management of AV ulcers. A total of 436 clinicians participated in the survey. A number of assessment techniques were perceived to be relevant for the assessment of AV ulcers; medical history and the appearance of ulcers were the most commonly used methods in clinical practice. While over 80% of the participants conceded that compression should be used to promote wound healing, half of them would consider using compression for AV ulcers if ankle brachial index was less than 0.8. Half of the participants considered an ankle brachial index of 0.8 or higher as the optimal cutoff value for safe compression. The majority of respondents disagreed with the perception that caring for people with AV ulcers was unrewarding. However, challenges to promote treatment adherence, address psychosocial concerns, and optimize symptom management are common.