Pub Date : 2026-03-01Epub Date: 2025-11-04DOI: 10.1016/j.jvn.2025.10.003
Iman Nurjaman S. Kep., Ners., M. Kep., CWCCA., CSI
{"title":"Expanding perspectives on DVT risk assessment and preventive nursing practices in surgical patients","authors":"Iman Nurjaman S. Kep., Ners., M. Kep., CWCCA., CSI","doi":"10.1016/j.jvn.2025.10.003","DOIUrl":"10.1016/j.jvn.2025.10.003","url":null,"abstract":"","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"44 1","pages":"Pages 109-110"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147419266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-31DOI: 10.1016/j.jvn.2026.01.002
Eleanor Dunlap DNP, ACNP-BC, Suzanna Fitzpatrick, Linda Morales, Sandra Wilkerson, Barbara Bosah, Khanjan Nagarsheth MD, MBA, RPVI
Background
Traditional morbidity and mortality (M&M) conferences often lack nursing involvement or perspectives despite nurses being frontline caregivers. On a vascular surgery unit, pre-intervention data revealed concerning gaps in nurses' medical knowledge and low confidence in escalating patient concerns to the vascular team.
Purpose
To implement a structured nursing-led M&M conference to improve nurses' clinical knowledge, care confidence, and interprofessional collaboration in vascular care.
Methods
A structured implementation approach was employed, utilizing a dedicated electronic project management system. Two nurses collaborated on each case review that was selected from safety events, mortality cases, and emerging patient care themes. Cases incorporated systematic literature reviews and evidence integration, with mentorship from nursing leadership and Advanced Practice Practitioners. Pre- and post-implementation surveys using 5-point Likert scales assessed perceived medical knowledge, care confidence, and comfort with escalation.
Results
Post-implementation data revealed large improvements across all metrics. Medical knowledge scores increased from 3.0 to 4.7, care confidence from 3.2 to 4.3, provider communication comfort from 2.3 to 4.1, and concern escalation confidence from 2.2 to 4.3. The initiative effectively addressed failure-to-rescue risks by improving complication identification and provider-nurse communication.
Conclusions
Structured nursing-led M&M conferences significantly enhance clinical competence, interdisciplinary communication, and patient safety outcomes, demonstrating the value of inclusive case review processes in elevating nursing practice standards.
{"title":"Learning from experience: Revolutionizing vascular care through nursing morbidity and mortality conferences","authors":"Eleanor Dunlap DNP, ACNP-BC, Suzanna Fitzpatrick, Linda Morales, Sandra Wilkerson, Barbara Bosah, Khanjan Nagarsheth MD, MBA, RPVI","doi":"10.1016/j.jvn.2026.01.002","DOIUrl":"10.1016/j.jvn.2026.01.002","url":null,"abstract":"<div><h3>Background</h3><div>Traditional morbidity and mortality (M&M) conferences often lack nursing involvement or perspectives despite nurses being frontline caregivers. On a vascular surgery unit, pre-intervention data revealed concerning gaps in nurses' medical knowledge and low confidence in escalating patient concerns to the vascular team.</div></div><div><h3>Purpose</h3><div>To implement a structured nursing-led M&M conference to improve nurses' clinical knowledge, care confidence, and interprofessional collaboration in vascular care.</div></div><div><h3>Methods</h3><div>A structured implementation approach was employed, utilizing a dedicated electronic project management system. Two nurses collaborated on each case review that was selected from safety events, mortality cases, and emerging patient care themes. Cases incorporated systematic literature reviews and evidence integration, with mentorship from nursing leadership and Advanced Practice Practitioners. Pre- and post-implementation surveys using 5-point Likert scales assessed perceived medical knowledge, care confidence, and comfort with escalation.</div></div><div><h3>Results</h3><div>Post-implementation data revealed large improvements across all metrics. Medical knowledge scores increased from 3.0 to 4.7, care confidence from 3.2 to 4.3, provider communication comfort from 2.3 to 4.1, and concern escalation confidence from 2.2 to 4.3. The initiative effectively addressed failure-to-rescue risks by improving complication identification and provider-nurse communication.</div></div><div><h3>Conclusions</h3><div>Structured nursing-led M&M conferences significantly enhance clinical competence, interdisciplinary communication, and patient safety outcomes, demonstrating the value of inclusive case review processes in elevating nursing practice standards.</div></div>","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"44 1","pages":"Pages 72-77"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147420143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-02-17DOI: 10.1016/j.jvn.2026.02.002
Karolina Tworek , Kamil Kosal , Barbara Owecka , Agata Tomaszewska , Jerzy T. Marcinkowski , Maciej Owecki
Background
The time between the onset of stroke symptoms and implementation of treatment plays a crucial role in the prognosis, with 4.5 h being the gold standard for thrombolytic therapy in Poland during 2016-2018, when our study was conducted. Therefore, the delay in admission influences prognosis. This study aimed to examine if patients’ comorbidities, both previously diagnosed and previously unknown, affect their time of hospital arrival.
Methods
The study group of 161 patients post-stroke admitted to the hospital after 4.5 h or more was assessed for the presence of previously diagnosed and previously undetected comorbidities. In the control group, the retrospective analysis of files of 85 patients with the diagnosis of stroke who had been admitted in less than 4.5 h and had received thrombolytic treatment was performed. A statistical analysis was performed to explore the differences between groups.
Results
A statistically significant difference was shown in the prevalence of previously diagnosed hypertension (78.3% vs. 89.41%; p=.030) and atrial fibrillation (20.5% vs. 5.88%; p=.003), in the examined and the control group, respectively. In the study group, we also found more cases of newly diagnosed: hypercholesterolemia (14.9% vs. 14.1% in the control group), atrial fibrillation (12.4% vs. 10.6%), and hypertension (8.1% vs. 3.5%), but their prevalence did not differ significantly between the groups (p>.05 for all).
Conclusions
In patients after stroke, previously diagnosed hypertension and atrial fibrillation are the most prevalent comorbidities. Moreover, previously diagnosed hypertension is associated with earlier admission to the hospital, which may be related to higher health awareness in these patients.
卒中症状发作和治疗实施之间的时间对预后起着至关重要的作用，在我们进行研究的2016-2018年期间，4.5小时是波兰溶栓治疗的金标准。因此，延迟入院影响预后。本研究旨在检查患者的合并症，无论是以前诊断的还是以前未知的，是否会影响他们的住院时间。方法对161例中风后住院4.5小时或更长时间的患者进行既往诊断和既往未发现的合并症的评估。对照组回顾性分析85例入院时间小于4.5 h并接受溶栓治疗的脑卒中患者档案。通过统计分析，探讨组间差异。结果检查组和对照组既往高血压患病率（78.3%比89.41%,p= 0.030）和房颤患病率（20.5%比5.88%,p= 0.003）差异有统计学意义。在研究组中，我们还发现了更多新诊断的病例：高胆固醇血症（14.9% vs. 14.1%）、心房颤动（12.4% vs. 10.6%）和高血压（8.1% vs. 3.5%），但它们的患病率在两组之间没有显著差异（p> 0.05）。结论在脑卒中患者中，既往诊断的高血压和房颤是最常见的合并症。此外，先前诊断出的高血压与更早入院有关，这可能与这些患者更高的健康意识有关。
{"title":"Previously diagnosed hypertension may reduce stroke response time","authors":"Karolina Tworek , Kamil Kosal , Barbara Owecka , Agata Tomaszewska , Jerzy T. Marcinkowski , Maciej Owecki","doi":"10.1016/j.jvn.2026.02.002","DOIUrl":"10.1016/j.jvn.2026.02.002","url":null,"abstract":"<div><h3>Background</h3><div>The time between the onset of stroke symptoms and implementation of treatment plays a crucial role in the prognosis, with 4.5 h being the gold standard for thrombolytic therapy in Poland during 2016-2018, when our study was conducted. Therefore, the delay in admission influences prognosis. This study aimed to examine if patients’ comorbidities, both previously diagnosed and previously unknown, affect their time of hospital arrival.</div></div><div><h3>Methods</h3><div>The study group of 161 patients post-stroke admitted to the hospital after 4.5 h or more was assessed for the presence of previously diagnosed and previously undetected comorbidities. In the control group, the retrospective analysis of files of 85 patients with the diagnosis of stroke who had been admitted in less than 4.5 h and had received thrombolytic treatment was performed. A statistical analysis was performed to explore the differences between groups.</div></div><div><h3>Results</h3><div>A statistically significant difference was shown in the prevalence of previously diagnosed hypertension (78.3% vs. 89.41%; p=.030) and atrial fibrillation (20.5% vs. 5.88%; p=.003), in the examined and the control group, respectively. In the study group, we also found more cases of newly diagnosed: hypercholesterolemia (14.9% vs. 14.1% in the control group), atrial fibrillation (12.4% vs. 10.6%), and hypertension (8.1% vs. 3.5%), but their prevalence did not differ significantly between the groups (p>.05 for all).</div></div><div><h3>Conclusions</h3><div>In patients after stroke, previously diagnosed hypertension and atrial fibrillation are the most prevalent comorbidities. Moreover, previously diagnosed hypertension is associated with earlier admission to the hospital, which may be related to higher health awareness in these patients.</div></div>","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"44 1","pages":"Pages 95-100"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147419267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-10-10DOI: 10.1016/j.jvn.2025.09.003
Stefânia Guimarães Nery , Marina Silva Reis , Iane Renata Carvalhais Mesquita , Danielle Rayssa Araújo Medeiros , Maria Vitória Rodrigues Souza , Dalyla Silva Lemos de Souza , Vivian Camargo Chaves , Keity Lamary Souza Silva , Lucas Frois Fernandes Oliveira , Matheus Ribeiro Ávila , Whesley Tanor Silva , Ana Cristina Rodrigues Lacerda , Vanessa Amaral Mendonça , Pedro Henrique Scheidt Figueiredo , Henrique Silveira Costa
Introduction
Chronic Venous Insufficiency (CVI) is characterized by impaired venous return, leading to venous hypertension. As it progresses, patients tend to develop functional alterations. The Human Activity Profile (HAP) is a validated instrument for assessing daily functional performance in chronic conditions. However, its validity and clinical utility as a functional assessment tool specifically for people with CVI remain unexplored.
Objective
To verify the validity of HAP in functional evaluation by the association with functional aspects in patients with CVI.
Methods
This is a cross-sectional study in which 50 patients with CVI (65.7 ± 11.5 years, CEAP 1 to 6) were recruited and submitted to assessment of physical activity level and functional performance by the HAP. Patients also performed the Sit-to-Stand Test (SST) of 5 repetitions and 60 s to assess lower limb strength and endurance. Ankle dorsiflexion range of motion (ROM) was assessed by the Weight Bearing Lunge Test (WBLT), calf muscle strength and endurance by the Heel-Rise Test (HRT), and handgrip strength by dynamometry. The CIVIQ-14 questionnaire assessed health-related quality of life, and calf circumference was also evaluated.
Results
In the correlation analysis, HAP correlated with WLT (r = 0.606; p < 0.001), HRT repetitions (r = 0.457; p = 0.001), HRT execution time (r = 0.427; p = 0.002), STS5 (r=-0.430; p = 0.002), STS60 (r = 0.450; p = 0.001), and quality of life (r=-0.631; p = 0.002). Participants in the highest HAP group performed better on the WBLT, HRT (repetitions and time), and STS60 (p < 0.05). A significant difference was found in the HAP score (p = 0.037) when the sample was stratified into mild CVI (CEAP ≤ 3) and severe CVI (CEAP ≥ 4).
Conclusion
HAP is a valuable tool that can be used both in the assessment of functionality and in monitoring clinical management and progression of CVI.
慢性静脉功能不全（CVI）的特点是静脉回流受损，导致静脉高压。随着病情的发展，患者往往会出现功能改变。人类活动概况（HAP）是一种经过验证的工具，用于评估慢性疾病的日常功能表现。然而，其有效性和临床效用作为功能评估工具，专门为CVI的人仍未被探索。目的通过与CVI患者功能方面的关联，验证HAP在功能评估中的有效性。方法本研究是一项横断面研究，招募50例CVI患者（65.7±11.5岁，CEAP 1 ~ 6），由HAP评估身体活动水平和功能表现。患者还进行了坐姿站立测试（SST），重复5次，每次60秒，以评估下肢力量和耐力。通过负重弓步测试（WBLT）评估踝关节背屈运动范围（ROM），通过脚跟上升测试（HRT）评估小腿肌肉力量和耐力，通过动力测量法评估握力。CIVIQ-14问卷评估了与健康相关的生活质量，并评估了小腿围。结果HAP与WLT （r= 0.606; p < 0.001）、HRT重复次数（r= 0.457; p = 0.001）、HRT执行时间（r= 0.427; p = 0.002）、STS5 （r=-0.430; p = 0.002）、STS60 （r= 0.450; p = 0.001）、生活质量（r=-0.631; p = 0.002）相关。高HAP组的参与者在WBLT、HRT（重复次数和时间）和STS60上表现更好（p < 0.05）。将样本分为轻度CVI （CEAP≤3）和重度CVI （CEAP≥4）时，HAP评分差异有统计学意义（p = 0.037）。结论hap是一种有价值的工具，可用于评估CVI的功能，监测CVI的临床管理和进展。
{"title":"Use of the Human Activity Profile to evaluate functional performance in chronic venous insufficiency: A validity study","authors":"Stefânia Guimarães Nery , Marina Silva Reis , Iane Renata Carvalhais Mesquita , Danielle Rayssa Araújo Medeiros , Maria Vitória Rodrigues Souza , Dalyla Silva Lemos de Souza , Vivian Camargo Chaves , Keity Lamary Souza Silva , Lucas Frois Fernandes Oliveira , Matheus Ribeiro Ávila , Whesley Tanor Silva , Ana Cristina Rodrigues Lacerda , Vanessa Amaral Mendonça , Pedro Henrique Scheidt Figueiredo , Henrique Silveira Costa","doi":"10.1016/j.jvn.2025.09.003","DOIUrl":"10.1016/j.jvn.2025.09.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic Venous Insufficiency (CVI) is characterized by impaired venous return, leading to venous hypertension. As it progresses, patients tend to develop functional alterations. The Human Activity Profile (HAP) is a validated instrument for assessing daily functional performance in chronic conditions. However, its validity and clinical utility as a functional assessment tool specifically for people with CVI remain unexplored.</div></div><div><h3>Objective</h3><div>To verify the validity of HAP in functional evaluation by the association with functional aspects in patients with CVI.</div></div><div><h3>Methods</h3><div>This is a cross-sectional study in which 50 patients with CVI (65.7 ± 11.5 years, CEAP 1 to 6) were recruited and submitted to assessment of physical activity level and functional performance by the HAP. Patients also performed the Sit-to-Stand Test (SST) of 5 repetitions and 60 s to assess lower limb strength and endurance. Ankle dorsiflexion range of motion (ROM) was assessed by the Weight Bearing Lunge Test (WBLT), calf muscle strength and endurance by the Heel-Rise Test (HRT), and handgrip strength by dynamometry. The CIVIQ-14 questionnaire assessed health-related quality of life, and calf circumference was also evaluated.</div></div><div><h3>Results</h3><div>In the correlation analysis, HAP correlated with WLT (<em>r</em> = 0.606; <em>p</em> < 0.001), HRT repetitions (<em>r</em> = 0.457; <em>p</em> = 0.001), HRT execution time (<em>r</em> = 0.427; <em>p</em> = 0.002), STS5 (<em>r</em>=-0.430; <em>p</em> = 0.002), STS60 (<em>r</em> = 0.450; <em>p</em> = 0.001), and quality of life (<em>r</em>=-0.631; <em>p</em> = 0.002). Participants in the highest HAP group performed better on the WBLT, HRT (repetitions and time), and STS60 (<em>p</em> < 0.05). A significant difference was found in the HAP score (<em>p</em> = 0.037) when the sample was stratified into mild CVI (CEAP ≤ 3) and severe CVI (CEAP ≥ 4).</div></div><div><h3>Conclusion</h3><div>HAP is a valuable tool that can be used both in the assessment of functionality and in monitoring clinical management and progression of CVI.</div></div>","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"44 1","pages":"Pages 6-11"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147420601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-11-04DOI: 10.1016/j.jvn.2025.10.004
Dr. Parth Aphale , Himanshu Shekhar , Shashank Dokania
{"title":"Enhancing the implementation of supervised exercise therapy for claudication: Lessons from the York experience","authors":"Dr. Parth Aphale , Himanshu Shekhar , Shashank Dokania","doi":"10.1016/j.jvn.2025.10.004","DOIUrl":"10.1016/j.jvn.2025.10.004","url":null,"abstract":"","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"44 1","pages":"Pages 111-112"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147420141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-12-13DOI: 10.1016/j.jvn.2025.11.004
Chris Seenan , Stephanie Hill , Ukachukwu Abaraogu , Stephen McSwiggan , Patricia A Roche , Chee-Wee Tan , Tom Mercer , Jill Belch
Background
Pain associated with claudication in peripheral arterial disease (PAD) is a key barrier to physical activity, limiting walking ability and impacting quality of life. Transcutaneous Electrical Nerve Stimulation (TENS) may offer non-pharmacological pain relief and has shown potential to improve walking performance. However, little is known about patients’ experiences using TENS in everyday life.
Aim
To explore the lived experience of using TENS at home among individuals with PAD and claudication.
Methods
Six participants with PAD and claudication received training in the use of a TENS device for home use during daily walking activities. After four weeks, experiences were explored through a focus group and an individual interview. Data were analysed using thematic analysis.
Results
Four themes emerged: Pain, Expectations, Usability, and Physical and social functioning. While some participants reported reduced pain and improved walking ability, others expressed disappointment when TENS did not fully meet their expectations. Variability in use and perceived benefit was influenced by prior knowledge, usability challenges, and personal preferences.
Conclusions
TENS may support self-management of claudication pain and enhance physical activity in some individuals with PAD. However, managing patient expectations and addressing device usability are essential to optimise outcomes. Healthcare practitioners may play a key role in supporting education, tailoring advice, and evaluating the appropriateness of TENS as part of individualised care plans.
{"title":"Exploring patients’ experiences of using Transcutaneous Electrical Nerve Stimulation for Claudication","authors":"Chris Seenan , Stephanie Hill , Ukachukwu Abaraogu , Stephen McSwiggan , Patricia A Roche , Chee-Wee Tan , Tom Mercer , Jill Belch","doi":"10.1016/j.jvn.2025.11.004","DOIUrl":"10.1016/j.jvn.2025.11.004","url":null,"abstract":"<div><h3>Background</h3><div>Pain associated with claudication in peripheral arterial disease (PAD) is a key barrier to physical activity, limiting walking ability and impacting quality of life. Transcutaneous Electrical Nerve Stimulation (TENS) may offer non-pharmacological pain relief and has shown potential to improve walking performance. However, little is known about patients’ experiences using TENS in everyday life.</div></div><div><h3>Aim</h3><div>To explore the lived experience of using TENS at home among individuals with PAD and claudication.</div></div><div><h3>Methods</h3><div>Six participants with PAD and claudication received training in the use of a TENS device for home use during daily walking activities. After four weeks, experiences were explored through a focus group and an individual interview. Data were analysed using thematic analysis.</div></div><div><h3>Results</h3><div>Four themes emerged: Pain, Expectations, Usability, and Physical and social functioning. While some participants reported reduced pain and improved walking ability, others expressed disappointment when TENS did not fully meet their expectations. Variability in use and perceived benefit was influenced by prior knowledge, usability challenges, and personal preferences.</div></div><div><h3>Conclusions</h3><div>TENS may support self-management of claudication pain and enhance physical activity in some individuals with PAD. However, managing patient expectations and addressing device usability are essential to optimise outcomes. Healthcare practitioners may play a key role in supporting education, tailoring advice, and evaluating the appropriateness of TENS as part of individualised care plans.</div></div>","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"44 1","pages":"Pages 30-37"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147420600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To compare the healing outcomes of two-layer (2LB) and four-layer (4LB) compression bandaging systems, both delivering approximately 40 mmHg, in the management of chronic venous leg ulcers (VLUs) of a single patient.
Methods
A patient with recalcitrant VLUs over the right medial malleolar, left medial malleolar, and left foot dorsum recurring since September 2024 over 30 weeks, presented to the outpatient vascular wound clinic. Initially, all wounds were managed with chitosan dressings and bilateral 4LB. From October 2024 (Week 2), compression bandaging was adjusted: the right leg received 2LB and the left leg remained on 4LB, both delivering approximately 40 mmHg pressure over the ankle till Week 30.
Results
At baseline, on week 2, ulcer measurements were as follows: right medial malleolar – 4.3 × 2.4 cm (10.32 cm²), left medial malleolar – 4.5 × 2 cm (9 cm²), and left dorsum of the foot – 1 × 1.2 cm (1.2 cm²). By week 28, the right malleolar ulcer had healed completely and remained closed through week 30. At week 30, the left malleolar ulcer had reduced to 2.4 × 2 cm (4.8 cm²), and the left dorsum ulcer had decreased to 0.7 × 0.5 cm (0.35 cm²).
Conclusion
This case demonstrates effective healing under both 2LB and 4LB systems at 40 mmHg. Complete healing with 2LB suggests comparable efficacy with potential advantages in comfort and ease of application. These findings support individualised compression strategies guided by wound characteristics and patient needs to optimise VLU healing outcomes.
目的比较两层（2LB）和四层（4LB）压缩包扎系统的愈合效果，两种包扎系统均提供约40 mmHg，用于治疗单个患者的慢性静脉性腿部溃疡（VLUs）。方法自2024年9月以来，1例右内踝、左内踝及左脚背反复出现难治性VLUs患者，时间超过30周。最初，所有伤口都用壳聚糖敷料和双侧4LB进行处理。从2024年10月（第2周）开始，调整压缩绷带：右腿接受2LB，左腿保持4LB，直到第30周，两者都在脚踝上施加约40mmhg的压力。结果基线时，第2周溃疡测量如下：右内踝- 4.3 × 2.4 cm （10.32 cm²），左内踝- 4.5 × 2 cm （9 cm²），左足背- 1 × 1.2 cm （1.2 cm²）。到第28周，右踝溃疡完全愈合，并一直闭合到第30周。第30周，左侧踝部溃疡缩小至2.4 × 2 cm （4.8 cm²），左侧背部溃疡缩小至0.7 × 0.5 cm （0.35 cm²）。结论该病例在2LB和4LB系统下均能有效愈合。2LB完全愈合显示出相当的疗效，在舒适和易于应用方面具有潜在的优势。这些发现支持以伤口特征和患者需求为指导的个体化压迫策略，以优化VLU愈合结果。
{"title":"Evaluating 2- and 4-Layer compression bandages at 40 mmHg for chronic venous leg ulcer: A case study","authors":"Nanthakumahrie Gunasegaran , Wee Ting Goh , Fazila Aloweni","doi":"10.1016/j.jvn.2025.12.002","DOIUrl":"10.1016/j.jvn.2025.12.002","url":null,"abstract":"<div><h3>Aims</h3><div>To compare the healing outcomes of two-layer (2LB) and four-layer (4LB) compression bandaging systems, both delivering approximately 40 mmHg, in the management of chronic venous leg ulcers (VLUs) of a single patient.</div></div><div><h3>Methods</h3><div>A patient with recalcitrant VLUs over the right medial malleolar, left medial malleolar, and left foot dorsum recurring since September 2024 over 30 weeks, presented to the outpatient vascular wound clinic. Initially, all wounds were managed with chitosan dressings and bilateral 4LB. From October 2024 (Week 2), compression bandaging was adjusted: the right leg received 2LB and the left leg remained on 4LB, both delivering approximately 40 mmHg pressure over the ankle till Week 30.</div></div><div><h3>Results</h3><div>At baseline, on week 2, ulcer measurements were as follows: right medial malleolar – 4.3 × 2.4 cm (10.32 cm²), left medial malleolar – 4.5 × 2 cm (9 cm²), and left dorsum of the foot – 1 × 1.2 cm (1.2 cm²). By week 28, the right malleolar ulcer had healed completely and remained closed through week 30. At week 30, the left malleolar ulcer had reduced to 2.4 × 2 cm (4.8 cm²), and the left dorsum ulcer had decreased to 0.7 × 0.5 cm (0.35 cm²).</div></div><div><h3>Conclusion</h3><div>This case demonstrates effective healing under both 2LB and 4LB systems at 40 mmHg. Complete healing with 2LB suggests comparable efficacy with potential advantages in comfort and ease of application. These findings support individualised compression strategies guided by wound characteristics and patient needs to optimise VLU healing outcomes.</div></div>","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"44 1","pages":"Pages 101-108"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147420138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-07DOI: 10.1016/j.jvn.2025.12.003
Mª Lourdes Del Rio-Sola MD, PhD , Carlos Garcia-Padron MD , Eva Alvarez Garcia MD , Rebeca Fernandez-Fernandez RN, BScN
Background
Patients undergoing lower limb endovascular surgery remain at high risk for restenosis, reintervention, and limb loss. Structured follow-up may has the potential improve early detection of complications, adherence to preventive therapy, and quality of life.
Methods
We conducted a prospective observational cohort study at a tertiary vascular centre in Spain between 2021 and 2023, including 308 patients who underwent infrainguinal endovascular revascularisation. Participants were allocated to nursing-led structured telephone surveillance (n = 154) or usual care (n = 154). Scheduled calls at 1, 3, 6, and 12 months assessed symptoms, wound status, and adherence to secondary prevention. Primary outcome was target-limb reintervention at 12 months. Secondary outcomes included major adverse limb events (MALE), all-cause mortality, medication adherence, quality of life (EQ-5D-5L), and early detection of complications. Group comparisons were performed using inverse probability of treatment weighting (IPTW) based on a propensity score model to account for baseline differences.
Results
At 12 months, target-limb reintervention occurred in 15.6% of the telephone follow-up group versus 26.6% in the usual care group. After adjustment, the association remained significant (adjusted HR 0.61, 95% CI 0.38–0.97, p = 0.039). Major adverse limb events (MALE) occurred in 18.8% versus 31.2% (adjusted HR 0.60, 95% CI 0.38–0.95, p = 0.031).
Medication adherence to antiplatelet and statin therapy was higher in the telephone group (92.6% and 89.4% vs 81.4% and 78.1%; p = 0.017). Structured telephone surveillance enabled earlier recognition of vascular warning signs (24.0% vs 7.8%, p < 0.001).
Health-related quality of life improved in both groups, but to a greater extent in the telephone group (mean change in EQ-5D-5L index score+0.11 vs +0.06; between-group difference 0.05, 95% CI 0.01–0.09, p = 0.022). No clinical adverse events related to the intervention were observed; mild transient anxiety related to the follow-up was reported in 4 patients (2.6%).
Conclusions
Nursing-led telephone surveillance after lower limb endovascular surgery is safe and effective. It reduces reinterventions and limb events, improves adherence to secondary prevention, and enhances quality of life, providing a scalable model that strengthens continuity of vascular nursing care.
背景：接受下肢血管内手术的患者发生再狭窄、再干预和肢体丧失的风险仍然很高。有组织的随访有可能改善并发症的早期发现、预防治疗的依从性和生活质量。方法：我们于2021年至2023年在西班牙三级血管中心进行了一项前瞻性观察队列研究，包括308例接受腹股沟下血管内重建术的患者。参与者被分配到以护士为主导的结构化电话监测组（n = 154）或常规护理组（n = 154）。在第1、3、6和12个月时安排出诊，评估症状、伤口状况和二级预防依从性。主要终点是12个月时的目标肢体再干预。次要结局包括主要肢体不良事件（MALE）、全因死亡率、药物依从性、生活质量（EQ-5D-5L）和并发症的早期发现。采用基于倾向评分模型的治疗加权逆概率（IPTW）进行组间比较，以解释基线差异。结果12个月后，电话随访组的再干预率为15.6%，常规护理组为26.6%。调整后，相关性仍然显著（调整后HR 0.61, 95% CI 0.38-0.97, p = 0.039）。主要肢体不良事件（MALE）发生率为18.8%比31.2%（调整后HR 0.60, 95% CI 0.38-0.95, p = 0.031）。电话组抗血小板和他汀类药物治疗的依从性更高（92.6%和89.4% vs 81.4%和78.1%;p = 0.017）。结构化电话监测能够更早地识别血管警告信号（24.0% vs 7.8%, p < 0.001）。两组的健康相关生活质量均有改善，但电话组的改善程度更大（EQ-5D-5L指数评分平均变化+0.11 vs +0.06；组间差异0.05,95% CI 0.01-0.09, p = 0.022）。未观察到与干预相关的临床不良事件；4例患者（2.6%）报告了与随访相关的轻度短暂性焦虑。结论护理引导下下肢血管内手术后电话监护安全有效。它减少了再干预和肢体事件，提高了二级预防的依从性，提高了生活质量，提供了一个可扩展的模型，加强了血管护理的连续性。
{"title":"Nursing-led telephone follow-up after lower limb endovascular surgery: An observational study on early detection and patient safety","authors":"Mª Lourdes Del Rio-Sola MD, PhD , Carlos Garcia-Padron MD , Eva Alvarez Garcia MD , Rebeca Fernandez-Fernandez RN, BScN","doi":"10.1016/j.jvn.2025.12.003","DOIUrl":"10.1016/j.jvn.2025.12.003","url":null,"abstract":"<div><h3>Background</h3><div>Patients undergoing lower limb endovascular surgery remain at high risk for restenosis, reintervention, and limb loss. Structured follow-up <del>may</del> has the potential improve early detection of complications, adherence to preventive therapy, and quality of life.</div></div><div><h3>Methods</h3><div>We conducted a prospective observational cohort study at a tertiary vascular centre in Spain between 2021 and 2023, including 308 patients who underwent infrainguinal endovascular revascularisation. Participants were allocated to nursing-led structured telephone surveillance (n = 154) or usual care (n = 154). Scheduled calls at 1, 3, 6, and 12 months assessed symptoms, wound status, and adherence to secondary prevention. Primary outcome was target-limb reintervention at 12 months. Secondary outcomes included major adverse limb events (MALE), all-cause mortality, medication adherence, quality of life (EQ-5D-5L), and early detection of complications. Group comparisons were performed using inverse probability of treatment weighting (IPTW) based on a propensity score model to account for baseline differences.</div></div><div><h3>Results</h3><div>At 12 months, target-limb reintervention occurred in 15.6% of the telephone follow-up group versus 26.6% in the usual care group. After adjustment, the association remained significant (adjusted HR 0.61, 95% CI 0.38–0.97, p = 0.039). Major adverse limb events (MALE) occurred in 18.8% versus 31.2% (adjusted HR 0.60, 95% CI 0.38–0.95, p = 0.031).</div><div>Medication adherence to antiplatelet and statin therapy was higher in the telephone group (92.6% and 89.4% vs 81.4% and 78.1%; p = 0.017). Structured telephone surveillance enabled earlier recognition of vascular warning signs (24.0% vs 7.8%, p < 0.001).</div><div>Health-related quality of life improved in both groups, but to a greater extent in the telephone group (mean change in EQ-5D-5L index score+0.11 vs +0.06; between-group difference 0.05, 95% CI 0.01–0.09, p = 0.022). No clinical adverse events related to the intervention were observed; mild transient anxiety related to the follow-up was reported in 4 patients (2.6%).</div></div><div><h3>Conclusions</h3><div>Nursing-led telephone surveillance after lower limb endovascular surgery is safe and effective. It reduces reinterventions and limb events, improves adherence to secondary prevention, and enhances quality of life, providing a scalable model that strengthens continuity of vascular nursing care.</div></div>","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"44 1","pages":"Pages 49-57"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147420146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-10-06DOI: 10.1016/j.jvn.2025.09.002
Aluísio Andrade-Lima , Breno Quintella Farah , Antonio Henrique Germano-Soares , Hélcio Kanegusuku , Nelson Wolosker , Marilia de Almeida Correia , Raphael Mendes Ritti-Dias
Background
Peripheral artery disease (PAD) is frequently accompanied by multiple comorbidities. Patients with PAD typically engage in low levels of physical activity (PA) and spend extended periods in sedentary behavior (SB). However, the relationship between these behaviors and the presence of comorbidities in this population remains unclear.
Objective
To analyze the association between PA and SB with multiple comorbid conditions in patients with PAD.
Methods
This cross-sectional study included 179 patients with PAD and claudication symptoms (66 ± 9 y.o.; 62.6% male), which had an ankle-brachial index <0.90 in at least one limb (0.58 ± 0.16). An accelerometer was worn for seven consecutive days to measure PA (light and moderate-vigorous) and the time spent in SB. Sociodemographic information (sex, age and current medication), body mass index, total walking distance (six-min walk test) and chronic diseases were obtained. Crude and adjusted linear regression models were created for the association between SB, light PA, and moderate-vigorous PA with the outcome (multiple comorbid conditions). For all the statistical analyses, p < 0.05 was considered statistically significant.
Results
The time spent in SB (β = 0.280; p = 0.012) and light PA (β = -0.209; p = 0.015) were positively and negatively associated with the multiple comorbid conditions after adjustments for sex, age, ankle-brachial index, total walking distance, body mass index and moderate-vigorous PA. The time spent in moderate-vigorous PA was not associated (p > 0.05).
Conclusion
Higher time spent in SB and lower time spent in light PA were associated with multiple comorbid conditions in patients with PAD. Recommendations should focus not only on increasing PA but also on reducing prolonged SB.
外周动脉疾病（PAD）经常伴有多种合并症。PAD患者通常从事低水平的身体活动（PA）和长时间的久坐行为（SB）。然而，在这一人群中，这些行为与合并症之间的关系尚不清楚。目的分析前列腺癌患者PA、SB与多种合并症的关系。方法本横断面研究纳入179例伴有跛行症状的PAD患者（66±9岁，男性占62.6%），至少一条肢体的踝肱指数为0.90（0.58±0.16）。连续7天佩戴加速度计测量PA（轻度和中度剧烈运动）和在SB中度过的时间。获得社会人口学信息（性别、年龄和当前用药）、体重指数、总步行距离（6分钟步行试验）和慢性疾病。为SB、轻度PA和中度重度PA与结果（多重共病条件）之间的关系建立了粗糙和调整后的线性回归模型。对于所有的统计分析，p <； 0.05被认为具有统计学意义。结果经性别、年龄、踝肱指数、总步行距离、体重指数和中高强度PA校正后，SB停留时间（β = 0.280, p = 0.012）和轻度PA （β = -0.209, p = 0.015）与多重共病呈正相关和负相关。中高强度PA的时间无相关性（p > 0.05）。结论较长的SB时间和较短的轻度PA时间与PAD患者的多种合并症有关。建议不仅应侧重于增加PA，而且应侧重于减少延长的SB。
{"title":"Light physical activity and sedentary time are associated with multiple comorbid conditions in patients with peripheral artery disease","authors":"Aluísio Andrade-Lima , Breno Quintella Farah , Antonio Henrique Germano-Soares , Hélcio Kanegusuku , Nelson Wolosker , Marilia de Almeida Correia , Raphael Mendes Ritti-Dias","doi":"10.1016/j.jvn.2025.09.002","DOIUrl":"10.1016/j.jvn.2025.09.002","url":null,"abstract":"<div><h3>Background</h3><div>Peripheral artery disease (PAD) is frequently accompanied by multiple comorbidities. Patients with PAD typically engage in low levels of physical activity (PA) and spend extended periods in sedentary behavior (SB). However, the relationship between these behaviors and the presence of comorbidities in this population remains unclear.</div></div><div><h3>Objective</h3><div>To analyze the association between PA and SB with multiple comorbid conditions in patients with PAD.</div></div><div><h3>Methods</h3><div>This cross-sectional study included 179 patients with PAD and claudication symptoms (66 ± 9 y.o.; 62.6% male), which had an ankle-brachial index <0.90 in at least one limb (0.58 ± 0.16). An accelerometer was worn for seven consecutive days to measure PA (light and moderate-vigorous) and the time spent in SB. Sociodemographic information (sex, age and current medication), body mass index, total walking distance (six-min walk test) and chronic diseases were obtained. Crude and adjusted linear regression models were created for the association between SB, light PA, and moderate-vigorous PA with the outcome (multiple comorbid conditions). For all the statistical analyses, <em>p</em> < 0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>The time spent in SB (β = 0.280; <em>p</em> = 0.012) and light PA (β = -0.209; <em>p</em> = 0.015) were positively and negatively associated with the multiple comorbid conditions after adjustments for sex, age, ankle-brachial index, total walking distance, body mass index and moderate-vigorous PA. The time spent in moderate-vigorous PA was not associated (<em>p</em> > 0.05).</div></div><div><h3>Conclusion</h3><div>Higher time spent in SB and lower time spent in light PA were associated with multiple comorbid conditions in patients with PAD. Recommendations should focus not only on increasing PA but also on reducing prolonged SB.</div></div>","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"44 1","pages":"Pages 1-5"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147420603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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