Laughing quiets leg ulcer’s misery

U. LEEDS (UK) — Laughter—which improves circulation of blood through the body—coupled with traditional nursing care works better to ease leg ulcers than ultrasound therapy.

“The healing energy of low-dose ultrasound can make a difference to some medical conditions but with venous leg ulcers, this is simply not the case,” says Andrea Nelson professor of health care at the University of Leeds.

“The key to care with this group of patients is to stimulate blood flow back up the legs to the heart and the best way to do that is with compression bandages and support stockings—not ‘magic wands’—coupled with advice on diet and exercise.”

The research is published online in the British Medical Journal and Health Technology Assessment.

Venous leg ulcers are common in people with varicose veins or mobility problems whose muscle pumps in the feet and calves struggle to drive blood up to the heart and can be painful and unsightly, having a significant negative impact on health and quality of life.

A significant proportion of the lesions take 12 months or longer to heal. The older and larger they become, the harder they are to get rid of.

Drawing on patients from across the UK and Ireland, Nelson found that adding ultrasound to the standard approach to care, dressings and compression therapy, does nothing to speed the healing or to lessen the chance of the ulcers coming back.

Ultrasound also raises the cost of care per patient by almost £200.

“Rising levels of obesity mean that the number of people who suffer from legs ulcers is likely to grow,” Nelson says.

“We do need to find ways to help those patients whose ulcers won’t go away, but our study shows that ultrasound is not the way to do that.

“We need to focus on what really matters, which is good quality nursing care. There really is no need for the NHS to provide district nurses with ultrasound machines. This would not be money well spent.”

The study was funded by the National Institute for Health Research (NIHR) Health Technology Assessment Programme.

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