This study aims to evaluate the effectiveness of advanced practice nurses with respect to complex chronic wounds (APN-CCWs) in the care of patients with venous ulcers. A multicentric, quasi-experimental pre-post study was conducted without a control group in the sanitary management areas where the APN-CCW program is being piloted. The intervention consisted of a mass training of clinical nurses from the participating districts on the proper management of injuries and the use of compression therapy. The data were collected through a specifically constructed questionnaire with questions regarding descriptive variables of injuries and their treatment. A total of 643 professionals responded (response rate of 89.1%), attending to a total population of 707,814 inhabitants. An increase in multilayer bandage use by 15.67%, an increase in elastic bandage use by 13.24%, and a significant decrease in the referral of patients to consultation with hospital specialists was achieved, from 21.08% to 12.34%. The number of patients referred to the APNs was 13.25%, which implied a resolution rate of 94.08% of their injuries. In conclusion, the coordination by the APN-CCWs in patients with venous ulcers was effective in improving the continuity of care, in the optimization of resources, and in their care role.

Introduction: Venous leg ulcers are the most severe manifestation of chronic venous insufficiency, and their treatment is based on compression therapy, whose effectiveness depends on the magnitude of the pressure and the biomechanical properties of the system. Doubts persist about the actual correlation between interface pressure, bandage stiffness and clinical outcomes in real-world practice. Objective: To compare the clinical efficacy and biomechanical behavior of different multicomponent compression systems in venous leg ulcers, analyzing the relationship between interface pressure, static stiffness, edema reduction and variation in the wound area. Methodology: This is a prospective, observational and multicenter study in six districts/health areas of Andalusia, in adults with active venous ulcers attended by Advanced Practice Nurses in Complex Chronic Wounds. Several multi-component compression systems were applied, and interface pressure was monitored using Tight Alright^® at three points on the leg for 96 h, recording final pressure, static stiffness, perimeters and ulcer area. Results: All systems achieved a reduction in leg circumference, more marked at the proximal points, evidencing an overall decongestant effect. The correlation between final pressure and edema reduction was weak, and relevant differences were observed in the reduction in ulcer area, with Urgo K2 and CPK Compress 2 standing out with decreases of more than 50% compared to medium or low yields of other systems with comparable pressures. The static stiffness analysis showed specific patterns according to system and leg size, as well as a heterogeneous longitudinal distribution of pressure. Conclusions: The efficacy of compression in venous ulcers depends on both the interface pressure and the design and biomechanical behavior of the system, with clinically relevant differences between multicomponent dressings. Multipoint pressure and stiffness monitoring provides useful information to optimize system selection and support decisions based on biomechanical parameters and standardized clinical outcomes.