Beatriz Guitton Renaud Baptista de Oliveira

Úlceras venosas: caracterização clínica e tratamento em usuários atendidos em rede ambulatorial

Ulcera venosa representa un desafio para los profesionales de salud, siendo una lesion cronica, recurrente y con impacto biopsicosocial. El objetivo de este estudio fue caracterizar las ulceras venosas de los usuarios atendidos en salas de curativos de la red municipal de salud. Esta pesquisa descriptiva, realizada entre octubre 2009 y julio 2010 incluyo a 58 personas. Los datos fueron recolectados mediante protocolo que incluyo entrevista, examen fisico, aplicacion de escala, registro fotografico de la lesion y planigraphia. Los resultados mostraron lesiones con mala cicatrizacion y tratamiento con violacion de las principales recomendaciones de la literatura en el area. Se concluye que es necesario repensar la organizacion de los servicios para servir mejor a esta poblacion.Venous ulcer represents a challenge for healths professionals, because its a chronic injury, recurrent and with biologic and psychosocial impact. The aim of this study was to characterize the venous ulcers of outpatients attended in curative rooms of the municipal health network and describe the treatment received. This descriptive study, carried out from October 2009 to July 2010 included 58 people. Data were collected using protocol that involved an interview, physical examination, application of scale, photographic record of the lesion and planigraphy. The results showed lesions with poor healing and treatment in violation of the main recommendations of the literature in the area. We conclude that it is necessary to rethink the organization of services to better serve this population.

Uso e efetividade da papaína no processo de cicatrização de feridas: uma revisão sistemática

Trata-se de uma revisao sistematica, cujo objetivo e analisar as evidencias sobre o uso da papaina na cicatrizacao de feridas. Foi realizado levantamento bibliografico manual e eletronico nas bases de dados: LILACS; COCHRANE; IBECS; MEDLINE via Pubmed e CINAHL, utilizando os seguintes termos como descritores e como palavras: Carica; Papaina; e Cicatrizacao, periodo de 1987 a 2010. Os resultados apontaram predominio de estudos descritivos, exploratorios, estudos de caso e relatos de caso, apenas um ensaio clinico randomizado e controlado. Os resultados tambem evidenciaram que a papaina e usada em feridas de diversas etiologias e em todas as fases da cicatrizacao, sem contraindicacoes especificas, sendo efetiva e segura, embora haja relatos de ardencia e dor. Conclui-se que este estudo contribuiu para demonstrar o uso da papaina nesse periodo, como fonte de consulta, alem de apontar para necessidade de pesquisas com maior rigor metodologico, que proporcionem evidencias fortes do seu uso e recomendacao.This systematic review is aimed at analyzing the evidences about the use of papain in wound healing. A manual and electronic bibliographic research was performed in the following databases: LILACS, Cochrane, IBECS, MEDLINE via Pubmed and CINAHL, using the following terms as descriptors and as word: Carica, Papain and Wound Healing, from 1987 to 2010. The types of studies that predominated were descriptive, exploratory, case studies, case reports and only one randomized controlled clinical trial. The articles showed that papain can be used in wounds of many etiologies and in various healing stages without any specific contraindications, proving to be effective and safe; although there were reports of burning and pain. We conclude that this review contributes to the demonstration of how papain has been used in this period becoming a learning source, besides pointing to the need of further studies conducted with greater methodological rigor.

O significado do profae segundo os alunos: contribuição para a construção de uma política pública de formação profissional em saúde

The objective of this qualitative research was to identify the meaning of The Nursing Worker Professionalization Project (Projeto de Profissionalizacao dos Trabalhadores da Area da Enfermagem) according to the students of the professional qualification courses and to contribute to the evaluation process of the implementation and development of these courses. Ninety students who participated in both courses took part in the study. The method was participative, using the application of the focus group technique. The thematic analysis of its content evidenced that the project was the opportunity that these individuals had to initiate or to improve their positions in the Nursing job market, amplifying their possibilities for employment. The continuity of the studies allowed for the development of group consciousness, solidarity exercises, mutual co-operation, and team work. As a result, the results may contribute to the evaluation process of the project, since they have demonstrated the importance of the social-political arena of the project in the light of the meaning attributed by a percentage of the social agents involved in its execution.

Treatment of venous ulcers with an unna boot: a case study

Objective: To assess the healing process of a patient wit h a venous ulcer in a lower limb subject to treatment with an Unna boot. Method: This case study was conducted in the Outpatient Wound Care service of a public hospital in Niteroi, RJ, Brazil between July and September, 2011. A protocol addressing clinica l data was used to assess the wounds healing process, together with measurement of the lesion area and photographic recording. The study was approved by the hospitals Institutional Review Board (Protocol No. 327\10). Results: the wound healed after 12 weeks of follow-up and the patient reported reduced pain and edema in his legs. Conclusion: The treatment with an Unna boot was effective in healing the venous ulcer when associated with systematized outpatient follow-up.

Venous ulcers: clinical characterization and treatment in users treated in outpatient facilities

Ulcera venosa representa un desafio para los profesionales de salud, siendo una lesion cronica, recurrente y con impacto biopsicosocial. El objetivo de este estudio fue caracterizar las ulceras venosas de los usuarios atendidos en salas de curativos de la red municipal de salud. Esta pesquisa descriptiva, realizada entre octubre 2009 y julio 2010 incluyo a 58 personas. Los datos fueron recolectados mediante protocolo que incluyo entrevista, examen fisico, aplicacion de escala, registro fotografico de la lesion y planigraphia. Los resultados mostraron lesiones con mala cicatrizacion y tratamiento con violacion de las principales recomendaciones de la literatura en el area. Se concluye que es necesario repensar la organizacion de los servicios para servir mejor a esta poblacion.Venous ulcer represents a challenge for healths professionals, because its a chronic injury, recurrent and with biologic and psychosocial impact. The aim of this study was to characterize the venous ulcers of outpatients attended in curative rooms of the municipal health network and describe the treatment received. This descriptive study, carried out from October 2009 to July 2010 included 58 people. Data were collected using protocol that involved an interview, physical examination, application of scale, photographic record of the lesion and planigraphy. The results showed lesions with poor healing and treatment in violation of the main recommendations of the literature in the area. We conclude that it is necessary to rethink the organization of services to better serve this population.

Profile of students registered in nursing auxiliary and technician courses of the Nursing Worker Professionalization Project (PROFAE) in Rio de Janeiro - Brazil

Este trabajo busca presentar el perfil de los alumnos que ingresaron a los cursos de Calificacion Profesional para Auxiliar de Enfermeria y complementacion para Tecnico de Enfermeria del Proyecto de Profesionalizacion de los trabajadores del Area de Enfermeria. Esta es una investigacion cuantitativa, desarrollada en el Estado de Rio de Janeiro, en el periodo de agosto del 2004 a enero del 2005, con aplicacion de 1.400 cuestionarios. Los datos fueron tratados con estadistica descriptiva, bajo la forma de frecuencia simple y porcentaje. Despues de tabular los datos, fueron divididos en las siguientes categorias: datos sociodemograficos, formacion escolar, perfil familiar, habitos, actuacion profesional, piso salarial, expectativas acerca de PROFAE y de la enfermeria, dificultades para participar del Proyecto y proceso de ensenanza-aprendizaje. Los alumnos/ trabajadores formados por el PROFAE tienden a mejorar la calidad de la atencion hospitalaria y ambulatoria, contribuyendo con la dinamica del mercado de trabajo en el sector de la salud.This paper aims to present a profile of students registered in the Professional Training Courses for Nursing Auxiliaries and Complementation Courses for Nursing Technicians of the Nursing Worker Professionalization Project - PROFAE. This quantitative study was carried out in the State of Rio de Janeiro, Brazil, from August 2004 to January 2005, through the application of 1,400 questionnaires. Data analysis used descriptive statistics, with simple frequencies and percentages. After tabulation, data were divided in the following categories: sociodemographic data, educational background, family profile, habits, professional activity, salary range, expectations about PROFAE and nursing, difficulties to participate in the project and the teaching-learning process. Students/workers graduated from the PROFAE program tend to improve the quality of hospital and outpatient care, contributing to labor market dynamics in the health sector.

A study of the Unna Boot compared with the elastic bandage in venous ulcers: a randomized clinical trial

Objective: to analyze the process of tissue repair in patients with venous ulcers using inelastic compression therapy (the Unna Boot), in comparison with the use of the elastic bandage.Method: a controlled randomized clinical trial in which the patients (n=18) were allocated to two groups, those who used the Unna Boot (group B) and those who used the elastic bandage (group A). The studys follow-up period was 13 weeks.Results: a significant reduction took place, at the level of 5%, in the area, in square centimeters, of the ulcers of group B (p<0.0001) throughout the treatment, and there was a tendency of group A for reduction in the area of the ulcer, in centimeters squared (p=0.06), only after the fifth week.Conclusion: the treatment with the Unna Boot presented better results in venous ulcers with areas over 10cm², and the elastic bandage with Petrolatum(r) gauze in venous ulcers below 10cm². Brazilian Clinical Trials Register: Trial (req: 195) and WHO UTN U1111-1122-5489.Objetivo:analizar el proceso de reparacion del tejido de pacientes con ulcera venosa que usan la terapia compresiva inelastica (Bota de Unna), en comparacion con el uso del vendaje elastico.Metodo:ensayo clinico controlado aleatorio en que los pacientes (n=18) fueron designados en dos grupos, los que utilizaban la Bota de Unna (grupo B) y los que utilizaban el vendaje elastico (grupo A). El tiempo de duracion de la investigacion fue de trece semanas.Resultados:se constato reduccion significativa, al nivel de 5%, en el area, en centimetros cuadrados, de las ulceras del grupo B (p<0,0001) a lo largo de todo el tratamiento; y tendencia del grupo A a la reduccion, en el area de la ulcera, en centimetros cuadrados (p=0,06), solamente despues de la quinta semana.Conclusion:el tratamiento con la Bota de Unna presento mejor resultado en ulceras venosas con areas superiores a 10cm², y el vendaje elastico con la gasa Petrolatum(r)en ulceras venosas inferiores a 10cm². Registro Brasileno de Ensayos Clinicos: Trial (req: 195) y WHO UTN U1111-1122-5489.Abstract Objective: to analyze the process of tissue repair in patients with venous ulcers using inelastic compression therapy (the Unna Boot), in comparison with the use of the elastic bandage. Method: a controlled randomized clinical trial in which the patients (n=18) were allocated to two groups, those who used the Unna Boot (group B) and those who used the elastic bandage (group A). The studys follow-up period was 13 weeks. Results: a significant reduction took place, at the level of 5%, in the area, in square centimeters, of the ulcers of group B (p<0.0001) throughout the treatment, and there was a tendency of group A for reduction in the area of the ulcer, in centimeters squared (p=0.06), only after the fifth week. Conclusion: the treatment with the Unna Boot presented better results in venous ulcers with areas over 10cm², and the elastic bandage with Petrolatum(r) gauze in venous ulcers below 10cm². Brazilian Clinical Trials Register: Trial (req: 195) and WHO UTN U1111-1122-5489.to analyze the process of tissue repair in patients with venous ulcers using inelastic compression therapy (the Unna Boot), in comparison with the use of the elastic bandage.a controlled randomized clinical trial in which the patients (n=18) were allocated to two groups, those who used the Unna Boot (group B) and those who used the elastic bandage (group A). The studys follow-up period was 13 weeks.a significant reduction took place, at the level of 5%, in the area, in square centimeters, of the ulcers of group B (p<0.0001) throughout the treatment, and there was a tendency of group A for reduction in the area of the ulcer, in centimeters squared (p=0.06), only after the fifth week.the treatment with the Unna Boot presented better results in venous ulcers with areas over 10cm², and the elastic bandage with Petrolatum® gauze in venous ulcers below 10cm². Brazilian Clinical Trials Register: Trial (req: 195) and WHO UTN U1111-1122-5489.

Effectiveness of papain gel in venous ulcer treatment: randomized clinical trial

; ;OBJECTIVE: ; ; to assess the effectiveness of 2% papain gel compared to 2% carboxymethyl cellulose in the treatment of chronic venous ulcer patients. ; ; ; ;METHOD: ; ; randomized controlled clinical trial with 12-week follow-up. The sample consisted of 18 volunteers and 28 venous ulcers. In the trial group, 2% papain gel was used and, in the control group, 2% carboxymethyl cellulose gel. ; ; ; ;RESULTS: ; ; the trial group showed a significant reduction in the lesion area, especially between the fifth and twelfth week of treatment, with two healed ulcers and a considerable increase in the amount of epithelial tissue in the wound bed. ; ; ; ;CONCLUSION: ; ; 2% papain gel demonstrated greater effectiveness in the reduction of the lesion area, but was similar to 2% carboxymethyl cellulose gel regarding the reduction in the amount of exudate and devitalized tissue. Multicenter research is suggested to evidence the effectiveness of 2% papain gel in the healing of venous ulcers. UTN number: U1111-1157-2998 ; ;OBJECTIVE: to assess the effectiveness of 2% papain gel compared to 2% carboxymethyl cellulose in the treatment of chronic venous ulcer patients. METHOD: randomized controlled clinical trial with 12-week follow-up. The sample consisted of 18 volunteers and 28 venous ulcers. In the trial group, 2% papain gel was used and, in the control group, 2% carboxymethyl cellulose gel. RESULTS: the trial group showed a significant reduction in the lesion area, especially between the fifth and twelfth week of treatment, with two healed ulcers and a considerable increase in the amount of epithelial tissue in the wound bed. CONCLUSION: 2% papain gel demonstrated greater effectiveness in the reduction of the lesion area, but was similar to 2% carboxymethyl cellulose gel regarding the reduction in the amount of exudate and devitalized tissue. Multicenter research is suggested to evidence the effectiveness of 2% papain gel in the healing of venous ulcers. UTN number: U1111-1157-2998

Ambulatory care of wounds – clients´ profile with chronic lesion. A prospective study

Abstratct. This study aims to characterize the clients porters of tissue lesion chronic which are attended in the Repair of Wound Ambulatory of Antonio Pedro University Hospital Aid Center (HUAP ), in view of the following variables: age, sex, education, the basic disease, type of wound, time and location of the wound from its beginnings. It is a quantitative, descriptive and exploratory nature study approved by the Ethic in Search Committee (CEP-CCM/HUAP ), being developed among 39 injury porter patients attended by the nurse consult, from May 2006 to April 2007. The results show that the population of the study is mostly male (51%), aged from 40 to 59 years (54%) and with incomplete middle (junior high) school (61%). With relation to clinical aspects, 28% get Mellitus Diabetes associated to Systemical Arterial Hypertension, 31% of them presented Mellitus Diabetes and 29% arterial hypertension; 85% having lesion upon the low members, being that 40% were caused by vein ulcers and 33% by diabetes ulcers; 27% showed the lesion from 1 year to 4 year. It was concluded that the systematic monitoring of wounded patients is fundamental not only to treat the wound but also to control basic illnesses and prevent complications. We recommend that new studies be carried out to obtain a more representative profile of t his population in the different levels of attention for the health

Risk Of Infection In Central Venous Catheter: Review Study To Nursing Care

Problem: The use of central venous catheters in intensive care units has been identified as an important risk factor for infection in the bloodstream. Objective: To examine the evidence in the literature about the indications and uses of central venous catheter insertion, the risk of infection, the professional conduct in relation to safe practices related to this type of device. Methods: Narrative review, which assesses the risk of infection in central venous catheters in intensive care units; by bibliographic study in database of BVS, in the time gap from 2005 to 2010 using the keywords: infection, intensive care unit , central venous catheterization and nursing care. Results: The analysis identified 03 thematic units: 1. Complications associated with central venous catheter, which evaluates the evidence from a framework of systemic infection where vascular access is implicated as a possible source, and lists the factors that influence the onset of complications associated; 2. Adoption of the correct technique of catheter-related coverage, which recommends to use the coverage appropriate to prevent skin toxicity, and increases patient comfort and satisfaction, besides attention to time of the use and signs of inflammation , 3. Realization of safe practices for the maintenance of the catheter, involving the manipulation control and use of protocols. Conclusion: We conclude that the quality of care for patients with this device is directly related to controlling the risks of infection; where efforts, not only the nurse, but the health team will be enable the application of evidence to guide a safe clinical practice and contribute to improving the quality of health care and nursing.