Eline Lima Borges

Systematic review of topic treatment for venous ulcers

Venous ulcer patients can experience this situation for several years without achieving healing if treatment is inadequate. Evidence-based professional practice generates effective results for patients and services. This research aimed to carry out a systematic review to assess the most effective method to improve venous return and the best topic treatment for these ulcers. Studies were collected in eight databases, using the following descriptors: leg ulcer, venous ulcer and similar terms. The sample consisted of 33 primary studies and two Meta-analyses. A wide range of treatments was identified, grouped in compression therapy (54.3%) and topical treatment (45.7%). It was evidenced that compression therapy increases ulcer healing rates and should be used in patients with intact arteries. There is no consensus about the best topical treatment, although different options should be associated with compression therapy.Venous ulcer patients can experience this situation for several years without achieving healing if treatment is inadequate. Evidence-based professional practice generates effective results for patients and services. This research aimed to carry out a systematic review to assess the most effective method to improve venous return and the best topic treatment for these ulcers. Studies were collected in eight databases, using the following descriptors: leg ulcer, venous ulcer and similar terms. The sample consisted of 33 primary studies and two Meta-analyses. A wide range of treatments was identified, grouped in compression therapy (54.3%) and topical treatment (45.7%). It was evidenced that compression therapy increases ulcer healing rates and should be used in patients with intact arteries. There is no consensus about the best topical treatment, although different options should be associated with compression therapy.

Revisão sistemática do tratamento tópico da úlcera venosa

Venous ulcer patients can experience this situation for several years without achieving healing if treatment is inadequate. Evidence-based professional practice generates effective results for patients and services. This research aimed to carry out a systematic review to assess the most effective method to improve venous return and the best topic treatment for these ulcers. Studies were collected in eight databases, using the following descriptors: leg ulcer, venous ulcer and similar terms. The sample consisted of 33 primary studies and two Meta-analyses. A wide range of treatments was identified, grouped in compression therapy (54.3%) and topical treatment (45.7%). It was evidenced that compression therapy increases ulcer healing rates and should be used in patients with intact arteries. There is no consensus about the best topical treatment, although different options should be associated with compression therapy.Venous ulcer patients can experience this situation for several years without achieving healing if treatment is inadequate. Evidence-based professional practice generates effective results for patients and services. This research aimed to carry out a systematic review to assess the most effective method to improve venous return and the best topic treatment for these ulcers. Studies were collected in eight databases, using the following descriptors: leg ulcer, venous ulcer and similar terms. The sample consisted of 33 primary studies and two Meta-analyses. A wide range of treatments was identified, grouped in compression therapy (54.3%) and topical treatment (45.7%). It was evidenced that compression therapy increases ulcer healing rates and should be used in patients with intact arteries. There is no consensus about the best topical treatment, although different options should be associated with compression therapy.

Bacterial biofilm in chronic venous ulcer.

presence of bacterial biofilm in chronic wounds may explain Venous leg ulcer (VLU) is a type of chronic wound that can take a long time to heal, being the most advanced presentation of chronic venous insufficiency (CVI).1 VLUs are usually recurrent, affecting work productivity, quality of life and high public health care treatment costs. It is estimated that VLUs affect up to 1% of the adult population.1 These chronic wounds are usually infected by a diverse microbial flora, which may probably contribute to the nonhealing phenotype.2 A study developed at the university hospital of the Federal University of Minas Gerais, Belo Horizonte, Brazil, included patients with VLU to investigate the presence of bacterial biofilm. A VLU biopsy was performed in a total of 45 patients who had not used antibiotics and presented signs of CVI, such as edema, varicose veins, hyperpigmentation, and lipodermatosclerosis (Fig. 1A). The samples were submitted to bacteriological tests to characterize the bacterial flora and examined by transmission electron microscopy

Measurement of the area of venous ulcers using two software programs

Objetivo: comparar a mensuracao de area de ulceras venosas por meio dos softwares AutoCAD(r) e Image Tool. Metodo: trata-se de um estudo de avaliacao de reprodutibilidade de testes, realizado em um ambulatorio de angiologia de um hospital universitario. Os dados foram coletados de 21 pacientes com ulceras venosas, no periodo de marco a julho de 2015, por meio de formulario de coleta e fotografia das feridas. Cinco enfermeiros (avaliadores) do Grupo de Estudos de Lesoes de Pele do hospital participaram da pesquisa. As feridas foram mensuradas em ambos os softwares. Os dados foram analisados por meio do Coeficiente de correlacao intraclasse, Coeficiente de correlacao de concordância e procedimento de Bland e Altman. A pesquisa respeitou os aspectos eticos de acordo com a legislacao vigente. Resultados: os tamanhos das ulceras apresentaram grande amplitude, porem, sem diferenca significativa entre as mensuracoes, existe excelente correlacao intraclasse e de concordância entre os softwares, os quais parecem ser mais precisos na mensuracao de feridas com area > 10 cm². Conclusao: o uso de ambos os softwares e indicado para a mensuracao de ulceras venosas, parecendo ser mais precisos quando utilizados para mensurar feridas com area > 10 cm².ABSTRACT Objective: to compare the measurement area of venous ulcers using AutoCAD(r) and Image Tool software. Method: this was an assessment of reproducibility tests conducted in a angiology clinic of a university hospital. Data were collected from 21 patients with venous ulcers, in the period from March to July of 2015, using a collection form and photograph of wounds. Five nurses (evaluators) of the hospital skin wound study group participated. The wounds were measured using both software programs. Data were analyzed using intraclass correlation coefficient, concordance correlation coefficient and Bland-Altman analysis. The study met the ethical aspects in accordance with current legislation. Results: the size of ulcers varied widely, however, without significant difference between the measurements; an excellent intraclass and concordance correlation was found between both software programs, which seem to be more accurate when measuring a wound area >10 cm². Conclusion: the use of both software programs is appropriate for measurement of venous ulcers, appearing to be more accurate when used to measure a wound area > 10 cm².

Costs of topical treatment of pressure ulcer patients

OBJECTIVE To evaluate the costs of a topical treatment of pressure ulcer (PU) patients in a hospital unit for treatment of chronic patients in 2014. METHOD This is an activity-based costing study. This method encompasses the identification, measurement and pricing of physical and human resources consumed for dressings. RESULTS Procedure costs varied between BRL 16.41 and BRL 260.18. For PUs of the same category, of near areas and with the same type of barrier/adjuvant, the cost varied between 3.5% and 614.6%. For most dressings, the cost increased proportionally to the increase of the area and to the development of PU category. The primary barrier accounted for a high percentage of costs among all items required to the application of dressings (human and material resources). Dressings applied in sacral PUs had longer application times. CONCLUSION This study allowed us to understand the costs involved in the treatment of PUs, and it may support decision-makers and other cost-effectiveness studies. OBJETIVO Realizar uma avaliação do custo do tratamento tópico de pacientes com úlceras por pressão (UP), em uma unidade hospitalar de atendimento a pacientes crônicos no ano de 2014. MÉTODO Trata-se de um estudo de custos baseado no Sistema de custeio Baseado em Atividades. Este método contempla a identificação, mensuração e precificação dos recursos físicos e humanos consumidos para a realização de curativos. RESULTADOS Os custos dos procedimentos variaram de R

Prevenção de recidiva de úlcera varicosa: um estudo de coorte

16,41 a R

Revisión sistemática del tratamiento tópico de la úlcera venosa

260,18. Para UP de mesma categoria, de áreas aproximadas e mesmo tipo de cobertura/adjuvante, a variação entre os custos foi de 3,5% a 614,6%. Para a maioria dos curativos, o custo aumentou proporcionalmente ao aumento da área e à progressão da categoria das UP. A cobertura primária representou elevado percentual nos custos entre todos os itens necessários para realizar os curativos (recursos humanos e materiais). Os curativos realizados nas UP sacrais foram os que apresentaram maiores tempos para execução. CONCLUSÃO Este estudo permitiu conhecer os custos envolvidos no tratamento das UP e pode fornecer subsídios para os tomadores de decisão, assim como para a realização de estudos de custo-efetividade.OBJECTIVE To evaluate the costs of a topical treatment of pressure ulcer (PU) patients in a hospital unit for treatment of chronic patients in 2014. METHOD This is an activity-based costing study. This method encompasses the identification, measurement and pricing of physical and human resources consumed for dressings. RESULTS Procedure costs varied between BRL 16.41 and BRL 260.18. For PUs of the same category, of near areas and with the same type of barrier/adjuvant, the cost varied between 3.5% and 614.6%. For most dressings, the cost increased proportionally to the increase of the area and to the development of PU category. The primary barrier accounted for a high percentage of costs among all items required to the application of dressings (human and material resources). Dressings applied in sacral PUs had longer application times. CONCLUSION This study allowed us to understand the costs involved in the treatment of PUs, and it may support decision-makers and other cost-effectiveness studies.

Custo comparativo do tratamento de feridas

Objetivo Determinar a taxa de recidiva de ulcera varicosa, e verificar a associacao entre recidiva e medidas de prevencao adotadas. Metodos Estudo de coorte com 50 pacientes maiores de 18 anos com ulcera varicosa pos-cicatrizacao acompanhados durante 10 anos. A recidiva foi avaliada por meio de inspecao direta durante a avaliacao clinica, e as medidas de prevencao usadas foram informadas pelo paciente. Utilizou-se o teste qui quadrado de Pearson, sendo significante p-value ≤0,05. Resultados A recidiva de ulcera varicosa foi de 62,2%, a maioria em mulheres, seguida por idosos, analfabetos e aposentados. Mostrou-se medida eficaz na prevencao de recidivas o seguinte conjunto: uso da meia de compressao, repouso e aplicar creme hidratante. Conclusao A taxa de recidiva de ulcera varicosa foi elevada e as principais medidas de prevencao aplicadas em conjunto foram usar meia de compressao, repousar e aplicar creme hidratante.

Factors associated with the healing of complex surgical wounds in the breast and abdomen: retrospective cohort study

Venous ulcer patients can experience this situation for several years without achieving healing if treatment is inadequate. Evidence-based professional practice generates effective results for patients and services. This research aimed to carry out a systematic review to assess the most effective method to improve venous return and the best topic treatment for these ulcers. Studies were collected in eight databases, using the following descriptors: leg ulcer, venous ulcer and similar terms. The sample consisted of 33 primary studies and two Meta-analyses. A wide range of treatments was identified, grouped in compression therapy (54.3%) and topical treatment (45.7%). It was evidenced that compression therapy increases ulcer healing rates and should be used in patients with intact arteries. There is no consensus about the best topical treatment, although different options should be associated with compression therapy.Venous ulcer patients can experience this situation for several years without achieving healing if treatment is inadequate. Evidence-based professional practice generates effective results for patients and services. This research aimed to carry out a systematic review to assess the most effective method to improve venous return and the best topic treatment for these ulcers. Studies were collected in eight databases, using the following descriptors: leg ulcer, venous ulcer and similar terms. The sample consisted of 33 primary studies and two Meta-analyses. A wide range of treatments was identified, grouped in compression therapy (54.3%) and topical treatment (45.7%). It was evidenced that compression therapy increases ulcer healing rates and should be used in patients with intact arteries. There is no consensus about the best topical treatment, although different options should be associated with compression therapy.

Uso de hidrocolóide e alginato de cálcio no tratamento de lesões cutâneas

Este estudio compara el coste del curativo tradicional y el del preconizado/propuesto por el protocolo del sector de Estomaterapia del HC/UFMG en el tratamiento de diversos tipos de heridas. Al final del trabajo se pudo concluir que el coste del ultimo es inferior al primero y que la frecuencia en el cambio del curativo tradicional constituye factor de mayor significancia para elevar su coste.This study compares the cost of traditional wound dressing and the one commended by HC/UFMG Stomotherapy sectors protocol for several kinds of wounds treatment. We finally concluded that the cost of the latter is inferior to the first, and the it is the frequency in changing the dressings that appoint a greater significance factor in the increasing of the price.