Marlene Andrade Martins

Avaliação da dor durante a troca de curativo de úlceras de perna

The aim in this study was to assess the pain resulting from leg ulcers during dressing change and to identify the most painful procedures in the opinion of SUS patients. Cross-sectional study with the participation of 76 patients with leg ulcers, 69.8% being male with an average age of 57.8 (sd=13.2) who were admitted at Primary Health Care Units and at the Outpatient Care Centre of Goiania Hospital das Clinicas, in the state of Goias, Brazil. For the assessment of pain, a Numerical Rating Scale (1-10) and the McGill Pain Questionnaire were used. The occurrence of pain during dressing change was 76.3%, with a moderate intensity (Mean=5, Q1=3, Q3+8, Min=1, Max=10). The degree of pain was described as tiring (63.2%) and throbbing (55.3%). The most painful procedures in the opinion of the participants included cleaning the wound and removing the previous dressing. The pain during dressing change for leg ulcers was frequent and increased during wound cleaning and removal of previous dressing DESCRIPTORS: Pain measurement. Leg ulcer. Bandages. Pain. Nursing.

Prevalence of resistance phenotypes in Staphylococcus aureus and coagulase-negative isolates of venous ulcers of primary healthcare patients

INTRODUCTION In venous ulcers, the presence of Staphylococcus aureus and coagulase-negative staphylococcus resistance phenotypes can aggravate and limit the choices for treatment. METHODS Staphylococcus isolated from 69 patients (98 ulcers) between October of 2009 and October of 2010 were tested. The macrolide, lincosamide, streptogramin B (MLS B) group resistance phenotype detection was performed using the D-test. Isolates resistant to cefoxitin and/or oxacillin (disk-diffusion) were subjected to the confirmatory test to detect minimum inhibitory concentration (MIC), using oxacillin strips (E-test®). RESULTS The prevalence of S. aureus was 83%, and 15% of coagulase-negative staphylococcus (CoNS). In addition were detected 28% of methicillin-resistant Staphylococcus aureus (MRSA) and 47% of methicillin-resistant coagulase-negative staphylococcus (MRCoNS). Among the S. aureus, 69.6% were resistant to erythromycin, 69.6% to clindamycin, 69.6% to gentamicin, and 100% to ciprofloxacin. Considering the MRSA, 74% were highly resistant to oxacillin, MIC ≥ 256µg/mL, and the MLS Bc constitutive resistance predominated in 65.2%. Among the 20 isolates sensitive to clindamycin, 12 presented an inducible MLS B phenotype. Of the MRCoNS, 71.4%were resistant to erythromycin, ciprofloxacin and gentamicin. Considering the isolates positive for β-lactamases, the MIC breakpoint was between 0.5 and 2µg/mL. CONCLUSIONS The results point to a high occurrence of multi-drug resistant bacteria in venous ulcers in primary healthcare patients, thus evidencing the need for preventive measures to avoid outbreaks caused by multi-drug resistant pathogens, and the importance of healthcare professionals being able to identifying colonized versus infected venous ulcers as an essential criteria to implementing systemic antibacterial therapy.

Impaired tissue integrity, related factors and defining characteristics in persons with vascular ulcers

This transversal study aimed to analyze factors related to, and defining characteristics of, Impaired Tissue Integrity in persons with vascular ulcers, and compare the mean of these factors between the groups presenting different degrees in the severity of tissue compromise. The study was undertaken in February-August 2009, in the municipal health network of Goiânia in the state of Goias, using interviews, clinical examinations and photographic records of the wounds. For analysis, simple and percentage frequencies and the Student t-test(p<0.05) were used. Five related factors were identified in more than half of the 42 participants: impaired circulation, knowledge deficit, chemical irritants, fluidexcessand nutritional factors. Three defining characteristics were identified in all of the participants. There was no difference in the mean of related factors between groups.Impaired Tissue Integrity in persons with vascular ulcers was a phenomenon which demands professional attention extending beyond circulatory impairment.The mean of factors did not indicate greater or lesser severity of the compromising of the tissue integrity.This transversal study aimed to analyze factors related to, and defining characteristics of, Impaired Tissue Integrity in persons with vascular ulcers, and compare the mean of these factors between the groups presenting different degrees in the severity of tissue compromise. The study was undertaken in February-August 2009, in the municipal health network of Goiânia in the state of Goias, using interviews, clinical examinations and photographic records of the wounds. For analysis, simple and percentage frequencies and the Student t-test (p<0.05) were used. Five related factors were identified in more than half of the 42 participants: impaired circulation, knowledge deficit, chemical irritants, fluid excess and nutritional factors. Three defining characteristics were identified in all of the participants. There was no difference in the mean of related factors between groups. Impaired Tissue Integrity in persons with vascular ulcers was a phenomenon which demands professional attention extending beyond circulatory impairment. The mean of factors did not indicate greater or lesser severity of the compromising of the tissue integrity.

Deterioro de la integridad cutácnea, factores relacionados y características determinantes en personas con úlceras vasculares

This transversal study aimed to analyze factors related to, and defining characteristics of, Impaired Tissue Integrity in persons with vascular ulcers, and compare the mean of these factors between the groups presenting different degrees in the severity of tissue compromise. The study was undertaken in February-August 2009, in the municipal health network of Goiânia in the state of Goias, using interviews, clinical examinations and photographic records of the wounds. For analysis, simple and percentage frequencies and the Student t-test(p<0.05) were used. Five related factors were identified in more than half of the 42 participants: impaired circulation, knowledge deficit, chemical irritants, fluidexcessand nutritional factors. Three defining characteristics were identified in all of the participants. There was no difference in the mean of related factors between groups.Impaired Tissue Integrity in persons with vascular ulcers was a phenomenon which demands professional attention extending beyond circulatory impairment.The mean of factors did not indicate greater or lesser severity of the compromising of the tissue integrity.This transversal study aimed to analyze factors related to, and defining characteristics of, Impaired Tissue Integrity in persons with vascular ulcers, and compare the mean of these factors between the groups presenting different degrees in the severity of tissue compromise. The study was undertaken in February-August 2009, in the municipal health network of Goiânia in the state of Goias, using interviews, clinical examinations and photographic records of the wounds. For analysis, simple and percentage frequencies and the Student t-test (p<0.05) were used. Five related factors were identified in more than half of the 42 participants: impaired circulation, knowledge deficit, chemical irritants, fluid excess and nutritional factors. Three defining characteristics were identified in all of the participants. There was no difference in the mean of related factors between groups. Impaired Tissue Integrity in persons with vascular ulcers was a phenomenon which demands professional attention extending beyond circulatory impairment. The mean of factors did not indicate greater or lesser severity of the compromising of the tissue integrity.

INTEGRIDADE TISSULAR PREJUDICADA, FATORES RELACIONADOS E CARACTERÍSTICAS DEFINIDORAS EM PESSOAS COM ÚLCERAS VASCULARES

This transversal study aimed to analyze factors related to, and defining characteristics of, Impaired Tissue Integrity in persons with vascular ulcers, and compare the mean of these factors between the groups presenting different degrees in the severity of tissue compromise. The study was undertaken in February-August 2009, in the municipal health network of Goiânia in the state of Goias, using interviews, clinical examinations and photographic records of the wounds. For analysis, simple and percentage frequencies and the Student t-test(p<0.05) were used. Five related factors were identified in more than half of the 42 participants: impaired circulation, knowledge deficit, chemical irritants, fluidexcessand nutritional factors. Three defining characteristics were identified in all of the participants. There was no difference in the mean of related factors between groups.Impaired Tissue Integrity in persons with vascular ulcers was a phenomenon which demands professional attention extending beyond circulatory impairment.The mean of factors did not indicate greater or lesser severity of the compromising of the tissue integrity.This transversal study aimed to analyze factors related to, and defining characteristics of, Impaired Tissue Integrity in persons with vascular ulcers, and compare the mean of these factors between the groups presenting different degrees in the severity of tissue compromise. The study was undertaken in February-August 2009, in the municipal health network of Goiânia in the state of Goias, using interviews, clinical examinations and photographic records of the wounds. For analysis, simple and percentage frequencies and the Student t-test (p<0.05) were used. Five related factors were identified in more than half of the 42 participants: impaired circulation, knowledge deficit, chemical irritants, fluid excess and nutritional factors. Three defining characteristics were identified in all of the participants. There was no difference in the mean of related factors between groups. Impaired Tissue Integrity in persons with vascular ulcers was a phenomenon which demands professional attention extending beyond circulatory impairment. The mean of factors did not indicate greater or lesser severity of the compromising of the tissue integrity.

Assessment of pain during leg ulcers' dressing change

The aim in this study was to assess the pain resulting from leg ulcers during dressing change and to identify the most painful procedures in the opinion of SUS patients. Cross-sectional study with the participation of 76 patients with leg ulcers, 69.8% being male with an average age of 57.8 (sd=13.2) who were admitted at Primary Health Care Units and at the Outpatient Care Centre of Goiania Hospital das Clinicas, in the state of Goias, Brazil. For the assessment of pain, a Numerical Rating Scale (1-10) and the McGill Pain Questionnaire were used. The occurrence of pain during dressing change was 76.3%, with a moderate intensity (Mean=5, Q1=3, Q3+8, Min=1, Max=10). The degree of pain was described as tiring (63.2%) and throbbing (55.3%). The most painful procedures in the opinion of the participants included cleaning the wound and removing the previous dressing. The pain during dressing change for leg ulcers was frequent and increased during wound cleaning and removal of previous dressing DESCRIPTORS: Pain measurement. Leg ulcer. Bandages. Pain. Nursing.

Evaluación del dolor durante la curación en las úlceras de la pierna

The aim in this study was to assess the pain resulting from leg ulcers during dressing change and to identify the most painful procedures in the opinion of SUS patients. Cross-sectional study with the participation of 76 patients with leg ulcers, 69.8% being male with an average age of 57.8 (sd=13.2) who were admitted at Primary Health Care Units and at the Outpatient Care Centre of Goiania Hospital das Clinicas, in the state of Goias, Brazil. For the assessment of pain, a Numerical Rating Scale (1-10) and the McGill Pain Questionnaire were used. The occurrence of pain during dressing change was 76.3%, with a moderate intensity (Mean=5, Q1=3, Q3+8, Min=1, Max=10). The degree of pain was described as tiring (63.2%) and throbbing (55.3%). The most painful procedures in the opinion of the participants included cleaning the wound and removing the previous dressing. The pain during dressing change for leg ulcers was frequent and increased during wound cleaning and removal of previous dressing DESCRIPTORS: Pain measurement. Leg ulcer. Bandages. Pain. Nursing.