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OBJECTIVES: The primary treatment for varicose ulcers is to address the underlying cause of venous hypertension, additionally, split-thickness skin transplantation (ST) is an effective option for large ulcers. The aim of this study was to compare the efficacy of venous surgery with or without split-thickness ST in the management of varicose ulcers (diameter ≥6 cm). METHODS: Patients with varicose ulcers between 2013 and 2023 were included in the real-world retrospective cohort study. The endovenous microwave ablation/endovenous laser ablation-high ligation-foam sclerotherapy-compression therapy + ST group (EMA/EVLA-CT-HL-FS + ST) consisted of 32 patients, while the EMA/EVLA-CT-HL-FS group consisted of 48 patients. RESULTS: A difference in ulcer healing time was found between the two groups (the hazard ratio [HR] was 4.4, 95% CI [2.3-8.2], P < 0.0001). However, the healing rate did not differ between the two groups at 6 and 12 months postoperatively. CONCLUSION: ST has been shown to expedite ulcer healing and ameliorate the symptoms of VVs in the early stages of treatment, while its intermediate to long-term efficacy for ulcer healing and overall patient quality of life may be limited.

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BACKGROUND: In the management of individuals with venous leg ulcers, education serves as a pivotal tool for acquiring knowledge, fostering appropriate attitudes, and promoting best practices. Consequently, assessing knowledge, skills, attitudes, confidence, and commitment becomes essential, necessitating the development of suitable evaluation instruments. Pre- and post-test assessments align with Level 2 of Kirkpatrick's model. Moreover, nurse educators should integrate assessment into the teaching-learning sequences. AIM: To psychometrically validate an instrument designed to assess undergraduate nursing students' knowledge of the aetiology, prevention, and treatment of venous leg ulcers. DESIGN: A multi-phase study was designed to develop the tool and subsequently validate its psychometric properties. SETTING(S): The study was conducted at three sites within the University of the Basque Country and one site within the University of Alicante. PARTICIPANTS: A total of 516 students from all four years of the nursing degree program participated. METHODS: The construct definition and instrument development were previously published. This article presents the psychometric evaluation, which involved classical item analysis, analysis of psychometric properties according to the Rasch model, differential item functioning analysis, construct validity analysis through hypothesis testing in known groups, and reliability analysis via internal consistency. RESULTS: The results validated the Knowledge on Venous Leg Ulcer Questionnaire, reducing it from 72 initial items to 36 definitive items. It was found to be a valid and reliable instrument, capable of detecting statistically significant differences between known groups. Knowledge scores on a 0-100 scale were found to be 33.1 (SD = 19.5) for the first-second year groups, and 48.3 (SD = 17.5) for the third-fourth year groups, demonstrating a progressive and logical increase in knowledge each year. CONCLUSIONS: The Knowledge on Venous Leg Ulcer Questionnaire appears to be a valid and reliable instrument for measuring nursing students' knowledge of venous leg ulcers. However, further research in different contexts is required to confirm these results.

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OBJECTIVE: To evaluate the short-term clinical outcomes of radiofrequency ablation (RFA) using a radiofrequency (RF) needle device for varicose ulcers. METHODS: From September 2020 to September 2021, a total of 80 patients with varicose ulcers were included in this study. Based on the different surgical methods, the patients were divided into RF group and control groups, with 40 cases in each group. In the RF group, RFA was performed using an RF needle device and foam sclerotherapy was used for superficial veins. The control group was treated with conventional high-ligation stripping. The surgical data, hospitalization data, clinical efficacy, and postoperative complications of two groups were compared. Meanwhile, the correlation between RBC, HB, HCT, and ulcer healing time was analyzed. RESULTS: Compared to the control group, RF group had shorter surgery time, duration in the hospital, and less intraoperative bleeding (p < .05). The VCSS and CIVIQ scores in RF group were significantly higher than that in control group (p < .05). The healing time of ulcers was shorter in the RF group (x2 = 19.766, p = .000). The RF group had fewer postoperative complications. There was a positive correlation between RBC, HB, and HCT, and ulcer healing time (p < .05). CONCLUSION: The use of the RF needle device for RFA to treat patients with varicose ulcers showed acceptable short-term clinical outcomes with less incidence of trauma, faster recovery, and fewer complications.

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May-Thurner syndrome (MTS) is an anatomical condition of external luminal compression of common iliac vein due to a partial obstruction of the common iliac vein between common iliac artery and lumbar vertebra causes deep-vein thrombosis, venous hypertension, and chronic venous insufficiencies. In this article, we review present evidence of the clinical diagnosis and management of MTS. Here, we conducted a literature review of studies on MTS. We also reviewed different clinical features, presentation, diagnostic methods, and therapeutic procedure for this condition. Most studies mentioned the diagnosis of this condition is performed by color Doppler, computed tomographic angiography, venography, and problem-solving cases by intravascular ultrasound technique. Nonsurgical methods of management are first line, and vascular surgery is reserved for refractory cases. Multiple modalities are required to reach the diagnosis of MTS, and noninvasive intervention radiology methods are the first line of management. This review highlights the presentations of MTS and outlines diagnostic procedure and management.

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Venous ulcers are open wounds commonly associated with chronic venous insufficiency. Each patient's healing process is unique, and factors like nutrition and compression therapy can affect it. Compression therapy and optimal nutritional status can assist in improving venous blood circulation, decreasing swelling, and promoting wound healing. This in-depth review looks at all the recent research on how nutrition and compression therapy can help heal venous ulcers, aiming to develop evidence-based guidelines for improving treatment outcomes. The systematic review, registered in the International Prospective Register of Systematic Reviews (PROSPERO) and following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) principles, conducted an extensive electronic search in databases such as PubMed, MEDLINE, Cochrane, Web of Science, and Scopus. Using Medical Subject Headings (MeSH) terms and different types of studies, the search method focused on studies that directly looked at how nutrition and compression therapy affected the healing of venous ulcers. After deduplicating and screening publications, a collaborative full-text review was conducted to determine their inclusion. As a result, several research studies were chosen for the qualitative synthesis. The authors created a data extraction form to document important variables such as demographics, therapy specifics, and wound features. Several studies on patients with venous ulcers have shown that consuming basic nutrients can improve wound healing. Treatment results differed depending on the types of compression and pressure intensity. Although minimal data indicates the possible benefits of two-layer therapy, a definitive comparison is still uncertain. Further clinical studies are necessary to investigate a wider range of dietary factors and to evaluate different treatments in similar situations.

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Background: The benefits of nurse-led therapeutic patient education regarding wound healing and the prevention of recurrences for individuals living with a venous leg ulcer remain unclear. Obtaining the individuals perspective could offer an in depth understanding of why and how they engage or not, in self-management strategies following nurse-led patient education. Despite strong evidence indicating the need for further investigation into the benefits of therapeutic patient education in this population there is a lack of research into how individuals cope with chronic venous insufficiency or resulting ulceration. With this discussion paper we therefore explore the challenges associated with employing a Constructivist Grounded Theory methodology to gain a deeper insight into the experiences of patients with venous leg ulcers receiving individualized nurse-led patient education programs focused on the self-management of their condition. Objective: To identify and analyse the specific methodological and practical challenges encountered when applying a Constructivist Grounded Theory methodology to gain a better understanding of how patients with venous leg ulcer experience an individualised nurse-led patient education programme concerning the self-management of their condition. Design: discussion paper. Results and Discussion: The constructivist approach to Grounded Theory methodology allows for the investigation of understudied phenomena such as nurse-led patient education for individuals living with venous leg ulcers. This methodology values the co-construction of a theory taking into consideration the inherent value of participants' and researchers' experiences. However, the specificities of constructivist epistemology challenge certain methodological aspects of Grounded Theory methods, such as how and when to use existing literature, conduct interviews to generate data and engage in the coding and theoretical sampling process for conceptualizing and proposing a theory. Conclusions: The constructivist paradigm of grounded theory methodolgy resonates with the art and science of nursing through its collaborative 'real-world' reflective approach, offering a unique way to explore understudied complex clinical nursing practice. Registration: This methodological paper is derived from a PhD study embedded in a clinical trial (NCT04019340) were the recruitment started on February 2020, approved by ethical committee of Geneva (CCER: 2019-01964). Tweetable abstract: Constructivist Grounded Theory Methodologies could support an in depth understanding of the impact of nursing interventions.

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Introducción: la úlcera de Marjolin hace referencia a la aparición de un carcinoma de células escamosas ulcerado sobre un área previamente lesionada, crónicamente inflamada o con cicatrices. Se estima que solo el 1,7 % de las heridas crónicas se malignizan. Caso clínico: se trata de una mujer de 76 años que presentó una úlcera venosa crónica en la región maleolar de diez años de evolución que se había extendido. Se realizó una biopsia insicional y se obtuvo un carcinoma de células escamosas, por lo que se realizó la resección del tejido afectado, cubriendo el área con injerto autólogo de piel libre, fenestrado, de espesor parcial, y posteriormente se realizaron curas durante la hospitalización y el manejo ambulatorio, con lo que se obtuvieron resultados satisfactorios. Discusión: la resección-desbridamiento quirúrgico de la úlcera de Marjolin y el cierre con injerto libre de piel permitió la evolución satisfactoria y la cicatrización de las lesiones.(AU)

Introduction: Marjolin’s ulcer refers to the appearance of ulcerated squamous cell carcinoma on a previously injured,chronically inflamed or scarred area; it is estimated that only 1.7 % of chronic wounds become malignant.Case report: this is a 76-year-old woman who presented a chronic venous ulcer in the malleolar region of ten years ofevolution that had spread. An incisional biopsy was taken, resulting in squamous cell carcinoma, for which resectionof the affected tissue was performed: the area was covered with a free, fenestrated, partial-thickness autologous skingraft. Later, cures were carried out during hospitalization and ambulatory management, obtaining satisfactory results.Discussion: the surgical resection-debridement of the Marjolin ulcer and the closure with a free skin graft allowed thesatisfactory evolution and healing of the lesions.(AU)

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Introduction: Significant evidence suggests that plasma-rich in growth factors (PRGF) favor the repair of chronic wounds, enabling a rapid return to functionality. However, components of PRGF and their effects on persistent ulcers and epithelial tissues are not well characterized. The goals of this research were to analyze the biological properties of platelet-derived factors, to examine their effectiveness on healing of venous ulcers, and to establish a correlation with clinical and sociodemographic data. Methods: For the preparation of PRGF, the centrifugation technique was used, obtaining a 100 % autologous and biocompatible blood sample that was treated with sodium citrate and calcium chloride. The patients were attended weekly at the outpatient clinic for nursing consultation and wound dressing changes, with PRGF application every 15 days. The treatment protocols are described, and follow-up results are reported. Results: Initially, the patients' ulcers ranged in sizes from 4 to 84 cm2. After 12 weeks of treatment, there was a significant mean reduction of 46.2 % in ulcer area. At baseline, epithelial tissue was absent in all venous ulcers, but its presence grew significantly by the treatment period. However, the reduction of the area of the ulcers did not show significant correlation with the concentrations of the patient's growth factors. Conclusions: Using the established protocol for PRGF isolating, it was possible to obtain a product with the presence of the six growth factors related to tissue regeneration and observed a positive response on wound healing following treatment of venous ulcers, with capacity to accelerate re-epithelialization and restore the skin functional integrity.

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OBJETIVO: Analisar a dosimetria do laser de baixa intensidade no processo de cicatrização de úlcera venosa. MÉTODO: Trata-se de um protocolo de revisão sistemática registrado no International Prospective Register of Systematic Reviews (PROSPERO) sob código de registro CRD420211256286. Serão realizadas buscas por evidências científicas em 11 bases de dados, utilizando os idiomas português, inglês e espanhol. A exportação das publicações seguirá as etapas de identificação e seleção dos estudos, e extração dos dados. As divergências serão resolvidas por consenso dos dois revisores, e caso persistam, um terceiro revisor será consultado para decidir sobre a inclusão do material. A ferramenta Risk of Bias 2 (RoB 2) será utilizada para avaliar o risco de viés dos estudos dos ensaios clínicos randomizados, ao passo que a ferramenta Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) será utilizada para avaliar o risco de viés dos ensaios clínicos não randomizados. A análise crítica dos materiais selecionados quanto à dosimetria do laser de baixa intensidade para cicatrização de úlcera venosa resultará em uma síntese narrativa, sem metanálise.

OBJECTIVE: To analyze the dosimetry of low-level laser therapy in the healing process of venous ulcers. METHOD: This is a protocol for systematic review registered in the International Prospective Register of Systematic Reviews under registry code CRD420211256286. Articles will be searched in 11 databases using Portuguese, English, and Spanish languages. The export of publications will follow the steps of study identification, selection, and data extraction. Disagreements will be resolved by consensus among reviewers; if they persist, a third reviewer will be consulted to decide whether to include the material. The Risk of Bias 2 (RoB 2) tool will be used to assess the validity of randomized clinical trials, while the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool will be used to assess the risk of bias in non-randomized clinical trials. The critical analysis of selected materials on dosimetry of low-level laser therapy for venous ulcer healing will result in a narrative synthesis without meta-analysis.

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INTRODUCTION/OBJECTIVE: Venous Leg Ulcers (VLU) present a challenging healing process. Attaining healing is a primary treatment objective, commonly pursued in Primary Health Care (PHC) or Specialist Wound Management Clinics. Our objective was to examine the association and interplay between sociodemographic, health, clinical, and care factors with the outcomes of VLU treatment in patients undergoing care at a Specialist Wound Management Clinic. METHODS: Longitudinal, observational study took place in a center for the treatment of chronic injuries linked to PHC. The sociodemographic aspects, health status and habits, clinical and care aspects of patients with VLU were scrutinized over a 1-year period. RESULTS: The sample comprised 103 participants, with some still under treatment (Treatment Group-TG/ n = 60) and others having achieved VLU healing (Healing Group-HG/ n = 43). An association between sociodemographic, health, clinical, and care factors and the healing outcome (HG) was identified. A moderate correlation was observed between factors predisposing to healing in the sociodemographic group and health habits. Notably, among sociodemographic factors, the older age group and improvements in health, particularly the reduced use of alcohol/smoking, appeared to exert the most significant influence on healing. Additionally, specialized service monitoring and the application of compression therapy were contributory factors. CONCLUSIONS: These findings substantiate the hypothesis that sociodemographic, health, clinical, and care-related aspects are intertwined with VLU healing. Protective factors associated with healing interacted synergistically, fostering a positive outcome over one year of treatment.

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The aim of this case-control study was to explore the potential risk factors for venous ulceration in patients with varicose veins of lower extremities and to establish a simplified diagnostic score model. Seventy subjects with varicose veins of lower extremities and venous ulceration were compared with 1164 controls with varicose veins of lower extremities and no history of venous ulceration. Stepwise multivariate logistic regression analysis was used to identify the risk factors for venous ulceration. The steps in developing the diagnostic score model were based on the Framingham Heart study. The area under the receiver operating characteristic curve (AUC) was calculated to assess the diagnostic ability of the diagnostic score model. Multivariate analysis showed that men, overweight, obesity, longer duration varicose veins, deep venous valve insufficiency, low lymphocyte counts, and high fibrinogen content were independently associated with an increased risk of venous ulceration. The AUC for the diagnostic score model was 0.75, which indicated good discriminatory ability. Special attention should be paid to the high-risk group of patients with lower extremity varicose veins. The diagnostic score model might be a useful screening tool for clinicians, policy makers, and patients.

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ABSTRACT Objective: To analyze the effect of Unna's Boot on the healing of venous ulcers compared to other therapies. Methods: Systematic Review carried out in the databases Scopus, Embase, Cochrane Library, Web of Science, PubMed, Cumulative Index of Nursing and Allied Health Literature, Latin American and Caribbean Literature in Health Sciences, and grey literature. Population - adult patients with venous ulcers; Intervention- Unna's Boot (UB); Control - other compression therapies (CT); Outcome- healing; Designs- randomized clinical trial, cohort study, and case control, published from 2001 to 2024. The effect of the intervention, risk of bias, and quality of evidence were evaluated. Registered with PROSPERO (CRD42021290077). Results: A total of 39 studies were included, with 5.151 patients. The majority (71.8%) were randomized controlled trials (RCT). UB was used as intervention/control in eight studies. When comparing CTs, only 1 study with UB showed a superior effect (p < .001) in healing, compared with high compression elastic bandage. In the quality of evidence analysis, 27 studies were assessed as having a high risk of bias. Conclusion: No superiority of UB was found in the healing of venous ulcers when compared to other CTs.

RESUMEN Objetivo: Analizar el efecto de la Bota de Unna en la cicatrización de úlceras venosas en comparación con otras terapias. Métodos: Revisión sistemática realizada en las bases de datos Scopus, Embase, Biblioteca Cochrane, Web de la Ciencia, PubMed, Índice acumulativo de literatura de enfermería y salud afines, Literatura Latinoamericana y del Caribe en Ciencias de la Salud, y literatura gris. Población - pacientes adultos con úlceras venosas; Intervención- Bota de Unna (BU); Control: otras terapias de compresión (TC); Resultado- curación; Diseños: ensayo clínico aleatorizado, estudio de cohorte y casos y controles, publicado del 2002 al 2023. Se evaluaron el efecto de la intervención, el riesgo de sesgo y la calidad de la evidencia. Registrada en PRÓSPERO (CRD42021290077). Resultados: Se incluyeron 39 estudios, con 5.151 pacientes. La mayoría (71,8%) fueron ensayos controlados aleatorios (ECA). La BU se utilizó como intervención/control en ocho estudios. Al comparar TC, sólo 1 estudio con BU mostró un efecto superior (p < .001) en la curación, en comparación con el vendaje elástico de alta compresión. En el análisis de la calidad de la evidencia, se evaluó que 27 estudios tenían un alto riesgo de sesgo. Conclusión: No se encontró superioridad de la BU en la curación de úlceras venosas en comparación con otras TC.

RESUMO Objetivo: Analisar o efeito da Bota de Unna na cicatrização de úlceras venosas em comparação com outras terapias. Métodos: Revisão Sistemática realizada nas bases de dados Scopus, Embase, Cochrane Library, Web of Science, PubMed, Cumulative Index of Nursing and Allied Health Literature, Literatura Latino-Americana e do Caribe em Ciências da Saúde, e de literatura cinzenta. População- pacientes adultos com úlcera venosa; Intervenção- Bota de Unna (BU); Controle- outras terapias compressivas (TC); Desfecho- cicatrização; Delineamentos- ensaio clínico randomizado, estudo de coorte e caso controle, publicados de 2002 a 2023. Avaliaramu-se efeito da intervenção, risco de viés e qualidade da evidência. Registrada no PROSPERO (CRD42021290077). Resultados: Foram incluídos 39 estudos, com 5.151 pacientes. A maioria (71,8%) era ensaios clínicos randomizados (ECR). A BU foi utilizada como intervenção/controle em oito estudos. Na comparação entre TC, somente 1 estudo com BU apresentou efeito superior (p < .001) na cicatrização, comparado com atadura elástica de alta compressão. Na análise de qualidade da evidência, 27 estudos foram avaliados com alto risco de viés. Conclusão: Não foi encontrada superioridade da BU na cicatrização de úlceras venosas quando comparada com outras TC.

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The process of healing venous ulcers is complex and influenced by many factors. By identifying the risk factors that influence a slower healing process, it is possible to predict impending delays and plan an individualised care plan. We analysed our database of patients with venous ulcers and identified clinical and demographic factors that delay the healing process. The research analysed the medical records of 754 patients with VLUs at Chronic Wound Treatment Unit of the University Hospital treated between 2001 and 2019. In study, the majority (64.3%) were women, the mean age was 65.7 years. The median duration of Chronic Venous Insufficiency was 24 years, 52% patients had had the disease >20 years, and 296 (39.3%) had experienced ulceration >12 months. Most of the patients (85.8%) had comorbidities, 84% were obese. At 12-week follow-up, 432 of the 754 ulcers had healed. Identified independent predictors of slower ulcer healing rates: wound area greater than 8.25 cm2 , location of the ulceration other than the medial ankle area, underlying disease >20 years, the presence of multiple comorbidities, depth of the ulcer, the presence of an unpleasant smell and alert pathogens. The presence of redness resulted in faster healing of VLUc. Many factors influence the healing process of venous ulceration. The results of the study can help in planning patient care and implementing appropriate early strategies to promote healing.

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Objetivo: analizar el costo-efectividad y calcular la relación costoefectividad incremental del tratamiento multicapa compresivo con respecto al inelástico (bota de Unna y estiramiento corto) según la literatura actual. Método: estudio cuantitativo de costo-efectividad a través de un modelo con ayuda del software TreeAge® para la elaboración del árbol de decisión. Los supuestos anunciados se obtuvieron mediante el uso de datos secundarios de la literatura para estimar el costo y la efectividad de los parámetros asumidos. Para ello, se realizó una revisión sistemática de la literatura con metaanálisis. Resultados: el árbol de decisión, después del Roll Back, mostró que la terapia multicapa prevaleció sobre las alternativas en el caso base, presentó un costo intermedio por aplicación, pero obtuvo la mayor efectividad. El gráfico del análisis de costo-efectividad también demostró que había un dominio extendido de la bota de Unna sobre el vendaje de estiramiento corto. El análisis de sensibilidad reveló que el vendaje multicapa sigue siendo la alternativa con mayor costoefectividad, dentro del umbral de disposición a pagar. Conclusión: la alternativa con mayor costo-efectividad fue el vendaje multicapa, considerado estándar de oro en la literatura. La segunda alternativa con mayor costo-efectividad fue la bota de Unna, la terapia más utilizada en Brasil.

Objective: to analyze the cost-effectiveness and calculate the incremental cost-effectiveness ratio of multilayer compressive treatment in relation to inelastic (Unna boot and short stretch) therapy according to the current literature. Method: quantitative study about cost-effectiveness through modeling with the aid of TreeAge® software for construction of the decision tree. The anticipated assumptions were obtained by using secondary literature data to estimate the cost and effectiveness of the assumed parameters. A systematic literature review with meta-analysis was performed for this end. Results: the decision tree after Roll Back showed that the multilayer therapy dominated the alternatives in the base case, representing an intermediate cost per application, although with the highest effectiveness. The cost-effectiveness analysis graph also showed extended dominance of the Unna boot in relation to the short stretch bandage. The sensitivity analysis showed that multilayer bandage remains a more cost-effective alternative, within the threshold of willingness to pay. Conclusion: the most cost-effective alternative was multilayer bandage, considered the gold standard in the literature. The second most cost-effective alternative was the Unna boot, the most used therapy in Brazil.

Objetivo: analisar a custo-efetividade e calcular a razão de custoefetividade incremental do tratamento compressivo multicamadas em relação ao inelástico (bota de Unna e curto estiramento) de acordo com a literatura atual. Método: estudo quantitativo sobre custo-efetividade por meio de modelagem com auxílio do software TreeAge® para a construção da árvore de decisão. Os pressupostos anunciados foram obtidos pelo uso de dados secundários de literatura para estimativa do custo e efetividade dos parâmetros assumidos. Para tal, foi realizada uma revisão sistemática de literatura com metanálise. Resultados: a árvore de decisão, após Roll Back mostrou que a terapia multicamadas dominou as alternativas no caso-base, representando custo intermediário por aplicação, porém, com a maior efetividade. O gráfico da análise de custo-efetividade também mostrou uma dominância estendida da bota de Unna em relação à bandagem de curto estiramento. A análise de sensibilidade mostrou que a bandagem multicamadas permanece como alternativa mais custo-efetiva, dentro do limiar de disposição para pagar. Conclusão: a alternativa com maior custo-efetividade foi a bandagem multicamadas, considerada padrão ouro na literatura. A segunda alternativa mais custo-efetiva foi a bota de Unna, terapia mais utilizada no Brasil.

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Objetivos:identificar as orientações fornecidas aos pacientes com úlceras venosas (UVs) submetidos à telenfermagem e descrever o desfecho ocorrido com os pacientes com UVs monitorados à distância. Método: estudo transversal e documental, realizado com 159 prontuários de pacientes com UV submetidos à telenfermagem numa clínica de estomaterapia no Rio de Janeiro. Os critérios de inclusão foram pacientes com diagnóstico de UV submetidos à telenfermagem, de abril de 2018 a fevereiro de 2020. A análise de dados ocorreu por meio de estatística descritiva (frequência absoluta e relativa para as variáveis categóricas), auxiliada por planilha do aplicativo Microsoft Excel. Resultados: identificou-se um equilíbrio entre os participantes em relação ao sexo; apresentaram idade média (desvio-padrão) de 68,07 (5,28); ensino fundamental completo ou médio incompleto; aposentados ou pensionistas. Verificou-se que 40,88% dos pacientes possuíam ao menos uma doença de base, predominando hipertensão arterial sistêmica e diabetes mellitus. As orientações mais prevalentes foram: repouso com os membros inferiores elevados, utilização da terapia compressiva com meia elástica ou atadura elástica e realização da troca de curativo secundário em sua residência. Conclusão: os achados evidenciam a necessidade de ampliar as ações de enfermagem desenvolvidas na Clínica, buscando proporcionar a saúde integral aos pacientes.

Objectives:To identify the guidelines provided to patients with venous ulcers submitted to telenursing and describe the outcome that occurred with patients with venous ulcers monitored remotely. Method: Cross-sectional and documentary study, carried out with 159 medical records of patients with venous ulcers submitted to telenursing at an enterostomal therapy clinic in Rio de Janeiro, Brazil. The inclusion criteria were patients with a diagnosis of venous ulcer submitted to Telenursing, from April 2018 to February 2020. Data analysis was performed using descriptive statistics (absolute and relative frequency for categorical variables), aided by the application spreadsheet Microsoft Excel. Results: A balance was identified between the participants in relation to gender; had a mean age (standard deviation) of 68.07 (5.28); completed elementary school or incomplete high school; retirees or pensioners. It was found that 40.88% of the patients had at least one underlying disease, predominantly systemic arterial hypertension and diabetes mellitus. The most prevalent guidelines were: resting with the lower limbs elevated, using compressive therapy with elastic stockings or elastic bandage, and changing the secondary dressing at home. Conclusion: The findings show the need to expand the nursing actions developed at the clinic, seeking to provide comprehensive health to patients.

Objetivos:identificar las orientaciones proporcionadas a los pacientes con úlceras venosas sometidos a Teleenfermería y describir el desenlace ocurrido con los pacientes con úlceras venosas monitorizados a distancia. Método: estudio transversal y documental, realizado con 159 prontuarios de pacientes con úlceras venosas sometidos a teleenfermería en una Clínica de Estomaterapia de Rio de Janeiro. Los criterios de inclusión fueron pacientes con diagnóstico de úlcera venosa sometidos a teleenfermería, de abril de 2018 a febrero de 2020. El análisis de datos se realizó mediante estadística descriptiva (frecuencia absoluta y relativa para variables categóricas), auxiliada por la hoja de cálculo de la aplicación Microsoft Excel. Resultados: se identificó un equilibrio entre los participantes en relación al género; tenía una edad media (DE) de 68,07 (5,28); primaria completa o secundaria incompleta; jubilados o pensionados. Se encontró que el 40,88% de los pacientes tenían al menos una enfermedad de base, predominantemente Hipertensión Arterial Sistémica y Diabetes Mellitus. Las pautas más prevalentes fueron: reposo con los miembros inferiores elevados, uso de terapia compresiva con medias elásticas o venda elástica y cambio del vendaje secundario en casa. Conclusión: los hallazgos muestran la necesidad de ampliar las acciones de enfermería desarrolladas en la Clínica, buscando brindar salud integral a los pacientes

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Resumo Enquadramento: No cuidado aos pacientes com úlceras crónicas de pernas, a sistematização do registo das informações sobre o estado e evolução das úlceras crónicas de pernas, contribui para a melhoria do tratamento. Objetivo: Descrever o desenvolvimento de um software para a monitorização do cuidado aos pacientes com úlceras crónicas de pernas. Metodologia: O estudo metodológico foi fulcrado no design de interação participativa e desenvolvido em quatro etapas interativas - 1) Análise de requisitos; 2) (Re)design; 3)Construção de protótipo e 4) Avaliação da qualidade. Resultados: O software contém descrição de fatores constitucionais, comportamentais, doença, métodos de avaliação, dados da consulta e monitorização de recidivas, além de alertas sinalizadores dos fatores intervenientes no processo cicatricial. Ademais, houve concordância de todos especialistas quanto aos critérios de usabilidade, funcionalidade, aparência, organização, sequência e compreensão. Conclusão: O software desenvolvido está adequado na sua qualidade, podendo ser útil para estomaterapeutas e enfermeiros generalistas.

Abstract Background: The systematization of data records about the status and evolution of chronic leg ulcers improves their treatment. Objective: To describe the development of a software for monitoring care provided to patients with chronic leg ulcers. Methodology: This methodological study was based on Participatory Interaction Design process and developed in four interactive stages - 1) Requirements analysis; 2) (Re)design; 3) Prototype construction, and 4) Quality assessment. Results: The software includes a description of constitutional and behavioral factors, the disease, evaluation methods, data from the consultation and monitoring of recurrences, and alerts indicating the factors involved in the healing process. Moreover, all experts agreed on the criteria of usability, functionality, appearance, organization, sequence, and understandability. Conclusion: The developed software is adequate in terms of quality and may be useful for stoma nurses and generalist nurses.

Resumen Marco contextual: En el cuidado de pacientes con úlceras crónicas de pierna, sistematizar el registro de información sobre el estado y la evolución de las úlceras crónicas de pierna contribuye a mejorar el tratamiento. Objetivo: Describir el desarrollo de un software para el seguimiento de los cuidados de pacientes con úlceras crónicas de pierna. Metodología: El estudio metodológico se centró en el diseño de interacción participativa y se desarrolló en cuatro fases interactivas: 1) Análisis de requisitos; 2) (Re)diseño; 3) Construcción de prototipos; y 4) Evaluación de la calidad. Resultados: El software contiene una descripción de los factores constitucionales y de comportamiento, enfermedad, métodos de evaluación, datos de consulta y seguimiento de las recaídas, así como alertas que señalan los factores que intervienen en el proceso de cicatrización. Además, todos los expertos coincidieron en los criterios de usabilidad, funcionalidad, aspecto, organización, secuencia y comprensión. Conclusión: El software desarrollado es de calidad adecuada y puede ser útil para estomaterapeutas y enfermeros generales.

RESUMEN

Objetivo: Identificar na literatura quais são as mais recentes práticas assistenciais prestadas ao paciente portador de úlcera visando a cicatrização da ferida. Método: trata-se de uma revisão integrativa da literatura realizada no período de novembro e dezembro de 2022 indexados nos portais LILACS e MEDLINE, os descritores usados na busca foram "Úlcera varicosa" OR "Insuficiência venosa'' AND "cicatrização" AND "Assistência ao paciente". Resultados: foram incluídos 8 artigos, como principais resultados observou-se que a enfermagem realiza várias intervenções para cicatrização das lesões sendo a mais utilizada é o tratamento com terapia compressiva, seguido do tratamento com hidrocoloide e tratamento com gel de plaquetas homólogo. No que tange a avaliação de lesões, prevalece o uso do instrumento PUSH. Considerações finais: faz-se necessário a avaliação adequada, orientação do paciente e cuidador, cuidado multidisciplinar e associação de novas tecnologias para o tratamento de úlceras venosas. A padronização da utilização de escalas como a PUSH na avaliação dos cuidados prestados é essencial para nortear o atendimento.(AU)

Objective: To identify in the literature which are the most recent care practices provided to patients with ulcers, aiming at wound healing. Method: this is an integrative literature review carried out in the period of November and December 2022 indexed in the LILACS and MEDLINE portals, the descriptors used in the search were "Varicose ulcer" OR "Venous insufficiency'' AND "healing" AND "Assistance to the patient". Results: 8 articles were included. With regard to the assessment of injuries, the use of the PUSH instrument prevails. Final considerations: proper assessment, patient and caregiver guidance, multidisciplinary care and association of new technologies for the treatment of venous ulcers are necessary. The standardization of the use of scales such as the PUSH in the assessment of the care provided is essential to guide care.(AU)

Objetivo: Identificar en la literatura cuáles son las prácticas más recientes de cuidados prestados a pacientes con úlceras visando la cicatrización de las heridas. Método: se trata de una revisión bibliográfica integradora realizada en el período de noviembre y diciembre de 2022 indexada en los portales LILACS y MEDLINE, los descriptores utilizados en la búsqueda fueron "Úlcera varicosa" O "Insuficiencia venosa" Y "cicatrización" Y "Cuidados del paciente". Resultados: Se incluyeron 8 artículos, como principales resultados se observó que enfermería realiza diversas intervenciones para la cicatrización de las lesiones, siendo la más utilizada el tratamiento con terapia compresiva, seguida del tratamiento con hidrocoloide y el tratamiento con gel de plaquetas homólogas. En cuanto a la valoración de las lesiones, prevalece el uso del instrumento PUSH. Consideraciones finales: son necesarias una evaluación adecuada, la orientación al paciente y al cuidador, la atención multidisciplinar y la asociación de nuevas tecnologías para el tratamiento de las úlceras venosas. La estandarización del uso de escalas como el PUSH en la evaluación de los cuidados prestados es esencial para orientar la asistencia.(AU)

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RESUMEN

Introducción: la úlcera venosa es la heridade origen vascular que más se presentaen la población adulta; afecta la calidad de vida,por loque se requiereun abordajeinterdisciplinarioparala atenciónde las personas que la padecen. Objetivo:describir las variables clínicas y sociales que interfieren en la calidad de vida relacionada con la salud de un grupo deadultosconúlcera venosa.Métodos:estudio observacional de tipo cohorte; incluyó 80 personas evaluadas en tres clínicas de Medellín(Colombia), en quienes seaplicó elinstrumento de evaluaciónCharing Cross Venous Ulcer Questionnaire. Se describieron las variablessociodemográficas y la evolución de la calidad de vidahasta la cicatrización y se construyó un modelo de regresión logística para explicar las variables asociadas a tener lapeorcalidad de vida. Resultados:el 28,8%de los participantes obtuvieron 64 o más puntos, es decir, grado de afección alto durantela primera mediciónde la calidad de vida;en el 68,8%el puntaje fue63o menos, lo que significó afecciónmoderadaysolo el 2,4%tuvo baja afección.Laspeores puntuaciones se registraron enmujeres,participantes de mayor edad y quienes tenían mayor compromiso de la herida; la afección involucró las dimensiones Estado emocional, Estética, Función social y Actividades domésticas,aunque hubo evolución favorablede la calidad de vidamientrasiba cicatrizandola úlcera. Conclusiones:lacalidad de vida relacionada con la saludestá altamente afectada en las personasque tienen úlcera venosa, siendo más frecuente en quienes tienen dolor constante,heridas más grandes, de mayor tiempo de antigüedad y aquellos con mala percepción desusalud; por tanto,se requiere oportunamentela intervención profesional e interdisciplinaria en salud para el logro de la cicatrizacióny del bienestary para mejorar la calidad de vida.

ntroduction: Venous ulcers are the most common vascular injury in the adult population. They affect the quality of life, so people who suffer from venous ulcers require an interdisciplinary approach to their care. Objective: To describe clinical and social variables that affect the health-related quality of life of a group of adults with venous ulcers. Methods: Observational cohort study carried out with 80 people examined in three medical centers in Medellín (Colombia) and who were given the Charing Cross Venous Ulcer Questionnaire to answer. Sociodemographic variables and the quality-of-life evolution until scarring were described. A logistic regression model was built to explain the variables associated with having the poorest quality of life. Results:There were28.8% of the participants who scored 64 or more points on the first quality of life measurement, which indicates a highly affected quality of life; 68.8% scored 63 or less, indicating a moderately affected quality of life, while only 2.4% indicated a slightly affected quality of life. The worst scores were seen among women, older participants, and those with greater ulcer severity. The dimensions of emotional status, cosmesis, social interaction, and domestic activities were affected, although there was a favorable evolution of the quality of life while the ulcer was healing. Conclusions: Health-related quality of life is highly affected in people with venous ulcers and is more common in those with constant pain, larger and older sores, and those with poor health perceptions. Therefore, timely professional and interdisciplinary healthcare interventions are required to achieve wound healing and wellness and improve quality of life

Introdução:a úlcera venosa é a ferida de origem vascular que ocorre mais frequentemente na população adulta e afeta a qualidade de vida, por isso é necessária uma abordagem interdisciplinar para o cuidado das pessoas que a sofrem. Objetivo:descrever as variáveis clínicas e sociais que interferem na qualidade de vida relacionada à saúde de um grupo de adultos com úlcera venosa.Métodos:estudo de coorte observacional; incluíram-se 80 pessoas avaliadas em três clínicas em Medellín (Colômbia), nas quais foi aplicado o instrumento de avaliação Charing Cross Venous Ulcer Questionnaire. Descreveram-se as variáveis sociodemográficas e a evolução da qualidade de vida até a cicatrizaçãoe construiu-se um modelo de regressão logística para explicar as variáveis associadas à pior qualidade de vida.Resultados: 28,8% dos participantes obtiveram 64 ou mais pontos, ou seja, alto grau de condição na primeira mensuração da qualidade de vida; em 68,8% a pontuação foi de 63 ou menos, o que significa condição moderada e apenas 2,4% em condição baixa. As piores pontuações foram registradas em mulheres, participantes mais velhos e naqueles com maior complicação da ferida; a afecção,envolvia as dimensões Estado Emocional, Estética, Função Social e Atividades Domésticas, embora houvesse evolução favorável da qualidade de vida enquanto a úlcera cicatrizava. Conclusões:a qualidade de vida relacionada à saúde é altamente afetada em pessoas com úlcera venosa, sendo mais frequente naquelas com dor constante, feridasmaiores, mais antigas e com má percepção de saúde; portanto, é necessária intervenção oportuna profissional e interdisciplinar em saúde para alcançar a cicatrização e o bem-estar e melhorar a qualidade de vida

RESUMEN

Introduction: Chronic venous ulcers have a negative impact on the physical, psychic, and social domains, affecting the quality of life of patients, especially the elderly. This study aimed to assess frailty, functional capacity, and feelings of helplessness in older people with venous ulcers. Method: 112 older people were divided into two groups according to the presence or absence of venous ulcers. All patients were interviewed using the Edmonton Frail Scale (EFS), Health Assessment Questionnaire-20 (HAQ20), and the Impotence Feelings Measurement Instrument (IMSI) from May 2017 to August 2018. Results: Regarding the EFS score, 76.8% of patients with venous ulcers were classified as vulnerable and frail, compared to 28.6% of patients in the group without ulcers. Scores on the HAQ-20 showed statistically significant differences between groups in all categories of the instrument, indicating that older people with venous ulcers had reduced general functional capacity compared to older people without ulcers. The mean IMSI score was 41.2 for the group with venous ulcers and 33.4 for the group without ulcers. Conclusion: Venous ulcers had a negative impact on functional capacity and increased frailty and feelings of powerlessness in the elderly.

Introdução: Úlceras venosas crônicas exercem impacto negativo nos domínios físico, psíquico e social, afetando a qualidade de vida de pacientes, especialmente os idosos. O objetivo deste estudo foi avaliar o nível de fragilidade, capacidade funcional e sentimento de impotência em idosos com úlcera venosa. Método: Um total de 112 idosos foram distribuídos em dois grupos de acordo com a presença ou ausência úlcera venosa. Todos os pacientes foram entrevistados utilizando-se os questionários Edmonton Frail Scale (EFS), Health Assessment Questionnaire-20 (HAQ-20) e o Instrumento de Medida de Sentimento de Impotência (IMSI) no período de maio de 2017 a agosto de 2018. Resultados: Em relação à pontuação na EFS, 76,8% dos pacientes com úlcera venosa foram classificados como vulneráveis e frágeis, em comparação a 28,6% dos pacientes do grupo sem úlcera. Pontuações no HAQ-20 mostraram diferenças estatisticamente significantes entre os grupos em todas as categorias do instrumento, indicando que idosos com úlcera venosa apresentavam redução da capacidade funcional geral em comparação aos idosos sem úlcera. A pontuação média para o IMSI foi de 41,2 para o grupo com úlcera venosa e 33,4 para o grupo sem úlcera. Conclusão: Úlceras venosas causaram impacto negativo na capacidade funcional e aumento de fragilidade e sentimento de impotência nos idosos.

RESUMEN

Venous Ulcers (VU) are a serious health problem that affect the Quality of Life (QoL). They are evaluated by many different scales in the literature. We aimed to analyze the correlation between the Medical Outcomes Short-Form Health QoL (SF-36) and Charing Cross Venous Ulcer Questionnaire (CCVUQ) scales. This is a cross-sectional study conducted in a Brazilian center specializing in chronic VU of the Primary Health Care (PHC) provided to patients with active VU. The general QoL instrument SF-36 and the CCVUQ, specific for people with VU, were used. Spearman's Rho Test determined the correlation between the variables analyzed. Our sample had a total of 150 patients. We found a direct correlation between the domestic activities division (CCVUQ) aspect and the SF-36 Physical role functioning (strong), and Physical functioning (moderate) domains. The Social interaction division (CCVUQ) aspect presented moderate correlation with the domains of the SF-36 Physical role functioning and Physical functioning. The Vitality domain (SF-36) showed moderate correlation with the aspects of CCVUQ Cosmesis division and Emotional status division. The greatest forces of direct correlation were observed between the physical, functional and vitality aspects of SF-36 with those represented by domestic activities and social interaction in the CCVUQ.

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