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Endovenous thermal ablation is now one of the most important techniques for treating chronic venous insufficiency. Technical refinements and technological innovations have made it possible to employ the method not only in the saphenous veins, but also to treat superficial veins such as varicose tributaries. We describe a technique for surgical treatment of varicose veins using endovenous laser thermal ablation employing multiple punctures and present the experience at our service with analysis of 601 cases operated using this technique. Thermoablative treatment of tributary veins with multiple puncture sites expands the applications for endolaser in treatment of lower limb varicose veins, providing, comprehensive, safe, and effective treatment.

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Chronic venous disease (CVD) significantly impacts global health, presenting a complex challenge in medical management. Despite its prevalence and the burden it places on healthcare systems, CVD remains underdiagnosed and undertreated. This review aims to provide a comprehensive analysis of the bioactive compounds in the Citrus genus, exploring their therapeutic potential in CVD treatment and addressing the gap in current treatment modalities. A narrative review methodology was adopted, focusing on the pharmacological effects of Citrus-derived bioactive compounds, including flavonoids and terpenes. Additionally, the review introduced the DBsimilarity method for analyzing the chemical space and structural similarities among Citrus compounds. The review highlights the Citrus genus as a rich source of pharmacologically active compounds, notably flavonoids and terpenes, which exhibit significant anti-inflammatory, antioxidant, and veno-protective properties. Some of these compounds have been integrated into existing therapies, underscoring their potential for CVD management. The DBsimilarity analysis further identified many clusters of compounds with more than 85% structural similarity. Citrus-derived bioactive compounds offer promising therapeutic potential for managing CVD, showcasing significant anti-inflammatory, antioxidant, and veno-protective effects. The need for further comparative studies, as well as safety and efficacy investigations specific to CVD treatment, is evident. This review underlines the importance of advancing our understanding of these natural compounds and encouraging the development of novel treatments and formulations for effective CVD management. The DBsimilarity method's introduction provides a novel approach to exploring the chemical diversity within the Citrus genus, opening new pathways for pharmacological research.

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Low-intensity laser therapy (LILT) is commonly used as an adjuvant therapy for treating injuries. This integrative literature review was carried out in the MEDLINE, LILACS, CUMED, BDENF, SPORTDiscus, Dentistry & Oral Sciences Source, Academic Source and CINAHL databases. Among the inclusion criteria were: range from 2011 to 2021, in English, Portuguese and Spanish and any study, with the exception of preprints and books. The question was answered: "What is the effectiveness described in the literature of using low-intensity laser therapy (LILT) in the treatment of venous lesions?" The wavelength used in studies varied from 635 nm of red ray to 780 nm of infrared ray, generating healing improvement at any length. LBI presented itself as a low-cost and easy-to-apply adjuvant option, alleviating pain complaints and improving healing in patients with vasculogenic lesions.

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INTRODUCTION: Chronic venous disease (CVD) is a highly prevalent disease that presents a wide spectrum of clinical expressions due to abnormalities in the venous system. Patients often have major functional changes that can limit daily activities. However, the functional factors associated with the severity of the disease remain poorly understood. OBJECTIVE: To identify the functional factors associated with CVD severity. METHODS: Seventy-five patients with CVD (92.0% females, 49.6 ± 13.3 years) were evaluated through clinical examination, lower limb perimetry, ankle range of motion (AROM), and lower limb muscle strength by the Heel Rise test, and Sit-to-stand test. Patients were stratified according to the disease severity as mild (telangiectasia, varicose veins, or edema in the lower limbs) or severe CVD (trophic changes or venous ulcer). RESULTS: Patients with severe CVD (n = 13) were older (p = 0.002), predominantly male (p = 0.007), with reduced AROM in dorsiflexion (p = 0.028) and inversion (p = 0.009), reduced lower limb strength by the Heel Rise test (p = 0.040), and greater circumference of the calf (p = 0.020), ankle (p = 0.003), and plantar arch (p = 0.041) when compared to mild CVD (n = 62). Advanced age, male sex, lower ankle range of motion in dorsiflexion, and greater ankle and plantar arch circumferences were associated with CVD severity. However, the ankle circumference (OR 1.258, 95% CI: 1.008-1.570; p = 0.042), together with advanced age and male sex, was the only functional variable that remained independently associated with CVD severity. CONCLUSION: The increased ankle circumference was a determinant of the CVD severity and may assist in risk stratification and guide treatment goals in this population.

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OBJECTIVE: To analyze the effects of lower limb muscle strengthening on interface pressure (IP), static stiffness index (SSI), dynamic stiffness index (DSI), and walking pressure amplitude (WPA) in older adults undergoing inelastic compression therapy. METHOD: Forty-three healthy older adults of both sexes (Age: 66.2 ± 4.4 years) met the eligibility criteria and completed all stages of the study (Resistance Training - RT: N = 20; Control - CONT: N = 23). Body composition, strength and functional mobility of lower limbs, IP, SSI, DSI, and WPA were evaluated before and after intervention. RESULTS: The two-way ANOVA with repeated measures demonstrated a significant time-group interaction effect on muscular strength for 1-RM [F (1, 41) = 21.091; p ≤ 0.001], IP in the orthostatic position [F (1, 41) = 5.124; p ≤ 0.05], minimum WPA [F (1, 41) = 10.999; p ≤ 0.05], maximum WPA [F (1, 41) = 8.315; p ≤ 0.05], DSI minimum (F (1, 41) = 4.608; p ≤ 0.05), DSI maximum (F (1, 41) = 8.926; p ≤ 0.05), and on the delta DSI (F (1, 41) = 7.891; p ≤ 0.05). CONCLUSIONS: In RT group, the increase in lower limb muscle strength was accompanied by an increase in IP in foot dorsiflexion and plantar flexion maneuvers, both in the standing position (DSI) and during gait (WPA).

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OBJECTIVE: We aim to report on the Laser-Sclerosing Foam Hybrid Treatment (LSFHT) and its outcomes when used on patients with great saphenous vein (GSV) insufficiency. METHODS: This was a single center retrospective cohort study on patients with GSV insufficiency that were treated with the LSFHT technique, a surgical procedure that comprises the use of both sclerosing foam and endovenous ablation and avoids the use of tumescent anesthesia. Occlusion rates and complications were reported. RESULTS: 139 legs from 106 patients were operated, achieving a 100% occlusion rate, while only a small burn and 2 popliteal vein thrombosis cases occurred. CONCLUSION: The study suggests that the LSFHT is a feasible fast procedure that proved both effective and safe for the treatment of GSV insufficiency.

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Resumo Atualmente, a ablação térmica endovenosa é uma das principais técnicas para o tratamento da insuficiência venosa crônica. Com o refinamento técnico e as inovações tecnológicas, é possível aplicá-la, além de em veias safenas, em veias superficiais como as tributárias varicosas. Descrevemos uma técnica de tratamento cirúrgico de varizes por termoablação com laser endovenoso empregando-se múltiplas punções e a experiência do serviço após a análise de 601 casos operados com a técnica. O tratamento termoablativo de veias tributárias com múltiplos sítios de punção expande a aplicação do uso do endolaser no tratamento das varizes de membros inferiores de forma adequada, visando, assim, a um tratamento amplo, seguro e eficaz.

Abstract Endovenous thermal ablation is now one of the most important techniques for treating chronic venous insufficiency. Technical refinements and technological innovations have made it possible to employ the method not only in the saphenous veins, but also to treat superficial veins such as varicose tributaries. We describe a technique for surgical treatment of varicose veins using endovenous laser thermal ablation employing multiple punctures and present the experience at our service with analysis of 601 cases operated using this technique. Thermoablative treatment of tributary veins with multiple puncture sites expands the applications for endolaser in treatment of lower limb varicose veins, providing, comprehensive, safe, and effective treatment.

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Resumo A laserterapia de baixa intensidade (LBI) é comumente utilizada como terapia adjuvante para tratamento de lesões. Essa revisão integrativa de literatura foi realizada nas bases MEDLINE, LILACS, CUMED, BDENF, SPORTDiscus, Dentistry & Oral Sciences Source, Fonte Acadêmica e CINAHL. Entre os critérios de inclusão estavam: intervalo de 2011 a 2021, nos idiomas inglês, português e espanhol e qualquer estudo, com exceção de preprints e livros. Respondeu-se à questão: "Qual a eficácia descrita na literatura do uso da laserterapia de baixa intensidade (LBI) no tratamento de lesões venosas?". O comprimento de onda usado nos estudos variou de 635 nm de raio vermelho ah 780 nm de raio infravermelho, gerando melhora cicatricial em qualquer comprimento. A LBI apresentou-se como uma opção coadjuvante de baixo custo e de fácil aplicação, amenizando queixas álgicas e melhorando a cicatrização de pacientes com lesões vasculogênicas.

Abstract Low-intensity laser therapy (LILT) is commonly used as an adjuvant therapy for treating injuries. This integrative literature review was carried out in the MEDLINE, LILACS, CUMED, BDENF, SPORTDiscus, Dentistry & Oral Sciences Source, Academic Source and CINAHL databases. Among the inclusion criteria were: range from 2011 to 2021, in English, Portuguese and Spanish and any study, with the exception of preprints and books. The question was answered: "What is the effectiveness described in the literature of using low-intensity laser therapy (LILT) in the treatment of venous lesions?" The wavelength used in studies varied from 635 nm of red ray to 780 nm of infrared ray, generating healing improvement at any length. LBI presented itself as a low-cost and easy-to-apply adjuvant option, alleviating pain complaints and improving healing in patients with vasculogenic lesions.

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The Brazilian Society of Angiology and Vascular Surgery has set up a committee to provide new evidence-based recommendations for patient care associated with chronic venous insufficiency. Topics were divided in five groups: 1. Classification, 2. Diagnosis, 3. Conservative or non-invasive treatment, 4. Invasive treatment and 5. Treatment of small vessels. This last series is closely related to the activities of Brazilian angiologists and vascular surgeons, who are heavily involved in the treatment of small superficial veins. These guidelines are intended to assist in clinical decision-making for attending physicians and health managers. The decision to follow a guideline recommendation should be made by the responsible physician on a case-by-case basis taking into account the patient's specific condition, as well as local resources, regulations, laws, and clinical practice recommendations.

A Sociedade Brasileira de Angiologia e de Cirurgia Vascular organizou uma comissão para fornecer novas recomendações baseadas em evidências sobre questões críticas de atendimento ao paciente com insuficiência venosa crônica. São abordados aqui os temas de classificação, diagnóstico, tratamento conservador, tratamento invasivo e tratamento de pequenos vasos. Esta última série está muito relacionada à atividade de angiologistas e cirurgiões vasculares, que possuem forte atuação no tratamento de pequenas veias superficiais. Estas diretrizes destinam-se a auxiliar na tomada de decisões clínicas de médicos assistentes e gestores de saúde. A decisão de seguir uma recomendação de diretriz deve ser feita pelo médico responsável caso a caso, levando em consideração a condição específica do paciente, bem como recursos locais, regulamentos, leis e recomendações de prática clínica.

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PURPOSE: To investigate the connection between the clinical severity of chronic venous insufficiency (CVI) and the biomechanics of the calf muscle pump (CMP). MATERIAL AND METHODS: Through a cross-sectional observational study, we analyzed women on the age range between 30 and 80 years with chronic venous insufficiency, stratified according to the clinical classification. Ninety-nine women were assessed and classified into groups with different levels of severity: C1 (n = 22); C2 (n = 22); C3 (n = 22); C4 (n = 22); C5 (n = 8); C6 (n = 3). The main purpose was to investigate the strength of the calf muscle pump through total work (TW) and peak torque (PT), and the range of motion (ROM) of the ankle joint. For a secondary analysis, the fatigue index was assessed. All results were run through the Humac®/NORMT isokinetic dynamometer to obtain the data. RESULTS: Our findings pointed out that as the clinical severity of CVI increases, there is a reduction on the PT, the TW, the maximum active ROM and the ROM at 120°/sec. As severity increased, there was a reduction of 24Nm in the TW at 30°/sec.and a reduction of 3Nm in the PT at 30°/sec. OUTCOMES: When increased, clinical severity of CVI may trigger downgrading in the strength of the CMP and the ROM in the ankle. These findings are of relevance to the clinician, since through these findings, individuals with venous insufficiency may be treated more precisely for each classification.

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BACKGROUND: Chronic venous disease is a frequent and prevalent pathology. Its surgical treatment has been shown to be cost-effective. Thermal endoablation performed as major outpatient surgery (MAS) is the technique of choice. OBJECTIVE: To know the satisfaction of patients after MAS and the quality of care provided. METHOD: Observational, descriptive, cross-sectional study, carried out between January 2019 and March 2020. A survey was carried out on patients who underwent endovascular radiofrequency thermoablation in two hospitals in Spain, consisting of two questionnaires: one ad hoc and one another of satisfaction (SERCAL). Quality indices for MAS were measured. RESULTS: We analyzed 156 episodes. 145 interventions were carried out. We found 4 (2.8%) unscheduled admissions. 3 patients (2.1%) attended the emergency department. There was a 99.3% success rate. 100% of the patients had pre-surgical recommendations and informed consent. We obtained 48 surveys (response rate: 33.1%). All the patients gave a rating greater ≥ 8 in quality of care (x = 9.83) and would recommend this procedure to their relatives (x = 9.71). CONCLUSIONS: Endovascular radiofrequency thermoablation performed in MAS has a high success rate and a very low rate of admission and visit to the emergency room. Patient satisfaction is high.

ANTECEDENTES: La enfermedad venosa crónica es una patología frecuente y prevalente. Su tratamiento quirúrgico ha mostrado ser coste-efectivo. La endoablación térmica realizada como cirugía mayor ambulatoria (CMA) es la técnica de elección. OBJETIVO: Conocer la satisfacción de los pacientes tras CMA y la calidad de la atención brindada. MÉTODO: Estudio observacional, descriptivo y transversal, realizado entre enero de 2019 y marzo de 2020. Se realizó una encuesta a los pacientes intervenidos mediante termoablación endovascular por radiofrecuencia en dos hospitales de España, con dos cuestionarios: uno ad hoc y otro de satisfacción (SERCAL). Se midieron índices de calidad para CMA. RESULTADOS: Analizamos 156 episodios. Se realizaron 145 intervenciones. Encontramos 4 (2.8%) ingresos no programados. Tres pacientes (2.1%) acudieron a urgencias. Hubo una tasa de éxito del 99.3%. El 100% de los pacientes contaban con recomendaciones prequirúrgicas y consentimiento informado. Obtuvimos 48 encuestas (índice de respuesta: 33.1%). Todos los pacientes otorgaron una calificación ≥ 8 en calidad de atención (x = 9.83) y recomendarían este procedimiento a sus familiares (x = 9.71). CONCLUSIONES: La termoablación endovascular por radiofrecuencia realizada en CMA tiene una alta tasa de éxito y unas tasas de ingreso y visita a urgencias muy bajas. La satisfacción de los pacientes es elevada.

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Chronic venous disease (CVD) associated with great saphenous vein (GSV) reflux has a higher prevalence of pain in the lower limbs. This study evaluates the impact of ultrasound-guided foam sclerotherapy (UGFS) for GSV and symptom control, accessed by the visual analogue scale (VAS). Patients with CVD who underwent GSV-UGFS were included in this retrospective cohort (417 limbs). The pain was measured before and after the treatment. The scale alteration was assessed as a function of age, sex, Clinical Etiologic Anatomic Pathophysiologic (CEAP) classes, total of sclerotherapy sessions, GSV occlusion patterns, and ulcer healing. Majority of patients were female (59.2%), and the mean age was 56 ± 11.5 years. In the total sample, 78.2% of the GSVs were fully occluded, 19.7% had partial occlusion, 2.2% remained open, and 3.2 ± 1.9 (median = 3.0) sessions were performed. The reduction of symptoms occurred in 88.3% of participants (VAS drop median = 4.8). Patients younger than 50 years and females had the greatest VAS decreases. When comparing the outcomes of complete occlusion versus partial occlusion, there was no significant difference in VAS pain reduction ( p = 0.14). The comparison between CEAP clinical classes also did not show statistically significant differences in delta VAS ( p = 0.71). GSV-UGFS was effective for pain control. However, this improvement does not appear to be related to the pattern of occlusion, indicating that in the short term, the outcomes of total and partial occlusion suggest successful management of symptoms. Other aspects such as gender, age, pretreatment pain intensity, and CEAP classes seem to play a role in the clinical outcome.

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Background: The use of compression dressings after phlebectomy is based solely on clinical experience due to the lack of a unified set of definitive recommendations, which makes clinical practice extremely heterogeneous. Objectives: To evaluate compression therapy with elastic stockings for 7 days after phlebectomy. Methods: We randomly allocated 104 lower limbs with disease classified as C1 and C2 to 1 of 2 groups: an intervention group (64 limbs) - wearing elastic compression stockings for the first 7 days after phlebectomy; or a control group (40 limbs) - given conventional bandaging for 24 hours postoperatively. We compared clinical response by analyzing the evolution of symptoms, hematoma formation, and preoperative vs. postoperative limb volume. Results: Pain (median 1.0 vs. 1.5, p=0.0320) and limb volume (mean 43.7 vs. 99.8, p=0.0071) were significantly improved in patients wearing elastic compression stockings for 7 days after phlebectomy compared with controls. Conclusions: Use of elastic compression therapy for 7 days after phlebectomy was effective for improving pain and lower limb volume.

Contexto: O uso de curativos após flebectomia é baseado apenas na experiência clínica, visto que não existe um conjunto unificado de recomendações definitivas, o que torna a prática clínica extremamente variável. Objetivos: Avaliar o uso de terapia elástica compressiva por 7 dias após flebectomia. Métodos: Cento e quatro membros inferiores, classificados como CEAP C1 e C2, foram randomizados em dois grupos: grupo de intervenção (64 membros) ­ uso de meia elástica por 24 horas após a cirurgia ­ e grupo controle (40 membros) ­ uso de curativo convencional por 7 dias após a cirurgia. A resposta clínica foi comparada por meio de análise da evolução dos sintomas, de hematoma e do volume dos membros antes e depois da cirurgia. Resultados: Os pacientes submetidos a terapia compressiva elástica apresentaram melhora significativa na dor (mediana 1,0 vs. 1,5; p=0,0320) e no volume dos membros (média 43,7 vs. 99,8; p=0,0071) em comparação ao grupo controle. Conclusões: O emprego da terapia compressiva elástica por 7 dias após flebectomia mostrou-se efetivo na melhora da dor e do volume dos membros inferiores.

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Background: Use of endolaser for chronic venous disease involves choosing the laser wavelength and optical fiber to use and the quantity of energy to be administered. Efficacy is assessed by the venous occlusion rate and safety is evaluated in terms of side effects. Objectives: To determine the incidence of total post-endolaser saphenous vein occlusion at 1-year follow-up. To describe side effects and their incidence and rates of reintervention or supplementary treatment during the postoperative period. Methods: A retrospective, observational cohort study with a quantitative approach, enrolling patients with saphenous vein incompetence treated with intravenous 1,470 nm laser ablation. Data were input to an MS Excel 2019 spreadsheet, calculating means and standard deviations with the software's Power Query supplement. Results: 38 patients and 104 venous segments were eligible for the study. 100% were occluded at 30 days and 99.04% were still occluded at 1 year after the procedure. Mean Linear Endovenous Energy Density administered to the internal saphenous vein was 2,040.52 W/cm/s with standard deviation of ± 1,510.06 W/cm/s and 1,168.4 W/cm/s with standard deviation of ± 665.011 W/cm/s was administered to the external saphenous vein. Pain along the saphenous path was the most common side effect, with eight cases (21.05%), followed by one case of paresthesia (2.63%). Conclusions: The total occlusion rate at 1-year follow-up suggests the technique is promising and is currently applicable in this sample. The incidence of pain and paresthesia may be caused by the high mean energy delivered in some cases. It is recommended that multicenter studies be conducted with larger and more uniform samples in terms of their Clinical-Etiological-Anatomical-Pathological classifications.

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La insuficiencia venosa es una patología prevalente a nivel mundial, dada la sintomatología incómoda que puede provocar, resulta necesario realizar un abordaje conservador o quirúrgico; el cuidado humanizado es parte de la recuperación del paciente posquirúrgico, busca rescatar la relación de confianza y empatía entre el paciente y el profesional en enfermería. Objetivo. Evaluar el cuidado humanizado por parte del personal de enfermería en pacientes safenectomizados atendidos en el Hospital General Riobamba "IESS". Materiales y métodos. Se realizó un estudio con enfoque cuantitativo, descriptivo, retrospectivo, observacional, contó con una población total de 56 pacientes safenectomizados, quienes previo consentimiento informado participaron del estudio; para la recolección de la información se usó como técnica la encuesta, y como instrumento el cuestionario Percepción del Cuidado Humanizado, constituido por tres variables: comunicación, calidad y disposición de la atención; el proceso se llevó a través de la aplicación GoogleForms. Resultados. Dimensión se puede evidenciar que el 64.3% de pacientes respondieron siempre frente a valores humanísticos y altruistas; la segunda dimensión, correspondiente a instalación de fe y esperanza, el 53,6% de los pacientes respondió casi siempre; la tercera dimensión cultivar la sensibilidad hacia uno mismo y hacia los demás, el 37,5% de los pacientes respondió casi siempre; la cuarta dimensión desarrollar una relación de cuidados humanos de ayuda y confianza el 23,2% respondió casi siempre. Conclusiones. Pacientes safenectomizados pertenecientes al servicio de Hospitalización de Cirugía del Hospital General Riobamba se pudo determinar que gozan de cuidados de enfermería humanizados.

Venous insufficiency is a prevalent pathology worldwide, given the uncomfortable symptomatology it can cause, it is necessary to perform a conservative or surgical approach; humanized care is part of the post-surgical patient's recovery, it seeks to rescue the relationship of trust and empathy between the patient and the nursing professional. Objective. To evaluate the humanized care provided by the nursing staff in saphenectomized patients treated at the Hospital General Riobamba "IESS". Materials and methods. A quantitative, descriptive, retrospective, retrospective, observational study was carried out with a total population of 56 saphenectomized patients, who with prior informed consent participated in the study; for the collection of information, the survey was used as a technique, and as an instrument the questionnaire Perception of Humanized Care, made up of three variables: communication, quality and disposition of care; the process was carried out through the GoogleForms application. Results. The first dimension shows that 64.3% of patients always responded to humanistic and altruistic values; the second dimension, corresponding to the installation of faith and hope, 53.6% of patients responded almost always; the third dimension, cultivating sensitivity towards oneself and others, 37.5% of patients responded almost always; the fourth dimension, developing a relationship of humane care of help and trust, 23.2% responded almost always. Conclusions. Saphenectomized patients belonging to the surgical hospitalization service of the General Hospital Riobamba were found to enjoy humanized nursing care.

A insuficiência venosa é uma patologia prevalente em todo o mundo, diante dos sintomas incômodos que pode causar, é necessário realizar uma abordagem conservadora ou cirúrgica; o cuidado humanizado faz parte da recuperação do paciente pós-cirúrgico, busca resgatar a relação de confiança e empatia entre o paciente e o profissional de enfermagem. Objetivos. Avaliar o cuidado humanizado prestado pela equipe de enfermagem em pacientes safenectomizados atendidos no Hospital Geral Riobamba "IESS". Materiais e métodos. Foi realizado um estudo quantitativo, descritivo, retrospectivo, observacional, retrospectivo, com uma população total de 56 pacientes safenectomizados que, com consentimento prévio informado, participaram do estudo; foi utilizada uma técnica de pesquisa para coletar as informações e como instrumento foi utilizado o questionário de Percepção do Cuidado Humanizado, composto por três variáveis: comunicação, qualidade e prestação de cuidados; o processo foi realizado usando o aplicativo GoogleForms. Resultados. Na primeira dimensão, pode-se observar que 64,3% dos pacientes responderam sempre aos valores humanísticos e altruístas; na segunda dimensão, correspondente à instalação da fé e da esperança, 53,6% dos pacientes responderam quase sempre; na terceira dimensão, cultivar a sensibilidade em relação a si mesmo e aos outros, 37,5% dos pacientes responderam quase sempre; na quarta dimensão, desenvolver uma relação de cuidado humano de ajuda e confiança, 23,2% responderam quase sempre. Conclusões. Verificou-se que os pacientes safenectomizados pertencentes ao serviço de internação cirúrgica do Hospital Geral de Riobamba desfrutam de cuidados de enfermagem humanizados.

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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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OBJECTIVES: Describe and analyze the sociodemographic, clinical and functional characteristics of individuals with chronic venous insufficiency (CVI) and compare the clinical severity with levels of mobility. METHODS: Exploratory cross-sectional study in a single public health center. The study cohort comprised 99 individuals. INTERVENTIONS: Clinical, sociodemographic and physical activity level questionnaires were applied; we also evaluated ankle amplitude and sural triceps function. Descriptive statistics, independent t test and one-way ANOVA with post hoc Least Significant Difference (LSD) were performed. RESULTS: Ninety-nine participants (87.9% woman) with an average age with an average age of 60.6 ± 14 years who where recruited to the study. The cohort was composed of individuals were moderately active, 80% exhibited symptoms of the disease and approximately 40% reported reduced mobility. Individuals who had reduced mobility and less physical activity showed reduced ankle amplitude and muscle function (p <0.05). CONCLUSION: CVI impacts on functional capacity, even in individuals with less severe disease.

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OBJECTIVE: Two-year follow-up results from a first-in-human study of patients implanted with the VenoValve are evaluated for supporting the long-term clinical safety and performance of the device. BACKGROUND: Chronic Venous Insufficiency (CVI) involves improper functioning of lower limb vein valves and inability of these valves to move blood back towards the heart. CVI symptoms include swelling, varicose veins, pain, and leg ulcers. Currently, there is no cure for this condition and treatment options are limited. This study provides 2-year outcomes for 8 patients who were implanted with the bioprosthetic VenoValve for treating severe CVI with deep venous reflux measured at the mid-popliteal vein. The 6-month and 1-year results were previously published. METHODS: Eleven patients with C5 & C6 CVI were implanted with VenoValve into the midthigh femoral vein and followed for 2 years. Assessed clinical outcomes include device-related adverse events, reflux time, disease severity, and pain scores. RESULTS: All 11 implant procedures were successful. Two-year follow-up data was obtained for 8 subjects: 1 patient died of non-device related causes, 1 was lost to follow-up, and 1 refused to follow-up due to the COVID-19 pandemic. No device-related adverse events occurred between the first and second years of follow-up. Reported 2-year clinical performance outcomes included significant decreases in mean reflux times of the mid-popliteal vein (61%), and significant improvements in mean scores for disease severity rVCSS (56%) and VAS pain (87%). CONCLUSIONS: Results from this study support long-term safety and effectiveness of the VenoValve for improving CVI severity by reducing reflux and thereby venous pressures in the lower extremities. With limited treatments for valvular incompetence involved in severe, deep venous CVI, the device may be considered as a novel therapy. A pivotal trial in the United States is currently being conducted to assess the device in a larger number of patients.

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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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PURPOSE: Obesity is a risk factor for chronic venous disease (CVD) of the lower limbs (LL), affecting venous anatomy and physiology. Weight loss after bariatric surgery (BS) can reduce intra-abdominal pressure, improve mobility, and ultimately improve venous hemodynamics and CVD-related symptoms. There are no studies in the literature that adequately assess the effect of the obesity and BS on the LL veins, especially the saphenous veins (SV). The aim of this study was to evaluate the effects of obesity and BS on the saphenous veins. METHODS: This is a longitudinal prospective study carried out from 2019 to 2021 with 19 patients, totaling 38 LL, underwent clinical evaluation (CEAP Classification) and by Doppler ultrasonography, to analyze their SV diameter and reflux measurements, in the preoperative period and again 6 months to 2 years after BS being performed. RESULTS: There was no statistical difference between the groups regarding the characteristics of reflux in the SV among the evaluated LL. There was no significant increase in the diameter of the great SV in the majority of its segments. The groups were similar in terms of the small SV diameters. Moreover, a significant reduction in the clinical class of CEAP was observed after BS. CONCLUSION: Obesity and bariatric surgery had no influence on diameter or reflux in saphenous veins, but a reduction in the CEAP Clinical Classification was observed in the postoperative period.

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