Guidelines for the treatment of venous ulcers

Robson, Martin C.; Cooper, Diane M.; Aslam, Rummana; Gould, Lisa; Harding, Keith; Margolis, David J.; Ochs, Diane; Serena, Thomas E; Snyder, Robert J.; Steed, David L.; Thomas, David; Wiersma-Bryant, Laurel

doi:10.1111/j.1524-475x.2006.00174.x

Cited by 173 publications

(151 citation statements)

References 150 publications

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“…Os guidelines (22) de tratamento de úlcera varicosa recomendam o uso de cobertura tópica associada à terapia de compressão. Existem várias coberturas e a avaliação do aspecto da ferida, tamanho, tipo de tecido e exsudato, devem ser considerados para a escolha da mais adequada.…”

Section: Discussionunclassified

Tecnologia Bota De Unna Na Cicatrização Da Úlcera Varicosa

Danski¹,

Liedke²,

Vayego³

et al. 2016

Cogitare Enferm.

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RESUMO: Objetivou-se analisar a eficiência da tecnologia Bota de Unna no processo de cicatrização de úlceras varicosas. Trata-se de pesquisa descritiva retrospectiva, realizada no ambulatório de tratamento de feridas de um hospital de ensino da região sul do Brasil, tendo como fonte de dados prontuários de pacientes portadores de úlcera venosa e que utilizaram a Bota de Unna. Incluiu-se 49 pacientes que apresentaram 80 úlceras varicosas, predominantemente em membro inferior direito com 56,2% (n=45) e região de maléolo medial com 42,5% (n=34). Em relação à cicatrização das úlceras, houve significância estatística para volume intenso do exsudato (p-valor=0,0193) e tamanho da úlcera (p-valor<0,0001), tendência para deambulação sem auxílio (p-valor=0,0986) e exsudato purulento (p-valor=0,0629) UNNA BOOT TECHNOLOGY IN THE HEALING OF VARICOSE ULCERS ABSTRACT:This study aimed to analyze the efficiency of Unna Boot technology in the varicose ulcer healing process. This was a retrospective descriptive study conducted in the wound care clinic of a teaching hospital in southern Brazil, using as the data source the medical records of patients with venous ulcers that used the Unna Boot. The study included 49 patients with 80 varicose ulcers, predominantly in the right lower limb, with 56.2% (n = 45), and the medial malleolus region, with 42.5% (n = 34). Regarding the healing of the ulcers, a large volume of exudate (p = 0.0193) and ulcer size (p <0.0001)were statistically significant, while walking without assistance (p = 0.0986) and purulent exudate (p = 0.0629) showed a tendency, as variables that affected the healing. Estudio cuyo objetivo fue analizar la eficiencia de la tecnología Bota de Unna en el proceso de cicatrización de úlceras varicosas. Fue una investigación descriptiva retrospectiva, realizada en el ambulatorio de tratamiento de heridas de un hospital de enseñanza de la región sur de Brasil, que tuvo como fuente de datos prontuarios de pacientes con úlcera venosa que utilizaron la Bota de Unna. Participaron 49 pacientes que presentaron 80 úlceras varicosas, con predominancia en el miembro inferior derecho con 56,2% (n=45) y región de maléolo medial con 42,5% (n=34). Acerca de la cicatrización de las úlceras, hubo significancia estadística para volumen intenso de exudato(p-valor=0,0193) y tamaño de la úlcera (p-valor<0,0001), tendencia para deambulación sin ayuda (p-valor=0,0986) y exudato purulento (p-valor=0,0629) como variables que interfieren en la cicatrización. Cuarenta y uno pacientes (51,3%) presentaron cicatrización de las lesiones a causa del uso de la Bota de Unna en hasta 12 semanas. La tecnología fue eficiente en la cicatrización de las úlceras varicosas, especialmente en las de pequeño tamaño.

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Section: Discussionunclassified

Tecnologia Bota De Unna Na Cicatrização Da Úlcera Varicosa

Danski¹,

Liedke²,

Vayego³

et al. 2016

Cogitare Enferm.

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“…It is indicated in the treatment for infected wounds and ulcers, impetigo and to eradicate MRSA in the nostrils 36 . The topic use of mupirocin for the decontamination of venous ulcers has not been described 35,39 nor is it recommended according to a systematic review about the topical indication of this antimicrobial 38 . On the venous ulcer treatment guidelines, the use of topical antibacterial agents can be necessary to reduce the microbial load, but this document does not indicate the class type of the agent 39 .…”

Section: Discussionmentioning

confidence: 99%

“…The topic use of mupirocin for the decontamination of venous ulcers has not been described 35,39 nor is it recommended according to a systematic review about the topical indication of this antimicrobial 38 . On the venous ulcer treatment guidelines, the use of topical antibacterial agents can be necessary to reduce the microbial load, but this document does not indicate the class type of the agent 39 . A study conducted in Brazil found 38% of MRCoNS isolates, and multi-drug resistance was detected in 86%; however, the MLS B i phenotype was not investigated 33 .…”

Section: Discussionmentioning

confidence: 99%

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

Martins

Santos

Leão

et al. 2012

Rev. Soc. Bras. Med. Trop.

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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 B c 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.

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“…The traditional and gold standard therapy is application of the multilayered compression dressing. This aims to improve the venous return by passive promotion of the peripheral hemodynamic pump (calf and the foot muscles) [6]. However, such routine practice is not necessarily applicable to large, longstanding and bilateral leg ulcers in obese and minimally mobile patients.…”

Section: • Pyoderma Gangrenosummentioning

confidence: 99%

Intermittent Pneumatic Compression in Treatment of Chronic Venous Leg Ulcers: A Case Report and Review of Literature

Kordzadeh¹,

Jonas²,

Panayiotopoulos³

2014

CRCM

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Introduction: The benefit of intermittent pneumatic compression (IPC) for the prevention of venous thromboembolism and lymphedema has been well established in the literature. Recent evidence suggests that IPC plays a beneficial role in circulation, hemodynamic peripheral pump, intravascular coagulation and arterial skin perfusion. Despite such evidence, the use of IPC in the treatment of resistant and chronic venous leg ulcers, has received little attention in practice. Case Presentation: We would like to report the case of successfully treated chronic and bilateral venous leg ulcer in an obese patient with IPC application and a review of the literature. Results: The use of IPC as an adjuvant therapy to the traditional multilayered compression therapy permitted significant resolution of the ulcers, reduced secondary infection incidence and prevented ulcer recurrence. Conclusion: In obese, minimally mobile patients with venous ulcers not responding to the traditional multilayered compression therapy application of IPC, an adjuvant therapy is recommended.

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Guidelines for the treatment of venous ulcers

Cited by 173 publications

References 150 publications

Tecnologia Bota De Unna Na Cicatrização Da Úlcera Varicosa

Tecnologia Bota De Unna Na Cicatrização Da Úlcera Varicosa

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

Intermittent Pneumatic Compression in Treatment of Chronic Venous Leg Ulcers: A Case Report and Review of Literature

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