Incidence of Recurrent Venous Ulcer in Patients Treated at an Outpatient Clinic: Historical Cohort

Characteristics of chronic ulcer patients by gender and ulcer aetiology from a multidisciplinary wound centre

Chronic ulcer patients form a heterogenous group of patients with various medical backgrounds. Cost-effective targeted treatment necessitates more knowledge about specific features related to different subgroups of ulcer patients. Hence, this study aimed to characterize ulcer patients according to gender and ulcer aetiology. A total of 946 consecutively recorded chronic ulcer patients in the Tampere Wound Registry (TWR) were included and data were gathered from the TWR and patient medical records. Comparisons were made between males and females and patients with venous-, arterial or mixed-, diabetic foot-, pressure- and atypical ulcers. Male patients were found to have diabetes, hypercholesterolemia and obesity significantly more often than females (59.2% vs. 39.6%; p < 0.001, 46.5% vs. 33.3%; p = 0.001, 42.7% vs. 35.9%; p = 0.017 respectively), whereas autoimmune diseases were more common among females (30.6% vs. 15.6%; p < 0.001). Recurrence of ulcers was most common among patients with venous ulcers (p < 0.001) and multimorbidity among those with diabetic foot ulcers (p < 0.001). To conclude, males with chronic ulcers would benefit particularly from lifestyle advice, multidisciplinary treatment should be targeted specifically at those with diabetic and arterial or mixed ulcers and preventive measures at those with venous ulcers.

SELF-ASSESSMENT OF PRIMARY CARE NURSES ABOUT CARE FOR PEOPLE WITH VENOUS ULCERS: A CROSS-CUTTING STUDY

Objective: To identify the self-knowledge of primary care nurses about care for people with venous ulcers. Method: This is a cross-sectional study with 40 nurses working in health units. Two data collection instruments were used: characterization, developed by the author, and self-assessment on venous ulcers. Results: All questions of the self-assessment instrument reached medians classified as little level of knowledge, except questions related to the application of elastic compression therapy, with the median = 3 (moderate), and the evaluation of lower limbs to investigate arterial involvement, with 3.50, between little and moderate. The item cleaning the lesion stood out, which obtained median = 4 (little) and the highest average found in the responses, 4.03 (little). Conclusion:The nurse’s self-assessment reached moderate and low scores of clinical practice in terms of knowing (theoretical knowledge) and doing (practical knowledge) in the care of people with venous ulcers. Venous ulcer is a complex wound and requires knowledge from nurses about the pathophysiology and appropriate treatment, interfering with the improvement of the person’s quality of life. It is believed that this study can encourage the reflection of this professional and education actions in the services.

AUTOAVALIAÇÃO DE ENFERMEIROS DA ATENÇÃO PRIMÁRIA SOBRE ASSISTÊNCIA À PESSOA COM ÚLCERAS VENOSAS: UM ESTUDO DE CORTE TRANSVERSA

Objetivo:Identificar o autoconhecimento de enfermeiros da atenção primária sobre assistência à pessoa com úlceras venosas. Método: Trata-se de um estudo de corte transversal com 40 enfermeiros lotados em unidades de saúde. Utilizaram-se dois instrumentos de coleta de dados: caracterização, elaborada pelo autor, e autoavaliação sobre úlcera venosa. Resultados: Todas as questões do instrumento autoavaliativo alcançaram medianas classificadas como nível de conhecimento pouco, à exceção das questões relativas à aplicação de terapia compressiva elástica com mediana = 3 (moderado) e à avaliação de membros inferiores para investigar comprometimento arterial, 3,50, entre pouco e moderado. Destacou-se o item limpeza da lesão, o qual obteve a mediana = 4 (pouco) e a maior média encontrada das respostas, 4,03 (pouco). Conclusão: A autoavaliação do enfermeiro atingiu os escores moderado e pouco da prática clínica no que tange ao saber (conhecimento teórico) e ao fazer (conhecimento prático) no cuidado à pessoa com úlcera venosa. A úlcera venosa é uma ferida complexa e exige do enfermeiro conhecimento sobre a fisiopatologia e o tratamento adequado, interferindo na melhora da qualidade de vida dessa pessoa. Acredita-se que este estudo possa fomentar a reflexão desse profissional e ações de educação nos serviços.