Poster Presentation
Monday, November 14, 2005
Topical Venous Ulcer Treatment: a Systematic Review
Maria Helena Larcher Caliri, PhD, RN, School of Nursing, University of Sao Paulo at Ribeirao Preto, Ribeirao Preto, Brazil and Eline Lima Borges, RN, MSN, College of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| Learning Objective #1: Describe patient care issues related to venous ulcer in Brazil |
| Learning Objective #2: Describe findings of a systematic review and learn about research utilization in the Brazilian context |
Venous insufficiency in the legs can lead to venous ulcer. In Brazil, in spite of a lack of data on prevalence rates, many persons attend basic health units during various consecutive years without achieving healing. This study aimed to accomplish a systematic literature review to evaluate what the best topical treatment is. The search was carried out in the following databases: MEDLINE, BDENF, LILACS, CINAHL, COCHRANE, NGC, Sigma Theta Thau International Registry of Nursing Research, as well as an inverse search and articles supplied by pharmaceutical industry representatives. The keywords leg ulcer / venous ulcer / stasis ulcer and varicose ulcer were used as selection criteria. The search was delimited by topical treatment in human beings in English, Portuguese and Spanish between 1993 and 2003. A data collection instrument was used. All articles were evaluated by the researcher, while 50% were also analyzed by a second evaluator for the sake of validation. The sample consisted of 33 primary studies and 2 cases of meta-analysis, totaling 35 studies. A diverse series of treatments were identified in two groups: compression (54.3%) and topical (45.7%). Compression therapy increases healing rates for venous leg ulcers as compared to with treatment without compression and should be used in patients who do not suffer from arterial problems. It is not clear what the best topical treatment for venous ulcer is. Wound dressing by means of polyurethane, hydrocolloid or calcium alginate foam are suggested. As to the use of antimicrobial agents, there are no criteria for choosing the most appropriate agent. The use of dressings must be associated with compression therapy. No information could be found about the cost efficiency of venous ulcer treatments. The study results will be used to propose medical and nursing practice guidelines.