Submitted by Fabiana Gonçalves Pinto (benf@ndc.uff.br) on 2015-11-26T18:23:43Z No. of bitstreams: 1 Alcione Matos de Abreu.pdf: 2227189 bytes, checksum: f73eb32bdd92709cccf5f1c0b4627d4d (MD5) / Made available in DSpace on 2015-11-26T18:23:43Z (GMT). No. of bitstreams: 1 Alcione Matos de Abreu.pdf: 2227189 bytes, checksum: f73eb32bdd92709cccf5f1c0b4627d4d (MD5) Previous issue date: 2012 / Universidade Federal Fluminense. Escola de Enfermagem Aurora de Afonso Costa / Este estudo teve os objetivos de avaliar os resultados clínicos e evolutivos do processo de reparo teci-dual em pacientes com úlcera venosa em uso da terapia compressiva inelástica (Bota de Unna) em comparação ao uso da terapia compressiva elástica (atadura elástica); e, analisar se existe variação significativa na área da úlcera ao longo de 13 semanas de tratamento nos dois grupos. Metodologia: Trata-se de um estudo clínico experimental randomizado e controlado, aberto, prospectivo, com abor-dagem quantitativa, realizado em um hospital universitário. A amostra foi de 18 pacientes, acompa-nhados por 13 semanas. Para alocação aleatória foi realizada uma lista através do software Biostat 5.0 que realizou o sorteio dos participantes em um dos grupos, onde metade destes utilizaram como trata-mento para as úlceras venosas a Bota de Unna, e a outra metade a atadura elástica. Todos os voluntá-rios atenderam aos critérios de inclusão. Este estudo foi aprovado pelo Comitê de Ética em Pesquisa da Faculdade de Medicina, sob o protocolo nº 327/2010 e CAAE:0252.0.258-000-10, os termos de consentimento e fotografia encontram-se de acordo com as Resoluções 196/96. A coleta de dados foi realizada durante seis meses, pela enfermeira pesquisadora e por uma bolsista de iniciação científica. Os dados foram analisados no SPSS 14.0 Windows, através de estatística descritiva e inferencial, e apresentados na forma de tabelas, quadros e gráficos. Entre os pesquisados, pôde-se identificar que (61,1%) eram homens e adultos, moradores de Niterói /RJ (66,6%) e com baixo grau de escolaridade (55,5%). Em relação às características clínicas das úlceras, encontrou-se que no grupo B, úlceras mais exsudativas, com maior tempo de evolução e maiores áreas. Já o Grupo A apresentou o maior numero de úlceras com presença no leito com tecido de hipergranulação e ou desvitalizado e destacou-se como a terapia compressiva mais confortável. O uso da Bota de Unna macerou as bordas das úlceras e a Gaze Petrolatum® levou a formação de crostas perilesional. Em relação a redução da área das úlceras venosas, pelo teste de ANOVA de Friedman, observou-se que existe queda significativa, ao nível de 5%, na área da úlcera apenas no grupo B (p < 0,0001) ao longo de todo o tratamento, mas pode-se dizer, que existe uma tendência do grupo A apresentar queda na área da lesão (p = 0,06), após a 5ª consulta. Conclui-se que a Bota de Unna apresentou melhor resultado em úlceras venosas com áreas superiores a 10 cm² e o uso da Gaze Petrolatum® com a atadura elástica em úlceras venosas inferiores a 10 cm². / This study aimed to evaluate clinical and evolutionist results of the process of tissues repairing in pa-tients with venous ulcer using the compressive inelastic (Unna Boot) comparing the usage of compres-sive elastic therapy (elastic bandage) and analyzing if there is a meaningful variation in the ulcer area with 13 weeks of treatment in both groups. Methodology: Concerning in a experimental, randomized and controlled, opened, prospective study with quantitative approach in a College Hospital. A sample of 18 patients was monitoring for 13 weeks. It was achieved a list of two groups in randomized draw by Biostat 5.0 software where half of participants used as therapy Unna Boot in venous ulcer and the other half of them used the elastic bandage one. All volunteers followed the inclusion criteria. This study was approved by The Committee of Ethics in research of Medical College; under the protocol number no 327/2010 and CAAE: 0252.0.258-000-10, terms of authorization and photography are in agreement to the resolutions 196/96. The data collection was done for six months by researcher nurse and a scholarship student of scientific study. Such data were analyzed in SAS 6.11, through descrip-tive and inferential statistic and performed in tables, squares and graphs. Among participants could identify that (61%) were adult male; inhabitants from Niteroi/RJ (66,6%) with a low degree of educa-tion (55,5%). Regarding to the ulcer clinical characteristics in Unna Boot group was found ulcers with more exsudation, with longer evolution time and larger areas. In elastic bandage group, a great number of ulcers with hyper-granulation and or desvitalization tissue on the bed was remarkable as the most comfortable compressive therapy. The usage of Unna Boot softened the ulcer borders and in the Petro-latum® Gaze took as a result a formation of a scab around the lesion. In relation to the reduction of venous ulcer area due to the ANOVA Friedman Test, analyzed that there is a meaningful decrease to the level of 5%, in the ulcer area in group B (p<0,0001) along of all the treatment, but there is a ten-dency of group A in performing a reduction in the affected area after the 5th consultation. Concluding that the Unna Boot performed better/satisfactory results in venous ulcer with area superior to 3.93 in². and the usage of Petrolatum® Gaze with elastic bandage in venous ulcer was inferior to 3.93 in².

The compression therapy is often being underestimated not only by medical staff and doctors, but also by patients. Therefore, it is often perceived as a simple task frequently handed over to hospital attendants. At the nursing schools the time devoted to the issue of compression therapy is minimal. That is probably why there are nurses with a very limited information at their disposal regarding this issue. The compression therapy is nevertheless an essential part of prevention and treatment of the venous and lymphatic diseases. When the compressive bandaging is carried out efficiently, it can improve the quality of life of a patient with a venous or lymphatic disease. Moreover, it can help in preventing thromboembolic diseases during surgical interventions. However, in order for the compressive bandage to be effective, several conditions must be met. First, it has to be carried out by a properly trained medical staff. Second, it is highly important that the patient undergoes a thorough education concerning compressive bandaging, so that he or she is able to keep the bandage effective when released home. Based on evidence, the aim of this thesis is to find out how effective is the practice of compressive bandaging within nursing care. The thesis consists of two parts. The first is theoretical and it contains the findings of various researches and publications related to the issue of venous diseases, aplication of the compressive bandage, differences between elastic stockings and elastic roller bandage and the findings concerning the education of a patient. The second part is practical. It consists of a quantitative research with a participation of 192 respondents who work as nurses in medical facilities and who are therefore closest to the patient undergoing compressive therapy. The thesis is interested in the amount of knowledge nurses have in relation to the compressive bandage, in the way they apply the bandage and in the process of the education of the patient. The research shows that the choice of a type of a compressive therapy is conditioned by the supply of the ward. Furthermore, the research reveals that there is no connection between the length of the professional experience of a nurse and her or his method of applying the compressive bandage. The recommendation for practice is an educational seminar for nurses aimed at completing their theoretical knowledge. This would also serve as an opportunity to practice not only the application of the bandage, but also the use of a measuring instrument Picopress.