Lipoxina A4 (LXA4) é um eicosanoide derivado do metabolismo do ácido araquidônico pelas lipoxigenases (5, 12 e 15-LO), tendo propriedades antiinflamatórias e pró-resolução. A estratégia de uso de LXA4 encapsulada em micropartículas de PLGA como fármaco tem fundamento nas propriedades que tais polímeros têm de preservar as atividades biológicas de moléculas diversas, como dos lipídeos, e promover liberação prolongada e sustentada das mesmas. No presente estudo, tivemos como hipótese de trabalho que a encapsulação de LXA4 em micropartículas de PLGA (LXA4-MS) preserva suas atividades biológicas, e mais eficientemente, acelera o fechamento de úlceras induzidas na pele de ratos. Para tanto, um modelo de úlceras cutâneas na região dorsal de ratos foi utilizado. As LXA4-MS foram fixadas em pele com adesivo biológico de fibrina, e seus efeitos comparados com aqueles induzidos por micropartículas vazias (Un-MS), LXA4 solúvel ou veículo (PBS). Nossos resultados mostraram que LXA4-MS aceleram a cicatrização da ferida, pois no 7º dia após a lesão, reduziu em 80% o diâmetro da úlcera inicial, enquanto no mesmo período, nas úlceras tratadas com LXA4 solúvel, Un-MS ou veículo ocorreu diminuição de somente 60%, 45% e 39%, respectivamente. O aumento do índice de cicatrização induzido pelo tratamento das úlceras com LXA4-MS foi acompanhado pela diminuição das citocinas pró-inflamatórias IL- 1?, TNF-?, e aumento de TGF- ?, uma citocina antiinflamatória indutora da deposição de colágeno. Além disso, nas úlceras tratadas com LXA4-MS o infiltrado inflamatório foi reduzido no tecido de cicatrização, como demonstrado pela diminuição de infiltrado celular, de MPO e de mRNA da metaloproteinase MMP8. Por outro lado, LXA4-MS induziu aumento da deposição de colágeno e do número de vasos sanguíneos, de NAG e de IL-4, quando comparado com os demais tratamentos. Quando as úlceras foram tratadas concomitantemente com LXA4-MS e o antagonista do receptor de LXA4 (ciclosporina H), observamos reversão de cerca de 50% no índice de cicatrização promovido pelo mediador encapsulado, sugerindo que os efeitos tópicos do tratamento com LXA4 são devidos à sua interação com seu receptor específico. Nossos resultados sugerem que novas formulações farmacêuticas para tratamento de úlceras cutâneas poderão ser obtidas com LXA4-MS. / Lipoxin A4 (LXA4) is an eicosanoid derived from the metabolism of arachidonic acid by lipoxygenases (5, 12, and 15-LO), having anti-inflammatory and pro-resolution properties. The strategy of using LXA4 encapsulated in PLGA microparticles as drug is due to some properties that such polymers have to preserve the biological activity of several molecules such as lipids, and promote a prolonged and sustained release of these molecules. In the present study, we hypothesized that the encapsulation of LXA4 in PLGA microparticles (LXA4-MS) preserves its biological activities, and more efficiently accelerates the closing of ulcers induced in the skin of rats. Thus, a model for cutaneous ulcers in the dorsal region of rats was used. The LXA4-MS were fixed in skin using biological adhesive of fibrin, and their effects compared to those induced by empty microparticles (Un-MS), soluble LXA4 or vehicleOur results showed that LXA4-MS accelerate wound healing, once on day 7 after injury, reduced by 80% the diameter of the initial ulcer, while at the same time, the ulcers treated with soluble LXA4, Un-MS or vehicle was decreased of only 60%, 45% and 39%, respectively. The increased healing rate of ulcers induced by treatment with LXA4-MS was accompanied by the decrease of pro-inflammatory cytokines IL-1?, TNF-?, and a TGF-? increasing, an anti-inflammatory cytokine-inducing collagen deposition. In addition, the inflammatory infiltrate was reduced in scar tissue as demonstrated by the decrease of neutrophils, MPO and MMP8 metalloproteinase mRNA. Moreover, LXA4-MS induced increase in collagen deposition and the number of blood vessels when compared with the other controls. When the ulcers were treated concomitantly with LXA4-MS and the antagonist LXA4 receptor (ALX), cyclosporine H, we observed the reversal of about 50% in healing rates promoted by the encapsulated agent, suggesting that topical treatment effects of LXA4 are due to interaction with its own receptor. Our results suggest that new pharmaceutical formulations for the treatment of skin ulcers can be obtained with LXA4-MS.

Submitted by Cássia Santos (cassia.bcufg@gmail.com) on 2016-03-04T12:38:20Z No. of bitstreams: 2 Dissertação - Rayana Gomes Oliveira Loreto - 2015.pdf: 1169507 bytes, checksum: 46f8b0eba8fb564884382192db0e7a7d (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2016-03-04T12:54:08Z (GMT) No. of bitstreams: 2 Dissertação - Rayana Gomes Oliveira Loreto - 2015.pdf: 1169507 bytes, checksum: 46f8b0eba8fb564884382192db0e7a7d (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2016-03-04T12:54:08Z (GMT). No. of bitstreams: 2 Dissertação - Rayana Gomes Oliveira Loreto - 2015.pdf: 1169507 bytes, checksum: 46f8b0eba8fb564884382192db0e7a7d (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2015-07-30 / The customer service of people with venous ulcers requires appropriately trained professionals with knowledge, skills and attitudes compatible with quality care. It is known that professionals don’t always have qualified to serve this population. For the educational activity planning and training of human resources it is necessary to have as a starting point the competencies expected of professionals. There aren’t documents in which are established competencies for nurses in the care of people with venous ulcers. The objective is to map the skills necessary to professional nursing care for people with venous ulcers. This is an integrative review that comes through the five stages second methodological framework adopted. The search was performed using the databases: Source of Nursing and Allied Health Literature (CINAHL), National Library of Medicine National Institutes of Health (PUBMED), and SciVerse Scopus, and guidelines published by organizations with internationally recognized experts in area of assessment and treatment of wounds. For definition of competence adopted the inductive and deductive method. 20 articles and 21 guidelines were included, totaling 41 references. Were identified six general competencies: assessment of people with venous ulcers, venous ulcer assessment, the individual treatment with venous ulcers, treatment of venous ulcers, the person monitoring with venous ulcers, prevention of venous ulcers. For each general competency were identified specific skills and their knowledge, skills and attitudes. CONCLUSION: The identified skills represent a boundary for the teaching of the nursing care of people with venous ulcers. Should be the subject of discussion and reflection among educators, for a decision wherein levels they’ll be addressed in the process of training of human resources. / A úlcera venosa é a mais prevalente dentro das úlceras de perna, e representa um problema de saúde pública. Para prestar assistência a essas pessoas exige profissionais qualificados. Os conhecimentos, habilidades e atitudes dos profissionais de saúde tem uma impacto significativo sobre a qualidade da assistência.Sabe-se que mais da metade dos profissionais que atende pessoas com úlceras venosas não possuem qualificação para atender essa população. Para o planejamento de ação educativa e formação de recursos humanos é preciso ter como ponto de partida as competências esperadas dos profissionais. Não há documentos que esteja estabelecido as competências para o enfermeiro no atendimento a pessoas com úlceras venosas.O objetivo deste estudo é mapear as competências necessárias ao profissional de enfermagem para atendimento a pessoas com úlceras venosas. Trata-se de um revisão integrativa que percorreu cinco etapas segundo referencial metodológico. A busca foi utitlizando as base de dados: Source of Nursing and Allied Health Literature (CINAHL), National Library of Medicine National Institutes of Health (PUBMED), e SciVerse Scopus, e guidelines publicados por organizações com reconhecimento internacional de especialistas na área de avaliação e tratamento de feridas. Para definição das competências adotou-se o método indutivo (DEMO, 2007). RESULTADOS: Mediante aos mecanismos de buscas, aplicação dos critérios de inclusão, exclusão e avaliação de qualidade foram identificados 21 artigos e 21 guidelines, totalizando 41 referências incluídas nesta pesquisa. Foram identificadas seis competências gerais: avaliação da pessoa com úlcera venosa, avaliação da úlcera venosa, tratamento da pessoa com úlcera venosa, tratamento da úlcera venosa, acompanhamento da pessoa com úlcera venosa, prevenção da úlcera venosa. Para cada competência específica foram identificadas as competências gerias, os conhecimentos, as habilidades e as atitudes. As competências que foram tratadas no presente estudo precisam ser objeto de reflexão dos educadores para que se decida em que níveis elas serão tratadas, na graduação e/ou especialização, devendo ser incorporadas ao processo de ensino, uma vez que são necessárias ao enfermeiro para o atendimento adequado a esta população.

Orientador: Clélia Akiko Hiruma-Lima / Resumo: As úlceras pépticas abrangem tanto as úlceras gástricas, quanto as úlceras duodenais e afetam cerca de 10% da população mundial, sendo 6,8% homens e 4,9% mulheres. A maior ocorrência de úlceras pépticas em homens do que em mulheres, provavelmente, está relacionada aos hormônios sexuais, pois existem relatos de que os hormônios femininos exercem um efeito protetor contra as ulcerações. A patogênese complexa e multifatorial desta doença ocorre devido a um desequilíbrio entre os fatores agressores [ácido clorídrico, pepsina, etanol, anti-inflamatórios não esteroidais (AINEs), estresse, Helicobacter pylori, entre outros] e os protetores (muco, bicarbonato, prostaglandinas e fluxo sanguíneo) da mucosa do estômago e/ou duodeno. Numa tentativa de proteger a mucosa gástrica do ácido clorídrico, melhorar a cicatrização da úlcera, e prevenir a sua recorrência, o controle farmacológico da secreção ácida tem sido uma das estratégias utilizadas ao longo dos anos. Dentre as opções disponíveis no mercado para o tratamento das úlceras pépticas existem os antagonistas de receptores H2, os inibidores da bomba de prótons e o uso de antibióticos para a erradicação da H. pylori. Entretanto, estes medicamentos podem promover não somente uma gama de efeitos colaterais, mas também uma menor eficácia no tratamento das úlceras, bem como o surgimento das recidivas logo após a interrupção do tratamento. Para tanto, se faz necessário as buscas de novas opções terapêuticas para tratamento adequado das ulc... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Peptic ulcers include both gastric and duodenal ulcers and affect about 10% of the world population, being 6.8% men and 4.9% women. The higher occurrence of peptic ulcers in men than in women is probably related to sex hormones, as there are reports that female hormones exert a protective effect against ulcerations. The complex and multifactorial pathogenesis of this disease occurs due to an imbalance between the aggressive (hydrochloric acid, pepsin, ethanol, nonsteroidal anti-inflammatory drugs (NSAIDs), stress, Helicobacter pylori, among others) and protective factors (mucus, bicarbonate, prostaglandins and blood flow) of the stomach and duodenum mucosa. In an attempt to protect gastric mucosa from the hydrochloric acid, improve ulcer healing, and prevent recurrence, pharmacological control of acid secretion has been one of the strategies used over the years. Among the options available in the market for the treatment of peptic ulcers are H2 receptor antagonists, proton pump inhibitors and the use of antibiotics for the eradication of H. pylori. However, these drugs may promote not only a range of side effects, but also a lower efficacy in the treatment of ulcers, as well as the occurrence of relapses soon after discontinuation of treatment. Therefore, it is necessary to search for new therapeutic options for appropriate treatment of peptic ulcers from natural products. Eugenia punicifolia (Kunth) DC., a specie commonly found in the Amazon region and in the Cerrado, has be... (Complete abstract click electronic access below) / Doutor

Vulnerable older adults residing in nursing homes continue to experience poor care outcomes due to nurse staffing levels that are below the levels required for maintaining their well-being. Studies have shown that patient care outcomes in nursing homes are related to nurse staffing standards/levels, which are affected by profit maximization on adherence to registered nurses and licensed nurse staffing standards. The purpose of this descriptive study was to determine if there was a relationship between adherence to staffing standards and care outcomes in for-profit (FP) and not-for-profit religious-based (NFPRB) nursing homes using the profit maximization theory. Research questions focused on the relationships that profit maximization and nurse staffing standards had on the quality of care outcomes measures and the differences between the nursing homes on these variables. Secondary data were collected from public database and analyzed using the descriptive and inferential statistics, nonparametric tests, and binary logistic regression. Findings showed that profit measures were not related to staffing standards and care outcome measures in the NFPRB. There was a significant relationship between FP nursing homes and standards to care outcomes in FP but not in the NFPRB nursing homes. FP nursing homes did worse than NFPRB on care outcomes. Further research, using qualitative and mixed methodologies, is needed to study the effects of profit measures on nursing home care outcomes. The results of this study can effect positive social change by informing policy makers and healthcare professionals/leaders, and, by reducing adverse events, untimely death, and positively affecting the quality of care and life of the frail and vulnerable older adults residing in nursing homes.

<p>Bakgrund: När människor drabbas av venösa bensår kan vardagen drastiskt förändras. Ett stort antal individer drabbas av bensår och incidensen ökar med åldern. För att kunna ge en god omvårdnad behöver vårdpersonalen ökade kunskaper för att förstå bensårens inverkan på individens dagliga liv. Syfte: Syftet med studien var att beskriva hur det är att leva med venösa bensår. Metod: Studien utfördes som en allmän litteraturstudie. Fjorton empiriska studier ingick. Resultat: I samband med bensår förekommer en rad faktorer som på olika sätt påverkar det dagliga livet. Framträdande faktorer var smärta, svullna ben, lukt och läckage, rädsla och välbefinnande. Smärta var det funktionella hälsotillstånd som hade störst inverkan på det dagliga livet. Smärtan ledde till störd nattsömn, försämrad rörlighet och social isolering. Slutsats: Patienter med smärtsamma bensår har svårt att leva det liv som de önskar. Om distriktssköterskan synliggör sambandet mellan dagligt liv och funktionellt hälsotillstånd, kan specifika omvårdnadsåtgärder genomföras. Patienterna kan då uppnå ett önskvärt dagligt liv oavsett funktionellt hälsotillstånd.</p> / <p>Background: When people suffer from venous leg ulcers, their everyday life can be drastically changed. A large number of individuals suffer from leg ulcers and the incidences increase with age. In order to provide good nursing, care staff need more knowledge in order to understand the effects of the ulcers on the individual's daily life. Purpose: The purpose of this study was to describe what it is like to live with venous leg ulcers. Method: The study was carried out as a general literature review. Fourteen observational studies were included. Results: In connection with leg ulcers there are a number of factors that affect the patients’ daily lives in different ways. Important factors were pain, swollen legs, odor and leakage, fear and well-being. Pain was the functional state of health which had the greatest impact on daily life. The pain led to interrupted sleep, impaired mobility and social isolation. Conclusion: Patients with painful leg ulcers have difficulty living the life they desire. If the district nurse makes the connection between daily life and functional health status explicit, specific care measures can be implemented. Then patients can achieve a desirable everyday life regardless their functional state of health.</p>

<p>&nbsp / </p> <p align="left">Oral ulcers and oral thrush could be indicative of serious illnesses such as oral cancer, HIV and other sexually transmitted infections (STIs), among others. There are many different health care workers that can be approached for advice and/or treatment for oral ulcers and oral thrush (sometimes referred to as mouth sores by patients), including pharmacists. In fact, the mild and intermittent nature of oral ulcers and oral thrush may most likely lead the patient to present to a pharmacist for immediate treatment. In addition, certain aspects of access are exempt at a pharmacy such as long queues and waiting times, the need to make an appointment and the cost for consultation. Thus pharmacies may serve as a reservoir of undetected cases of oral cancer, HIV and other STIs. <b><font face="Times New Roman">Aim</font></b><font face="TimesNewRomanPSMT" size="3"><font face="TimesNewRomanPSMT" size="3"><font face="Times New Roman">: To determine how community pharmacists in the Western Cape manage </font>oral ulcers and oral thrush.</font></font></p>

Bakgrund: När människor drabbas av venösa bensår kan vardagen drastiskt förändras. Ett stort antal individer drabbas av bensår och incidensen ökar med åldern. För att kunna ge en god omvårdnad behöver vårdpersonalen ökade kunskaper för att förstå bensårens inverkan på individens dagliga liv. Syfte: Syftet med studien var att beskriva hur det är att leva med venösa bensår. Metod: Studien utfördes som en allmän litteraturstudie. Fjorton empiriska studier ingick. Resultat: I samband med bensår förekommer en rad faktorer som på olika sätt påverkar det dagliga livet. Framträdande faktorer var smärta, svullna ben, lukt och läckage, rädsla och välbefinnande. Smärta var det funktionella hälsotillstånd som hade störst inverkan på det dagliga livet. Smärtan ledde till störd nattsömn, försämrad rörlighet och social isolering. Slutsats: Patienter med smärtsamma bensår har svårt att leva det liv som de önskar. Om distriktssköterskan synliggör sambandet mellan dagligt liv och funktionellt hälsotillstånd, kan specifika omvårdnadsåtgärder genomföras. Patienterna kan då uppnå ett önskvärt dagligt liv oavsett funktionellt hälsotillstånd. / Background: When people suffer from venous leg ulcers, their everyday life can be drastically changed. A large number of individuals suffer from leg ulcers and the incidences increase with age. In order to provide good nursing, care staff need more knowledge in order to understand the effects of the ulcers on the individual's daily life. Purpose: The purpose of this study was to describe what it is like to live with venous leg ulcers. Method: The study was carried out as a general literature review. Fourteen observational studies were included. Results: In connection with leg ulcers there are a number of factors that affect the patients’ daily lives in different ways. Important factors were pain, swollen legs, odor and leakage, fear and well-being. Pain was the functional state of health which had the greatest impact on daily life. The pain led to interrupted sleep, impaired mobility and social isolation. Conclusion: Patients with painful leg ulcers have difficulty living the life they desire. If the district nurse makes the connection between daily life and functional health status explicit, specific care measures can be implemented. Then patients can achieve a desirable everyday life regardless their functional state of health.

The purpose of this study was to determine if the level of Nurse Manager (NM) emotional intelligence (EI) predicted registered nurse (RN) job satisfaction and RN perceptions of the practice environment. In addition, relationships to patient, nursing, and hospital outcomes were explored. Participants included RNs (N=659) and NMs (N=38) from 53 nursing units at eight hospitals located in the southeast region of the United States. A cross-sectional, correlational research design was used to test the hypotheses. Pearson product-moment correlation coefficients, simple linear and multiple regression statistics were conducted to analyze the data. Level of NM EI had a positive, not significant relationshp to RN job satisfaction and RN perceptions of the practice environment. A direct, positive significant relationship was observed between the variables NM EI and patient satisfaction with nursing care. There was a positive, significant relationship noted between the variables RN job satisfaction and RN perceptions of the practice environment. The indirect relationships between the level of NM EI and patient, nursing and hospital outcomes were not significant. There was a direct significant, positive relationship noted between the variables RN perceptions of the practice environment and patient satisfaction with nursing care. In addition, the interaction between RN job satisfaction and RN hours of care had a positive, significant relationship with unit level pressure ulcer rates. This study indicated that units with higher RN hours of care have increased pressure ulcer rates. In addition, results illustrate a marked increase in pressure ulcer rates on those units with higher levels of job satisfaction. In this study, pressure ulcer rates depended on the level of RN job satisfaction.

<p>&nbsp / </p> <p align="left">Oral ulcers and oral thrush could be indicative of serious illnesses such as oral cancer, HIV and other sexually transmitted infections (STIs), among others. There are many different health care workers that can be approached for advice and/or treatment for oral ulcers and oral thrush (sometimes referred to as mouth sores by patients), including pharmacists. In fact, the mild and intermittent nature of oral ulcers and oral thrush may most likely lead the patient to present to a pharmacist for immediate treatment. In addition, certain aspects of access are exempt at a pharmacy such as long queues and waiting times, the need to make an appointment and the cost for consultation. Thus pharmacies may serve as a reservoir of undetected cases of oral cancer, HIV and other STIs. <b><font face="Times New Roman">Aim</font></b><font face="TimesNewRomanPSMT" size="3"><font face="TimesNewRomanPSMT" size="3"><font face="Times New Roman">: To determine how community pharmacists in the Western Cape manage </font>oral ulcers and oral thrush.</font></font></p>

Made available in DSpace on 2014-12-17T14:46:44Z (GMT). No. of bitstreams: 1 DanieleVD_DISSERT.pdf: 1474768 bytes, checksum: 2c3fc77468bc489daec37da03412db3e (MD5) Previous issue date: 2010-09-03 / Universidade Federal do Rio Grande do Norte / Venous ulcers (VU), recurrent chronic wounds resulting from Chronic Venous Insufficiency (CVI), affect different age groups and would severely affect ambulation of patients. The lesions require treatment lasting and complex and are responsible for significant morbidity and mortality. Thus, this study aims to identify the important aspects covered in the scientific literature protocol for assisting patients with venous ulcers, identifying the issues to be proposed by the judges of the study (nurses, doctors and physiotherapists) to the protocol of care provided to patients venous ulcers and present the structure of protocol proposed by the judges of the study to assist patients with venous ulcers treated at a referral hospital of Rio Grande do Norte. This is a descriptive study using a quantitative approach, carried out at the dressings, located in the outpatient surgical clinic of the Hospital University Onofre Lopes (HUOL), located in East Sanitary District, Natal-RN. The sample consisted of 39 professionals, 30 nurses, seven doctors and two physical therapists, team members HUOL surgical clinic and other public and private institutions of Rio Grande do Norte and Jequi?/Bahia. These professionals were the judges responsible for selecting the guidelines already proposed in the literature on VU protocols. Approved by the Ethics in Research HUOL (Report n.o 081/07), began the first stage of the study which consisted of reviewing the scientific literature about the relevant aspects to be included in a protocol for assisting patients with VU. These aspects were organized into a proposed questionnaire to the judges of the study. Following examination, held on the content validation with application of the Kappa (K), accepting a score higher than 0.80 and the Likert Scale, whereas rates from 4.0 to 5.0. The data collected were organized in Microsoft Excel and exported into Statistical Package for Social Sciences (SPSS) 15.0. The literature review included national and international scientific articles, thesis, dissertation and institutional protocols. Regarding the characterization of professional nurses predominated (76.1%), between 34 and 45 years (41.0%), female (79.5%), married/consensual union (46.2%), with specialization in VU care (61.5%), working in the hospital network (46.1%), with up to 5 years experience in VU (69.2%) and claiming to feel prepared to care for these injuries (92.3 %). With regard to aspects that had very good agreement (K &#8805; 0.81), remained the items found in the literature with some modifications. In the analysis of the proposed evaluation items had very important, ranging from 4.1 (drug treatment) to 4.9 (patient assessment and care of the injury and the injured and perilesional skin). The proposition of the protocol is arranged in eleven items: A) Evaluation of patient and lesion, B) Registration and documentation, C) the wound and perilesional skin, D) an indication of coverage, E) Use of antibiotic and pain treatment, F) Surgical treatment of CVI, G) Drug treatment, H) Improving venous return and prevetion of recurrence, I) Referral of patients, J) Training and K) Reference and counter reference / As ?lceras venosas (UV), feridas cr?nicas recidivantes que resultam da Insufici?ncia Venosa Cr?nica (IVC), acometem diferentes faixas et?rias e repercutem de forma severa na deambula??o dos portadores. As les?es requerem tratamento duradouro e complexo e s?o respons?veis por morbi-mortalidade significativas. Diante disso, este estudo tem como objetivos identificar os aspectos relevantes da literatura cient?fica contemplados em protocolo para assist?ncia aos portadores de ?lceras venosas; identificar os aspectos a serem propostos pelos ju?zes do estudo (enfermeiros, m?dicos e fisioterapeutas) para o protocolo de assist?ncia aos portadores de ?lceras venosas e apresentar a estrutura de protocolo proposta pelos ju?zes do estudo para assist?ncia aos portadores de ?lceras venosas atendidos em um hospital de refer?ncia do Rio Grande do Norte. Trata-se de um estudo descritivo, com abordagem quantitativa, realizado no setor de curativos, situado no ambulat?rio de cl?nica cir?rgica do Hospital Universit?rio Onofre Lopes (HUOL), localizado no Distrito Sanit?rio Leste, em Natal-RN. A amostra foi composta por 39 profissionais, sendo 30 enfermeiros, 7 m?dicos e 2 fisioterapeutas, integrantes da equipe de cl?nica cir?rgica do HUOL e de outras institui??es p?blicas e privadas do Rio Grande do Norte e de Jequi?/Bahia. Esses profissionais foram os ju?zes respons?veis por selecionar as diretrizes j? propostas na literatura sobre protocolos de UV. Aprovado pelo Comit? de ?tica em Pesquisa do HUOL (Parecer n.o 081/07), iniciou-se a primeira etapa do estudo que consistiu na realiza??o de revis?o de literatura cient?fica acerca dos aspectos relevantes a serem contemplados em um protocolo para assist?ncia aos portadores de UV. Esses aspectos foram organizados em um question?rio proposto aos ju?zes do estudo. Ap?s aprecia??o, realizou-se a valida??o de conte?do com aplica??o do ?ndice Kappa (K), aceitando-se escore superior a 0,80 e da Escala de Likert, considerando ?ndices de 4,0 a 5,0. Os dados coletados foram organizados no Microsoft Excel e exportados para Statistical Package for Social Science (SPSS) 15.0. O levantamento da literatura contemplou artigos cient?ficos nacionais e internacionais, tese, disserta??es e protocolos institucionais. Quanto a caracteriza??o dos profissionais predominaram enfermeiros (76,1%), entre 34 e 45 anos (41,0%), sexo feminino (79,5%), casados/uni?o consensual (46,2%), com especializa??o na ?rea de cuidado a UV (61,5%), atuando na rede hospitalar (46,1%), com at? 5 anos de experi?ncia em UV (69,2%) e alegando sentir-se preparado para cuidar dessas les?es (92,3%). No que diz respeito aos aspectos que obtiveram concord?ncia ?tima (K &#8805; 0,81), permaneceram os itens encontrados na literatura com algumas modifica??es. Na an?lise dos aspectos propostos, os itens obtiveram avalia??o muito importante, variando de 4,1 (tratamento medicamentoso) a 4,9 (avalia??o do paciente e da les?o e cuidado com a ferida e a pele perilesional). A proposi??o do protocolo est? disposta em onze itens: A) Avalia??o do paciente e da les?o, B) Registro e documenta??o, C) Cuidado com a ferida e a pele perilesional, D) Indica??o de cobertura, E) Uso de antibi?tico e tratamento da dor, F) Tratamento cir?rgico da IVC, G) Tratamento medicamentoso, H) Melhoria do retorno venoso e preven??o de recidiva, I) Encaminhamento dos pacientes, J) Capacita??o profissional e K) Refer?ncia e contra-refer?ncia