Healing process of venous ulcers of difficult healing in treatment with an Unna's boot

Keywords: Wound Healing; Lower Extremity; Technology; Ulcer; Varicose Ulcer.

Abstract

Objective: to analyze the healing process of venous ulcers treated with an Unna’s boot. Methods: longitudinal study, prospective, with 14 individuals with chronic venous ulcers, followed at four different moments of time. Data collection was based on clinical and sociodemographic profile and clinical evaluation of the lesions. Data were analyzed using the Friedman test. Wilcoxon’s signed ranks test was used to compare means, and for multiple comparisons Bonferroni’s correction was used (p<0.05). Results: the Bonferroni post hoc test revealed a reduction in pain scores (p=0.038), amount of exudate (p=0.005) and dry border (p=0.044). Improvement in healing was observed by means of the Pressure Ulcer Scale for Healing (p=0.004) after use of the Unna boot between the first and fourth moments. Conclusion: there was a reduction in the Pressure Ulcer Scale for Healing indicators, pain, amount of exudate and dry border of the lesion in patients using Unna’s boot after four weeks. Contributions to practice: the need to manage indicators such as Pressure Ulcer Scale for Healing classification, pain, amount of exudate, and dry border based on the Unna Boot is highlighted.


References

Oliveira AS, Correia DL, Vasconcelos KVP, Ferreira SL, Silva FAA, Alexandre SG. Venous ulcer: characterization of outpatient care at a university hospital. Estima Braz J Enterostomal Ther. 2020;18:e2320. doi: https://doi.org/10.30886/estima.v18.928_PT

Souza AJG, Campos SMDL, Salvetti MG, Queiroz CG, Torres GV, Costa IF. Self-esteem of people with venous ulcers. Rev Rene. 2017;18(5):569-76.doi:https://dx.doi.org/10.15253/2175-6783.2017000500002

Cardoso LV, Godoy JMP, Godoy MFG, Czorny RCN. Compression therapy: unna boot applied to venous injuries: an integrative review of the literature. 2018;52:e03394. doi: https://dx.doi.org/10.1590/S1980-220X2017047503394

Castro-Ferreira R, Cardoso R, Leite-Moreira A, Mansilha A. The role of endothelial dysfunction and inflammation in chronic venous disease. Ann Vasc Surg. 2018;46:380-93. doi: https://doi.org/10.1016/j.avsg.2017.06.131

Kelly M, Gethin G. Prevalence of chronic illness and risk factors for chronic illness among patients with venous leg ulceration: a cross-sectional study. Int J Low Extrem Wounds. 2019;18(3):301-8. doi: https://doi.org/10.1177/1534734619850444

Alsaigh T, Fukaya E. Varicose veins and chronic venous disease. Cardiol Clin. 2021;39(4):567-81. doi: https://doi.org/10.1016/j.ccl.2021.06.009

Norman G, Westby MJ, Rithalia AD, Stubbs N, Soares MO, Dumville JC. Dressings and topical agents for treating venous leg ulcers. Cochrane Database Syst Rev. 2018;6(6):CD012583. doi: https://doi.org/10.1002/14651858.CD012583.pub2

Todd M. Compression therapy for chronic oedema and venous leg ulcers: CoFlex TLC calamine. Brit J Nurs. 2019;28(12):32-7. doi: https://doi.org/10.12968/bjon.2019.28.12.S32

Carvalho MR, Andrade IS, Abreu AM, Ribeiro APL, Peixoto BU, Oliveira BGRB. All about compression: a literature review. J Vasc Nurs. 2016;34(2):47-53.doi: https://doi.org/10.1016/j.jvn.2015.12.005

Danski MTR, Liedke DCF, Vayego SA, Pontes L, Lind J, Johann DA, et al. Unna boot technology in the healing of varicose ulcers. Cogitare Enferm. 2016;21(3):1-9. doi: https://dx.doi.org/10.5380/ce.v21i3.48803

Melo FA, Damasceno CAV, Medeiros ML, Fernandes RC, Mendonça ARA, Loyola ABAT. Microorganisms present after use of Unna’s boot from ulcers venous patient. Medicina (Ribeirão Preto) 2017;50(4):227-36. doi: https://doi.org/10.11606/issn.2176-7262.v50i4p227-236

Shi C, Dumville JC, Cullum N, Connaughton E, Norman G. Compression bandages or stockings versus no compression for treating venous leg ulcers. Cochrane Database Syst Rev. 2021; 2021(7):CD013397. doi: https://dx.doi.org/10.1002/14651858.cd013397.pu

Paranhos T, Paiva CSB, Cardoso FCI, Apolinário PP, Rodrigues RCM, Oliveira HC, et al. Systematic review and meta‐analysis of the efficacy of Unna boot in the treatment of venous leg ulcers. Wound Repair Regen. 2021;29(3):443-51. doi: https://doi.org/10.1111/wrr.12903

Santos VLCG, Azevedo MAJ, Silvia TS, Carvalho VMJ, Carvalho VF. Adaptação transcultural do Pressure Ulcer Scale for Healing (PUSH) para a língua portuguesa. Rev Latino-Am Enfermagem. 2005;13(3):305-13. doi: http://doi.org/10.1590/S0104-11692005000300004

Santos VLCG, Sellmer D, Massulo MME. Inter rater reliability of Pressure Ulcer Scale for Healing (PUSH) in patients with chronic leg ulcers. Rev Latino-Am Enfermagem. 2007;15(3): 391-6. doi: https://dx.doi.org/10.1590/S0104-11692007000300005

Abreu AM, Oliveira BGRB. A study of the Unna Boot compared with the elastic bandage in venous ulcers: a randomized clinical trial. Rev Latino-Am Enfermagem. 2015; 23(4):571-7. doi: https://doi.org/10.1590/0104-1169.0373.2590

Silva FLB, Melo GAA, Santos RC, Silva RA, Aguiar LL, Caetano JA. Assessment of pain in chronic renal failure patients going through hemodialysis. Rev Rene. 2020;21:e43685. doi: https://doi.org/10.15253/2175-6783.20202143685

Nunes CAB, Melo PG, Malaquias SG, Amaral KVÁ, Alves GR, Meira AA, et al. Effectiveness of two bundles in venous leg ulcer healing: a randomized controlled trial. J Vasc Nurs. 2019;37(4):232-45. doi: https://doi.org/10.1016/j.jvn.2019.09.004

Brown A. Managing exudate and maceration in venous leg ulceration within the acute health setting. Br J Nurs. 2017;26(20):18-24. doi: https://doi.org/10.12968/bjon.2017.26.Sup20.S18

Teixeira AKS, Silva LF, Silva ANC, Freire EDA, Menezes HKL, Farias MS, et al. Análises das produções científicas sobre cuidados de enfermagem a pessoas com úlcera venosa: revisão integrativa. Rev Enferm Atual In Derme. 2019;88(27):1-12. doi: https://doi.org/10.31011/reaid-2019-v.89-n.27-art.477

Teixeira AKS, Silva LF, Oliveira ACA, Menzes HKL, Fernandes SS, Silva ANC, et al. Cuidado clínico de enfermagem à pessoa com Úlcera Venosa fundamentado na teoria de Imogene King. Rev Enferm Atual In Derme. 2019;88(26):1-8. doi: https://doi.org/10.31011/reaid-2019-v.88-n.26-art.385

Published
2022-07-19
How to Cite
Sousa, Érica do N., Alexandre, S. G., Silva, R. A., Araújo, T. M. de, Martins, M. G., & Caetano, J. Áfio. (2022). Healing process of venous ulcers of difficult healing in treatment with an Unna’s boot. Rev Rene, 23, e72429. https://doi.org/10.15253/2175-6783.20222372429
Section
Research Article