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      Terapia compresiva para el tratamiento de úlceras venosas: una revisión sistemática de la literatura Translated title: Terapia compressiva para o tratamento de úlceras venosas: uma revisão sistemática da literatura Translated title: Compression therapy for venous leg ulcers: a systematic review of the literature

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          Abstract

          Resumen Objetivo Identificar artículos indexados que tienen que ver con el uso de la terapia de compresión elástica o inelástica como propuesta terapéutica para los pacientes con úlceras venosas. Métodos Revisión sistemática de búsqueda bibliográfica en las bases de datos electrónicas Medline / Pubmed; Medline y Journals @ Ovid / Ovidio; CINAHL; Lilas y Cochrane, las estrategias de búsqueda utilizan los siguientes descriptores y palabras clave: leg ulcer; varicose ulcer; bandage; "stockings, compression"; venous ulceration; venous ulcer; compressive therapy; compression therapy; stocking. Resultados La búsqueda arrojó 25 artículos. El uso del vendaje con compresión fue más eficaz que el vendaje sin compresión. Los vendajes multicapa contribuyen a la curación de las úlceras venosas. El uso de medias de compresión y la cirugía correctora del flujo sanguíneo están asociados con la prevención de la recurrencia de las úlceras. Conclusión El tratamiento de las úlceras venosas utilizando algún tipo de compresión fue eficaz en el proceso de curación.

          Translated abstract

          Resumo Objetivo Identificar artigos indexados que tratam do uso da terapia compressiva elástica ou inelástica como proposta terapêutica para pacientes com úlceras venosas. Método Revisão sistemática de literatura com busca nas bases de dados eletrônicas Medline/Pubmed; Medline e Journals@Ovid/Ovid; Cinahl; Lilacs e Cochrane, a estratégias de busca utilizou os seguintes descritores e palavras-chave: leg ulcer; varicose ulcer; bandage; "stockings, compression"; venous ulceration; venous ulcer; compressive therapy; compression therapy; stocking. Resultados A busca resultou em 25 artigos. O uso de bandagem com compressão mostrou-se mais eficaz que a bandagem sem compressão. Bandagens com multicamadas contribuem para a cicatrização das úlceras venosas. O uso da meia elástica e cirurgia corretora do fluxo sanguíneo estão associadas à prevenção da reincidência das úlceras. Conclusão O tratamento de úlceras venosas utilizando algum tipo de compressão mostrou-se eficiente no processo de cicatrização.

          Translated abstract

          Abstract Aim To identify indexed articles that deal with the use of elastic or inelastic compression therapy as a therapeutic approach for patients with venous leg ulcers. Methods Systematic review of literature search in the electronic databases Medline/Pubmed; Medline and Journal @Ovid / Ovid; CINAHL; Lilacs and Cochrane, the search strategies used the following descriptors and keywords: leg ulcer; varicose ulcer; bandage; "Stockings, compression"; venous ulceration; venous ulcer; compressive therapy; compression therapy; stocking. Results The search yielded 25 articles. The use of bandage compression was more effective than the bandage without compression. Bandages multilayer contribute to the healing of venous ulcers. The use of compression stockings and blood flow brokerage surgery are associated with the prevention of recurrence of ulcers. Conclusion The treatment of venous ulcers using some type of compression was effective in the healing process.

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            Comparison of surgery and compression with compression alone in chronic venous ulceration (ESCHAR study): randomised controlled trial.

            Chronic venous leg ulceration can be managed by compression treatment, elevation of the leg, and exercise. The addition of ablative superficial venous surgery to this strategy has not been shown to affect ulcer healing, but does reduce ulcer recurrence. We aimed to assess healing and recurrence rates after treatment with compression with or without surgery in people with leg ulceration. We did venous duplex imaging of ulcerated or recently healed legs in 500 consecutive patients from three centres. We randomly allocated those with isolated superficial venous reflux and mixed superficial and deep reflux either compression treatment alone or in combination with superficial venous surgery. Compression consisted of multilayer compression bandaging every week until healing then class 2 below-knee stockings. Primary endpoints were 24-week healing rates and 12-month recurrence rates. Analysis was by intention to treat. 40 patients were lost to follow-up and were censored. Overall 24-week healing rates were similar in the compression and surgery and compression alone groups (65% vs 65%, hazard 0.84 [95% CI 0.77 to 1.24]; p=0.85) but 12-month ulcer recurrence rates were significantly reduced in the compression and surgery group (12% vs 28%, hazard -2.76 [95% CI -1.78 to -4.27]; p<0.0001). Adverse events were minimal and about equal in each group. Surgical correction of superficial venous reflux reduces 12-month ulcer recurrence. Most patients with chronic venous ulceration will benefit from the addition of simple venous surgery.
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              Long term results of compression therapy alone versus compression plus surgery in chronic venous ulceration (ESCHAR): randomised controlled trial.

              To determine whether recurrence of leg ulcers may be prevented by surgical correction of superficial venous reflux in addition to compression. Randomised controlled trial. Specialist nurse led leg ulcer clinics in three UK vascular centres. 500 patients (500 legs) with open or recently healed leg ulcers and superficial venous reflux. Compression alone or compression plus saphenous surgery. Primary outcomes were ulcer healing and ulcer recurrence. The secondary outcome was ulcer free time. Ulcer healing rates at three years were 89% for the compression group and 93% for the compression plus surgery group (P=0.73, log rank test). Rates of ulcer recurrence at four years were 56% for the compression group and 31% for the compression plus surgery group (P<0.01). For patients with isolated superficial reflux, recurrence rates at four years were 51% for the compression group and 27% for the compress plus surgery group (P<0.01). For patients who had superficial with segmental deep reflux, recurrence rates at three years were 52% for the compression group and 24% for the compression plus surgery group (P=0.04). For patients with superficial and total deep reflux, recurrence rates at three years were 46% for the compression group and 32% for the compression plus surgery group (P=0.33). Patients in the compression plus surgery group experienced a greater proportion of ulcer free time after three years compared with patients in the compression group (78% v 71%; P=0.007, Mann-Whitney U test). Surgical correction of superficial venous reflux in addition to compression bandaging does not improve ulcer healing but reduces the recurrence of ulcers at four years and results in a greater proportion of ulcer free time. Current Controlled Trials ISRCTN07549334 [controlled-trials.com].
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                Author and article information

                Journal
                eg
                Enfermería Global
                Enferm. glob.
                Universidad de Murcia (Murcia, Murcia, Spain )
                1695-6141
                2017
                : 16
                : 45
                : 574-633
                Affiliations
                [1] Niterói Rio de Janeiro orgnameUniversidade Federal Fluminense Brazil magalirecar@ 123456gmail.com
                [2] Niterói Rio de Janeiro orgnameUniversidade Federal Fluminense orgdiv1Escuela de Enfermería Aurora de Afonso Costa Brazil
                Article
                S1695-61412017000100574 S1695-6141(17)01604500574
                10.6018/eglobal.16.1.237141
                c67302a7-ef1d-4f8b-a7a9-ab423f801f13

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 International License.

                History
                : 13 September 2015
                : 18 December 2015
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 41, Pages: 60
                Product

                SciELO Spain

                Categories
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                Cuidados de enfermagem,Varicose ulcer,Nursing care,Enfermagem baseada em evidências,Úlcera varicosa,Cuidados de enfermería,Enfermería basada en la evidencia,Evidence-based nursing

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