Venous ulcer: characterization of outpatient care at a university hospital

Objective: To characterize the clinical and sociodemographic profile of people with venous ulcers followed up in a specialized outpatient clinic of a university hospital. Method: documentary study carried out in a general surgery outpatient clinic of a university hospital. 104 instruments applied in the first nursing consultation were reviewed. Results: there was a predominance of females, with a mean age of 54 years. The majority did not perform paid work, the wound being the reason for leaving work activities. Systemic arterial hypertension and obesity were the most prevalent comorbidities. The person with venous ulcer was the main person involved in direct care of the wound. Conclusion: the profile of the study population is compatible with other studies in different contexts in Brazil. The results allow a reflection on the assistance provided and the effectiveness of the implemented interventions. con una edad media de 54 años. La mayoría no realizó trabajo remunerado, la la dejó las actividades laborales. La hipertensión la las comorbilidades La persona con úlcera venosa fue la involucrada en el cuidado directo de la herida. Conclusión: El perfil de la población de estudio es compatible con otros estudios en diferentes contextos en Brasil. Los resultados permiten reflexionar sobre la asistencia brindada y la efectividad de las intervenciones implementadas.


INTRODUCTION
Ulcers of venous etiology are the most common ulcers of the lower limbs, accounting for approximately 80 to 90% of these wounds 1  Activities of daily living can be compromised due to pain, mobility difficulties and decreased productivity.
This often results in removal from the work environment and disability pensions for people of working age.
Social relationships can also be affected, especially in individuals whose wounds have abundant exudation and odor, resulting in social isolation, low self-esteem and feeling of hopelessness regarding treatment 4

RESUMEN
Objetivo: caracterizar el perfil clínico y sociodemográfico de las personas con úlceras venosas seguidas en una consulta externa especializada de un hospital universitario. Métodos: estudio documental realizado en una consulta externa de cirugía general de un hospital universitario. Se revisaron 104 instrumentos aplicados en la primera consulta de enfermería. Resultados: Predominó el sexo femenino, con una edad media de 54 años. La mayoría no realizó trabajo remunerado, siendo la herida la razón por la que dejó las actividades laborales. La hipertensión arterial sistémica y la obesidad fueron las comorbilidades más prevalentes. La persona con úlcera venosa fue la persona principal involucrada en el cuidado directo de la herida. Conclusión: El perfil de la población de estudio es compatible con otros estudios en diferentes contextos en Brasil. Los resultados permiten reflexionar sobre la asistencia brindada y la efectividad de las intervenciones implementadas. for cleaning the wound, followed by soap and water (11.5%; 11) ; in the other medical records (11.5%; 11) there was no record about the product used to clean the wound.    In people with diabetes the healing process is slowed down. Some mechanisms identified as important factors for delayed healing are: excessive production of reactive oxygen species (ROS), decreased nitric oxide (NO) and decreased response to growth factors. Excessive ROS production is a primary factor that contributes to impaired healing. NO reduction impairs angiogenesis and cell mobilization to the wound bed 12 .

DISCUSSION
In an integrative review conducted by Almeida et al. The presence of an effective support network, such as the help of a partner or family member, is an important ally for caring for VUs, as it helps in facing difficulties and acts as a facilitating agent in the treatment process, which can positively influence adherence to appropriate conducts 3,10 .
Due to changes inherent to aging, such as reduced bone density, muscle mass and strength, as well as a progressive decrease in visual and auditory acuity, the elderly person has greater fragility and difficulties to perform some daily activities 13 . In this sense, the performance of the dressing itself by the elderly is not such a simple task to be performed and can contribute to the greater risk of imbalance and falls. The presence of a family member or caregiver when performing the dressing is important, as it helps in better performing the procedure, as well as reducing the risk of falls and other accidents to which the elderly are exposed when alone.
Adherence to treatment is one of the factors responsible