Estima – Brazilian Journal of Enterostomal Therapy
The Brazilian Journal of Enterostomal Therapy – Revista Estima, is the only specialized journal in Stomatheraphy Nursing in Latin America, classified as Qualis B1 by the Comissão de Aperfeiçoamento de Pessoal do Nível Superior (CAPES), and is indexed in the following databases: BDENF - Base de dados de enfermagem (BVS – Biblioteca Virtual de Saúde), LILACS - Literatura Latino-Americana e do Caribe em Ciências da Saúde, CINAHL - Cumulative Index to Nursing and Allied Health Literature, CUIDEN - Base de Datos Bibliográfica de la Fundación Index, EBSCO publishing, LATINDEX - Sistema regional de información en línea para revistas científicas de América Latina, el Caribe, España y Portugal, SCHOLAR GOOGLE and Sumarios.org. Its scope contemplates the three comprehensive areas of the specialty: ostomies, wounds, and incontinence, as well as articles related to the professional development of the specialist. It is edited and produced by the Associação Brasileira de Estomaterapia: Estomias, Feridas e Incontinências (SOBEST), its first number was published in 2003, with a regular quarterly period until 2017. The content has been published continuously since January 2018.
SOBEST- Associação Brasileira de Estomaterapia
The enterostomal therapy nurse and artificial intelligence: ethics, clinical judgment and decision-making
Objective: To analyze how the incorporation of artificial intelligence into enterostomal therapy influences clinical judgment, decision-making, and the ethical foundations of specialized care. Method: A theoretical essay based on a critical analysis of recent scientific literature on artificial intelligence in healthcare, with an emphasis on generative models, computer vision systems, bioethics, and data protection. Results: Artificial intelligence enhances analytical capacity and assessment accuracy but introduces risks related to uncritical reliance on automated recommendations, reduced patient autonomy, and the inappropriate handling of sensitive data, particularly clinical images. Conclusion: Artificial intelligence can contribute to safer, higher-quality decisions when used as a support tool under human supervision, clinical discernment, and ethical responsibility, reaffirming the role of the enterostomal therapy nurse as a critical interpreter of technology and a guardian of autonomy, privacy, and humanized care.
Copyright (c) 2026 Edson Maruyama Diniz https://creativecommons.org/licenses/by/4.0
Biometric Skin parameters in Individuals with Diabetes Mellitus: moisture, oiliness, elasticity, and pH
Objective: To assess, through skin biometry, skin moisture, elasticity, oiliness, and pH in individuals with type 1 and type 2 diabetes mellitus. The evaluated regions included the forearm, palm and dorsum of the hands, leg, heel, and dorsum and plantar surface of the feet. The examination was performed before and after the use of a 10% urea-based cream. Method: This was an exploratory, longitudinal clinical study with a before-and-after design and no control group, conducted in primary healthcare units in the city of Pouso Alegre, Minas Gerais, Brazil. Thirty-four individuals participated in the study. Measurements were performed on days 0, 5, and 10 using the Digital Skin Analyser and a pH meter, model 6118 (Fujian WatapproveElectronic), following the application of a 10% urea cream. Results: The evaluated regions exhibited significant changes on different days of assessment. A marked improvement in skin elasticity and in the overall balance of cutaneous parameters was observed following the use of the cream. Conclusion: After 10 days of use of the 10% urea cream, skin biometry indicated improvements in moisture, oiliness, elasticity, and pH across the evaluated areas, demonstrating greater skin balance compared with the first day of assessment and supporting the applicability of the product as a simple and beneficial skincare measure.
Copyright (c) 2026 LUIZ AUGUSTO MOTA LINO https://creativecommons.org/licenses/by/4.0
Practices and challenges in the care provided to hospitalized patients with wounds in an Emergency Care Unit
Objective: To understand the care provided by nurses to patients with wounds who, while hospitalized in an Emergency Care Unit (UPA), await transfer to a referral hospital. Methods: This was a qualitative, exploratory, and descriptive study conducted in a virtual environment between February and March 2025 with nurses working in a UPA. Data collection was carried out through semi-structured interviews, and data analysis was performed using the Collective Subject Discourse method. Results: Thirteen nurses participated in the study, most of whom were female, with a mean age of 41 years, 15.9 years of professional experience, and 6 years of experience in the sector. Care provided to patients with wounds hospitalized in the UPA was characterized as a complex and challenging phenomenon influenced by multiple factors — overcrowding, prolonged patient stays, increased demands, nurses’ workload burden, provision of care without adequate supervision, gaps in professional training, and noncompliance with current legislation — all of which directly compromise the quality and safety of the care provided. Conclusion: The prolonged stay of patients in UPAs changes the care profile and poses challenges to nursing care for individuals with hard-to-heal wounds, within a context of work overload and structural limitations.
Copyright (c) 2026 Gismay Rodrigues de Freitas, Melissa Godinho de Andrade, Silmar Maria da Silva https://creativecommons.org/licenses/by/4.0
Treating peristomal irritant dermatitis with low-level laser therapy: a case report
Objective: To report the clinical case of a patient with an ileostomy who underwent Low-Level Laser Therapy (LLLT) for the treatment of peristomal dermatitis. Method: This is a case study conducted in an ostomy care service in southern Brazil in 2025, following the Case Report (CARE) guidelines of the Enhancing the Quality and Transparency of Health Research. Data were collected during 11 outpatient consultations, including clinical assessment of the peristomal lesion, measurement with a ruler, serial photographic records, and analysis of the electronic medical record. Results: A 28-year-old female patient, diagnosed with cervical cancer in 2024, was treated with radiotherapy and brachytherapy. She subsequently developed actinic colitis, rectal stenosis, and a rectovaginal fistula, requiring an ileostomy. The patient presented with peristomal dermatitis, pain, weakness, and difficulty in securing the ostomy appliance. Treatment with LLLT was initiated, resulting in progressive improvement of the skin condition and better adhesion of the ostomy appliance. Throughout follow-up, cutaneous recovery was observed, with reduction of dermatitis and improvement in overall condition. Conclusion: LLLT proved effective in the treatment of peristomal dermatitis in a patient with an ileostomy, promoting rapid skin recovery, improved adhesion of the ostomy appliance, and relief of symptoms. The intervention significantly contributed to the patient’s rehabilitation and quality of life, highlighting its importance as a complementary resource in ostomy care.
Copyright (c) 2026 Cristhiane de Souza Silveira, Rosaura Soares Paczek, Vania Celina Dezoti Micheletti, Luciani Aparecida da Silva Melo https://creativecommons.org/licenses/by/4.0
Mesenchymal stromal cells suspended in a platelet lysate gel improve wound healing in mice
Objective: To assess the safety and efficacy of topical wound treatment with mesenchymal stromal cells derived from bone marrow cultured and suspended in platelet lysate. Method: A prospective, interventional, controlled study was conducted with 42 C57BL/6 mice with induced excisional wounds. They were divided into four treatment groups: hydrogel (standard wound treatment), saline gel (control), platelet lysate gel, and platelet lysate gel containing mesenchymal stromal cells. Immunohistochemistry analyses were performed on day 7 (n=5) and day 13 (n=7), and safety on day 21 (n=30). Follow-up was conducted through clinical (adverse events, weight, pain, behavior, wound size reduction) and histological (healing, vascularization, collagenization) assessments. Results: Regarding safety, no adverse events or physiological changes related to the treatment were identified. The group treated with cells showed better results in wound healing through macro and microscopic assessments, followed by the platelet lysate gel group. Conclusion: The topical application of mesenchymal stromal cells was safe and showed favorable results.
Copyright (c) 2026 Luciana da Rosa Zinn Sostizzo, Raul Rodrigues, Tuane Nerissa Alves Garcez, Victor de Mello Palma, Annelise Martins Pezzi da Silva, Vanessa de Souza Valim, Ana Helena da Rosa Paz, Anelise Bergmann Araujo, Alessandra Aparecida Paz, Lucia Silla https://creativecommons.org/licenses/by/4.0
Impacts of a psychoeducational group on the self-care of people with ostomies
Objective: To analyze the perceptions of individuals with elimination ostomies regarding the repercussions of participating in a psychoeducational group aimed at strengthening self-care. Method: This qualitative, descriptive, and exploratory study included thirteen individuals with elimination ostomies who participated in a psychoeducational group developed in a specialized stomatherapy clinic affiliated with a public higher education institution in the state of Rio de Janeiro. Data were collected through semi-structured interviews conducted either in person or by telephone, according to participants’ preferences, and were subjected to thematic content analysis. Results: Before joining the group, participants reported experiences marked by negative and traumatic feelings related to the ostomy, difficulties in managing collection devices and accessories, limitations in self-care, and limited psychosocial support. After participation in the psychoeducational group, positive transformations were observed, including increased knowledge, greater confidence in self-care, strengthened autonomy, reframing of the ostomy experience, and a perceived improvement in quality of life. Conclusion: Participation in the psychoeducational group proved to be an effective strategy for strengthening self-care and autonomy among individuals with elimination ostomies by promoting emotional support, exchange of experiences, and access to reliable information, thereby contributing to adaptation to the ostomy condition and to comprehensive care.
Copyright (c) 2026 Daniele Pinto Freire, Priscila Francisca Almeida, Carolina Cabral Pereira da Costa, Caroline Rodrigues de Oliveira, Patrícia Britto Ribeiro de Jesus, Norma Valéria Dantas de Oliveira Souza https://creativecommons.org/licenses/by/4.0
Prevalence and factors associated with incontinence-associated dermatitis in Pediatric Units
Objective: To estimate the prevalence of and factors associated with the occurrence of incontinence-associated dermatitis (IAD) in children. Method: This observational, cross-sectional study used a quantitative approach and electronic medical record data. It included data from patients aged 0 to 14 years who had been hospitalized for at least 24 hours in pediatric units of a tertiary hospital in the state of São Paulo, Brazil, between January 2021 and December 2022. Descriptive analysis and Poisson regression models were used. Results: The sample consisted of 297 patients with some type of skin lesion, of whom 31.9% (n=95) had IAD. Significant associations were identified between IAD and age, type of hospitalization, comorbidities, medications acting on the cardiovascular system, systemic anti-infective agents, vitamins, and diaper use. The likelihood of developing IAD was 1.87 times higher among patients with preexisting comorbidities, 3.98 times higher among those receiving anti-infective agents, and 2.79 times higher among those using diapers. Conclusion: The prevalence of IAD was 31.9%. Therefore, identifying associated factors is essential for planning preventive strategies aimed at reducing the risk and occurrence of IAD.
Copyright (c) 2026 Rafaella Manhoni Lima de Miranda, Denise Desconsi, Angelo Antonio Paulino Martins Zanetti, Meire Cristina Novelli e Castro, Anna Paula Ferrari, Ana Paula Pinho Carvalheira, Clarita Terra Rodrigues Serafim https://creativecommons.org/licenses/by/4.0
Health technologies for the education of individuals with intestinal stoma: a scoping review
Objective: To map the scientific evidence related to health technologies aimed at the education of adults and older adults with intestinal stoma in the hospital setting. Method: A scoping review conducted in accordance with the recommendations of the JBI and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses – extension for Scoping Reviews. Studies conducted by nurses, in any language, without time restrictions, and with different methodological designs were included. Searches were carried out in five databases. Data were based on thematic and statistical analyses. Results: The studies highlighted multiple technologies for individual education, such as verbal instructions, printed textual materials, multimedia resources, demonstrations, and hands-on practices focused on self-care, etc. Conclusion: The technologies adopted for the development of the teaching-learning process are organized in diverse formats. These tools are essential for disseminating knowledge and promoting self-care, contributing to improvements in the context of health promotion, prevention, and rehabilitation. This study provided a synthesis of existing educational resources, supporting nursing professional practice through the mapping and analysis of their applications.
Copyright (c) 2025 Gustavo Assis Afonso, Daniele Monteiro de Jesus Maldonado, Lana de Medeiros Escobar, Thayná Ferreira Dias, Norma Valéria Dantas de Oliveira Souza, Carolina Cabral Pereira da Costa https://creativecommons.org/licenses/by/4.0
Educational program for self-care training in the postoperative period for individuals with urostomy
Objective: To describe the process of developing and validating the content of an educational program for training in urostomy self-care, based on scientific evidence, and present an initial feasibility test of its clinical application. Method: The program was developed based on nursing interventions identified in a scoping review and submitted for content validation to a panel of six wound, ostomy, and continence-certified nurses using the Delphi method. Subsequently, its operationalization was assessed through an exploratory feasibility test (single-case study), with data collected for process monitoring using the Urostomy Education Scale (UES). Results: The scoping review identified 114 nursing interventions, supporting the development of a structured educational program comprising five sessions. After its elaboration, it was submitted to a validation process, obtaining a certified nurse agreement rate of 0.8. The feasibility test demonstrated the program's operationalization and the UES's sensitivity in monitoring self-care progression (from deficit to autonomy), confirming the relevance of the intervention algorithm for situations of skills stagnation. Conclusion: The developed and validated educational program is a relevant tool for systematizing clinical practice. The feasibility test demonstrated its potential in promoting patient autonomy and monitoring the training process.
Copyright (c) 2026 Nádia Filipa Carvalho Pégo Marques https://creativecommons.org/licenses/by/4.0
Radiodermatitis in older patients with head and neck cancer
Objective: To analyze the incidence of radiodermatitis in older individuals with head and neck cancer undergoing radiotherapy. Method: Observational, prospective, quantitative study. The study included patients aged 60 years or older with head and neck cancer who underwent radiotherapy. Patients were monitored daily during radiotherapy sessions. Skin was assessed using the Acute Radiodermatitis Grading scale, and the occurrence of radiodermatitis and associated signs and symptoms in the irradiated area and skin hydration were recorded. Results: Thirty-three participants were monitored, who were submitted to an average of 33 radiotherapy sessions. Radiodermatitis occurred in 93.9% of participants, with an average dose of 34.7 Gy of ionizing radiation. Symptoms of heat, burning, itching, dry skin, and pain, present in 68% of participants, were reported most often in the fifth week of radiotherapy. Regarding skin hydration, most participants showed a marked imbalance, characterized by low moisture and oiliness. Conclusion: Most patients monitored displayed signs and symptoms of radiodermatitis during radiotherapy sessions. Nurses play a fundamental role in assessing, monitoring the skin, and providing health education on skin care for older patients during radiotherapy, aiming to prevent signs and symptoms of radiodermatitis.
Copyright (c) 2025 Amanda Gomes de Menêses, Luana Alves de Oliveira, Elaine Barros Ferreira, Paula Elaine Diniz dos Reis, Fatima Helena do Espírito Santo https://creativecommons.org/licenses/by/4.0
Pilot study on the applicability and functionality of an ileostomy catheter: experience report
Objective: To report a pilot study analyzing the applicability and functionality of an ileostomy catheter. Method: This is an experience report on the applicability and functionality of the catheter during insertion, in directing the effluent to a temporary collecting device, and in stabilization. Data were collected through systematic observation and video recording of one adult participant. Results: The innovative product, named the TomJeff® catheter, was inserted without difficulty; the effluent was directed to the temporary collecting device; and the catheter remained stable. The participant reported discomfort, pain, cramping, and fear from the period prior to insertion through removal; however, all symptoms were tolerated. Video recording allowed documentation of behaviors, expressions, and interactions, providing rich data and enabling review of all stages; however, it reduced spontaneity. Conclusion: The study enabled the identification of necessary adjustments to the catheter and validated its feasibility. Although it does not allow for generalizations, the results provide valuable support for the next steps of the research. The modifications made to the device, including resizing the catheter to facilitate insertion, demonstrate how technological development aligned with clinical practice can contribute to improving the user experience.
Copyright (c) 2026 Thomaz Jefferson Massaneiro, Fernanda Broering Gomes Torres, Sabrina do Rocio Kopietz, Mariane Mota Dhein, Marcia Regina Cubas https://creativecommons.org/licenses/by/4.0
ERRATUM: Epidemiological, sociodemographic, and clinical aspects of individuals with chronic skin lesions in an enterostomal therapy service
Copyright (c) 2025 https://creativecommons.org/licenses/by/4.0
Newborn skin care practices performed by parents or caregivers: a survey study
Objective: To analyze the skin care practices of healthy full-term newborns performed by parents and/or caregivers. Method: This is a descriptive, analytical, and cross-sectional study. The sample consisted of 72 parents or caregivers of newborns from five Basic Health Units. A specific questionnaire containing questions about sociodemographic data and newborn skin care practices was constructed and validated in content. The association between the variables was performed using the Shapiro-Wilk test and Fisher's exact test, considering a significance level of 5%. Results: Of the 72 parents or caregivers included in the study, the majority (91.7%) were women, with a mean age of 37.8 years (SD=12.2). Regarding skin care practices, 95.8% usually observe the newborn's skin. For body hygiene, 55.6% reported using soap. When caring for the umbilical stump, most people use 70% alcohol, especially after bathing (36.6%). In the perianal region, most people use some product to clean the area (36.1%), and 86.1% use cream or ointment to protect this region. Conclusion: It was found that the practices of parents and/or caregivers are diverse and are not always consistent with the recommendations of scientific evidence.
Copyright (c) 2025 Rosimar Cabral Coelho, Marcia Ferreira Correa de Oliveira, Mily Constanza Moreno Ramos https://creativecommons.org/licenses/by/4.0
Profile analysis and hospitalization outcomes in critically ill patients with pressure ulcers
Objective: To describe the clinical profile of patients who developed pressure ulcers (PU) during intensive care in a cardiology unit and to identify the factors associated with discharge and death outcomes. Method: Observational, retrospective cohort study. Patients who developed PU during their stay in the intensive care units (ICUs) of a philanthropic hospital in São Paulo and were recorded in the database from January 2018 to June 2020 were included. The study was approved by the institution’s Research Ethics Committee. Fisher’s Exact Test, Student’s t-test, and Pearson’s ꭓ2 test were used to assess the associations, with a significance level of 0.05. Results: Among 456 critically ill patients evaluated, 51 developed PU in the ICU, with a prevalence of 11%. The sample consisted of 84.3% male patients, with a mean age of 75.8 years (SD=13.6). Sacral PU were present in 70.5% of the cases. Nutritional risk, SAPS 3 score, length of ICU stays, capillary refill time, age, and RASS score showed significant correlations with death as an outcome. Conclusion: Clinical factors correlated with death outcomes were identified in critically ill patients who developed PU in the ICU. As a clinical implication, the findings highlight the importance of guiding care teams to implement targeted care strategies for these patients.
Copyright (c) 2025 Isabela Gomes Musa dos Santos, Beatriz Santana Prado , Henrique Mateus Fernandes , Natalia Balestra , Karoline Razimavicius Barbado , Aline de Oliveira Ramalho https://creativecommons.org/licenses/by/4.0
Interprofessional strengths and weaknesses in the care of people with ostomies: a mixed-methods study
Objective: To analyze the activities of a secondary care team specialized in assisting individuals with elimination stomas, interpreting the distances and proximities with interprofessionality. Method: A mixed-method study conducted in a service for people with stomas in northern Brazil, involving 16 professionals. The descriptive qualitative phase was based on Émile Durkheim’s Social Facts, and utilized semi-structured interviews and field notes with reflective thematic analysis. The quantitative phase used a questionnaire survey designed by experts and descriptive percentage analysis. Results: A total of 31 activities were described, with low expressiveness of those that foster interprofessionality, such as reception, checking family dynamics, education in the waiting room, active search for vulnerable patients’ records, scheduling follow-up with social services, reviewing family dynamics, and addressing patients’ rights. Two topics were developed: (1) Operational aspects of (search for) interprofessionality: registration, management, active search, and referrals; and (2) Acquiring autonomy for social reintegration and moving away from self-care: collaborative elements in the journey from beginning to “restart”. Conclusion: Interprofessionality remains a distant work model; however, collaborative practices have begun to emerge through referrals. Emphasis on intersectionality and intersectorality is crucial to support the social reintegration of patients.
Copyright (c) 2025 Antonio Jorge Silva Correa Júnior, Pedro Emílio Gomes Prates, Mary Elizabeth de Santana, Fernando Conceição de Lima, André Aparecido da Silva Teles, Helena Megumi Sonobe https://creativecommons.org/licenses/by/4.0
Digital educational technologies for people with intestinal stoma: a technological prospect
Objective: To identify and analyze digital technologies developed to guide care for people with intestinal ostomies. Method: Technological prospecting conducted through documentary research conducted between March and September 2024. Data collection took place in patent registration databases, theses/dissertation repositories, and mobile app stores, including educational technologies in Portuguese, English, and Spanish, with no time or geographic limitations. Results: The results were organized into the following categories: software/hardware, mobile app, virtual environment, and educational video. Twelve productions were included: one patent, five theses/dissertations, and six mobile apps. The patent refers to software/hardware for postoperative care; the theses/dissertations resulted in an app prototype, an app, a virtual environment, and two educational videos. Conclusion: The conclusion is that, although still incipient, the digital technologies analyzed in this research, with an emphasis on mobile applications, which predominate over other technologies, have the potential to strengthen health education, self-care, and nursing practice. Furthermore, they represent innovative strategies for providing guidance on intestinal ostomy care.
Copyright (c) 2025 Kelin Müller , Juliana Balbinot Reis Girondi, Simone Vidal Santos, Gabriela Beims Gapski, Daniela Soldera https://creativecommons.org/licenses/by/4.0
Production and validation of a booklet on intestinal ostomy care for colorectal cancer patients
Objective: To produce and validate an educational booklet on intestinal ostomy care for patients with colorectal cancer. Method: A methodological study conducted in three stages: literature review, production of the booklet, and content and appearance validation by experts using the Content Validity Index (CVI). A convenience sample was utilized. Contact was made electronically, where the booklet and an assessment instrument containing 21 questions were sent, covering: objective, content, relevance, figures, writing style, and organization. The specialists evaluated whether items were: highly adequate, adequate, partially adequate, or totally inadequate. The study was approved by the Ethics Committee. Results: The booklet titled "Intestinal Ostomy Care" consists of 22 pages and 37 illustrations. The content addressed: colorectal cancer; care of the collection equipment; oncological treatment; social rights; psychological aspects; nutritional aspects; and physical activity. Twelve specialists responded. All 21 items were considered valid (CVI > 0.70); of these, 16 had a CVI = 1, 3 had a CVI = 0.9167, and 1 had a CVI = 0.75. Conclusion: The booklet was considered valid. The validation process provided the material with the methodological rigor necessary for its use in scientific environments and patient guidance. However, clinical validation with the target audience is suggested.
Copyright (c) 2025 Letícia Ellen Vieira Rocha, Filipe Monteiro de Oliveira, Helder Matheus Alves Fernandes, Rodrigo Lima Bandeira, Marcelo Leite Cavalcante, Andrezza Silvano Barreto, Viviane Mamede Vasconcelos Cavalcante, Manuela de Mendonça Figueirêdo Coelho https://creativecommons.org/licenses/by/4.0
Nursing Interventions for Biofilm Treatment and Control in People with Chronic Wounds
Objective: To map the actions performed by nurses related to the control and treatment of biofilm in individuals with chronic wounds. Method: Scoping review following the JBI guidelines. The search was performed across four databases, and Google Scholar (as a source of Gray Literature), using the PCC framework as inclusion criteria: Participants: People with chronic wounds; Concept: Biofilms in chronic wounds; Context: Nursing care, with no language or time frame restrictions. A total of 572 publications were identified and, after the eligibility criteria were applied by two independent reviewers, 20 studies were included in the review. Results: The studies selected, published between 2006 and 2021, were predominantly in English. Of these, nine were narrative reviews, two were randomized clinical trials, and one was a systematic review. The treatment and control actions identified included debridement techniques and use of products such as polyhexamethylene biguanide, silver, and iodine, as well as negative pressure wound therapy and ultrasound. Conclusion: The actions identified mainly focus on wound care without prioritizing a comprehensive assessment of the individual. Given the nature of the publications, there is a need for further research with more robust scientific evidence and a broader, more holistic approach to care.
Copyright (c) 2025 Giulia da Cunha Novais, Euzeli da Silva Brandão https://creativecommons.org/licenses/by/4.0
Use of Pessaries in Pelvic Organ Prolapse: An integrative review
Objective: To analyze the studies available in the literature on the use of pessaries for the treatment of pelvic organ prolapse. Method: Integrative review of the literature, carried out from May to September 2023, by consulting the databases: Medical Literature Analysis via PubMed, Latin American Literature in Health Sciences, Nursing Database: Brazilian Bibliography and Scientific Electronic Library Online via Virtual Health Library. Results: 174 articles were recovered, 06 of the BVS and 168 of Medline. 07 duplicated publications were removed and 140 were excluded because they did not respond to the research issue. Thus, 28 studies were eligible, 12 excluded because they did not meet the inclusion and exclusion criteria, and 15 were selected for the study. Conclusion: The use of vaginal pessaries not only represents an effective conservative approach, but also proves to be a significant ally in the preoperative context for the treatment of pelvic organ prolapse. Pessaries should be offered to patients as a first-line treatment, as they present low risks, improve symptoms almost immediately.
Francisca das Chagas Sheyla Almeida Gomes Braga
Copyright (c) 2025 Fernanda Karolina de Oliveira Gonçalves, Cláudia Daniella Avelino Vasconcelos, Francisca das Chagas Sheyla Almeida Gomes Braga, Marta Lira Goulart, Sabrina de Oliveira Carvalho, Vitória Pires Alencar https://creativecommons.org/licenses/by/4.0
Assessing perceived stress in people with hard-to-heal wounds: cases series
Objective: To exemplify the stress, distress, and coping assessment perceived by patients with hard-to-heal wounds (HHW) receiving treatment in a Stomatherapy outpatient clinic. Methods: Observational, prospective secondary study involved 10 adult patients with HHW, who were followed over two to six consultations. The following tools were used: sociodemographic and clinical data form; Brief Pain Inventory (sensitivity - BPI-S and interference - BPI-I); Bates-Jensen Wound Assessment Tool (BWAT); Perceived Stress Scale (PSS), which included measures of coping and distress with data expressed as means. Results: Patients primarily had HHW located on the lower extremities, with a duration of 21.2 months; BWAT score was 23.7; BPI-S was 4; and BPI-I was 3.2. Stress was characterized by a total PSS score of 28.5 points, with a distress score of 16.4 and a coping score of 16. In the final consultation, there was a decrease of 4.3 points in BWAT; 0.8 points in BPI-S; and 7.6 points in PSS, with a 5.3 point reduction in distress. The BPI-I increased by 0.7, and coping improved by 2.2. Conclusion: The wound seems to interfere with the level of perceived stress, i.e. the patient's biopsychosocial dimension. Coping stands out as a determining factor in the perception of stress, and a multidisciplinary approach is essential for its management and assessment of distress.
Copyright (c) 2025 Beatriz Costa Ferreira, Carol Viviana Serna González, Beatriz Yamada, Vera Lucia Conceição de Gouveia Santos https://creativecommons.org/licenses/by/4.0
Development and validation of an educational technology for the prevention and treatment of pressure injuries
Objective: To develop and validate an educational technology designed for patients, family members, and caregivers focused on the prevention and treatment of pressure injuries. Method: This methodological study was conducted in three stages: 1) an integrative review (IR) that guided the development of the technology’s content; 2) the development of a website-based educational tool; and 3) content validation by experts, valuating both the content and the technology itself. Regarding the integrative review stage, research was conducted using the databases of the Virtual Health Library (Portuguese Acronym: BVS), the Journal Portal of the Coordination for the Improvement of Higher Education Personnel (Portuguese Acronym: CAPES), and the Scientific Electronic Library Online (SciELO). Articles published between 2015 and 2019 were included. Experts for content evaluation were selected through convenience sampling, and validation was conducted using the Content Validity Index (CVI). Results: In the integrative review, ten articles and one guideline were selected. Two categories emerged from the analysis: pressure injury prevention and nutritional treatment, which guided the development of the educational technology titled “PreventPele”. The literature review also informed the development of care guidance tabs, a measurement scale, and sections on treatment-related products and technologies. Content validation was conducted by 12 expert judges, achieving a 95.2% agreement rate and an overall Content Validity Index (CVI) of 1. Conclusion: This study led to the development of an open-access website on pressure injury prevention designed for healthcare professionals, family members, and caregivers, offering validated, up-to-date, and high-quality information.
Copyright (c) 2025 Elisandra Leites , Patrícia Pedroso da Silva, Luisa Pavinatto, Juliano Teixeira Moraes, Sidiclei Machado Carvalho, Sandra Maria Cezar Leal https://creativecommons.org/licenses/by/4.0
Development of an interactive game for the evaluation, prevention, and treatment of incontinence-associated dermatitis
Objective: To develop and validate an educational game for the assessment, prevention, and treatment of IAD. Method: The game "IAD – Incontinence-Associated Dermatitis" is an applied research study with technological production. The process followed three stages: analysis, design, and validation. In the analysis phase, an integrative literature review was conducted to support the game's development, identifying assessment, prevention, and treatment measures for IAD. During the design phase, planning and construction of the didactic content were carried out, including topic selection, text development for each screen, media selection, and interface layout design. The validation phase involved 44 experts, using the Delphi technique and the Content Validity Index (CVI), ensuring a validated educational resource for clinical practice. Results: In the initial assessment, most evaluators rated the game from inadequate to fully adequate, with a CVI ranging from 86.36 to 95.45%. After incorporating improvement suggestions, the game was reassessed and rated between adequate and fully adequate, achieving a CVI of 99.99 to 100.00%. Conclusion: The game "IAD – Incontinence-Associated Dermatitis" was developed as an educational tool based on scientific evidence for the assessment, prevention, and treatment of IAD, with the potential to contribute to clinical practice.
Copyright (c) 2025 Geraldo Magela Salomé, Jéssica de Aquino Pereira, Catherinne Souza da Cruz Duarte https://creativecommons.org/licenses/by/4.0
Medical device–related pressure injury in an intensive care unit: an observational study
Objective: To analyze the incidence of Medical Device-Related Pressure Injury (MDRPI) in a general adult intensive care unit. Method: A cross-sectional study conducted in an intensive care unit of a university hospital in Rio de Janeiro, from May to September 2022. The sample consisted of 70 patients with at least one medical device. Patients readmitted during the study period were excluded. Data were collected starting on the third day of hospitalization and analyzed using Stata software. Results: The incidence of medical device–related pressure injury was 18.57%. The most affected site was the auricle (62%), and the device most frequently causing injury was the orotracheal tube (61.54%). No statistically significant associations were identified between sociodemographic and clinical characteristics and the occurrence of MDRPI among participants. A length of stay equal to or greater than 16 days increased the likelihood of this type of injury by sevenfold. Conclusion: The incidence of MDRPI in the investigated unit was related to patients’ length of stay. MDRPI risk assessment and skin integrity assessment at admission and on a daily basis are necessary, in addition to documenting the actions implemented in medical records.
Copyright (c) 2025 Julio Cesar Faustino Junior, Luana Ferreira de Almeida, Dayse Carvalho do Nascimento, Vanessa Galdino de Paula, Caroline de Deus Lisboa, Ayla Maria Farias de Mesquita https://creativecommons.org/licenses/by/4.0
Validation of educational technology for wound care in lower limbs
Objective: To develop and validate the Wound Diary for patients undergoing enterostomal therapy, focusing on chronic skin wounds in the lower limbs. Method: This was a methodological study. The evaluation followed a structured process of content and appearance validation to assess the appropriateness of the objectives, content, style, organization, and images of the material. Validation was conducted by expert judges in the field, who rated the diary based on relevance, clarity, and applicability. Data were analyzed using the Content Validity Index (CVI). Results: Validation indicated that the Wound Diary achieved a CVI higher than 0.75 and a Kappa coefficient above 0.63 across all evaluated criteria, demonstrating a high level of agreement among experts. These results showed the material’s adequacy and relevance for providing patients with pertinent information and encouraging self-care. Conclusion: The Lower Limb Wound Diary was considered valid by the experts, covering all assessed topics. Additionally, the study highlighted the relevance of integrating educational technologies and health education to meet the needs of patients with chronic skin lesions, improving their quality of life and promoting effective collaboration between patients and healthcare professionals.
Copyright (c) 2025 Tifanny Horta Castro, Camila Barroso Martins, Beatriz Alves de Oliveira, Thalia Alves Chagas Menezes, Victorya Leitão Lopes Teixeira, Nataly Pereira Pontes, Mariana Cavalcante Martins, Fabiane do Amaral Gubert, Manuela de Mendonça Figueirêdo Coelho, Viviane Mamede Vasconcelos Cavalcante https://creativecommons.org/licenses/by/4.0
Zero Callus Campaign: a strategy to prevent ulcers, amputations and death in people with Diabetes Mellitus
Copyright (c) 2025 Mariana Alves Bandeira, Vera Lucia Conceição de Gouveia Santos, José Luis Lázaro Martínez https://creativecommons.org/licenses/by/4.0
Development of a Nursing Care Protocol for Patients Undergoing Microsurgical Breast Reconstruction
Objective: To develop a nursing protocol for the care of patients undergoing microsurgical breast reconstruction. Method: This methodological study used a qualitative approach and adopted the Transitions Theory as its theoretical framework. The protocol development followed the criteria established by the Federal Nursing Council and the phases of Convergent Care Research, with the participation of three nurses and the use of data from 25 women. The International Classification for Nursing Practice (ICNP®) was used as the terminology system for documentation. Results: The protocol comprises 17 nursing diagnoses, 17 nursing outcomes, and 29 nursing interventions mapped according to the ICNP®. In addition, it includes guidance for the care of patients in the postoperative period following microsurgical breast reconstruction. Conclusion: The protocol is a technological tool with the potential to contribute to the field. Its use is expected to enhance patient safety by preventing complications and hospital readmissions. The use of standardized terminology for documentation should also enhance the visibility of nurses’ work.
Copyright (c) 2026 Larissa Sydor Victor, Lia Híria Campozana, Francine Dutra Mattei, Marcia Regina Cubas https://creativecommons.org/licenses/by/4.0
Outcome of Surgical Wound in Neuromuscular Scoliosis: Conventional Dressings vs. Negative Pressure Therapy
Objective: To evaluate surgical wound complications by comparing conventional dressings and incisional negative pressure therapy (NPT) in spinal surgeries. Method: This was a longitudinal, observational, exploratory, and retrospective study with a quantitative approach, including 50 patients treated with conventional dressings and 50 with incisional NPT, conducted between 2017 and 2021. Data collection involved the analysis of 25 variables, with statistical tests conducted using an alpha level (p-value) of 0.05 and a 95% confidence interval (CI). Results: The overall complication rate was 37%, with a higher incidence of exudate and suture dehiscence. Patients treated with conventional dressings experienced more complications during hospitalization (88.24%) compared to those in the NPT group, who had a higher proportion of complications after discharge (50%) (p = 0.03). No statistically significant differences were found for the other variables. The conventional group also showed a higher frequency of infection one year postoperatively (14% vs. 12.24%). Conclusion: Patients with neuromuscular scoliosis have high rates of surgical wound complications. NPT was associated with a reduction in surgical wound infection and high-volume exudate compared to conventional dressings, although these differences were not statistically significant. Expanding the study sample is necessary to confirm the efficacy and potential superiority of incisional NPT.
Copyright (c) 2025 Priscila Sales de Lima, Isadora Cristina de Oliveira Yoneiama , Rebeca Sutto da Silva https://creativecommons.org/licenses/by/4.0
Validation of a guide for peristomal skin care in adults with elimination ostomy
Objective: To validate the content, appearance, and semantics of a guide for peristomal skin care in adults with elimination ostomies. Method: A methodological study structured in four phases: 1) Exploratory phase, 2) Development, 3) Validation phase, and 4) Publication. This research presented the validation phase, which includes a) content validation by stomal therapy nurses; b) appearance validation by graphic designers; and c) semantic validation with the target audience (individuals with ostomies and nurses). Data were analyzed using the Content Validation Index (CVI), Appearance Validity Index (AVI), and Semantic Agreement Index (SAI). Results: The final guide comprised 32 pages, divided into pre-textual, textual, and post-textual elements. The global CVI was 88.6%, total AVI was 83.3% and global SAI was 98.2%. Conclusion: The guide was validated as an educational and assistance technology in three stages, presenting clinical applicability in Nursing Consultations, support groups, and self-care for individuals with ostomies and their families. The material has high replicability potential, as it will be available in both digital and print versions.
Copyright (c) 2025 Angela Bruna Luchese Sari, Edlamar Kátia Adamy, Rafael Gué Martini https://creativecommons.org/licenses/by/4.0
Necrotizing Fasciitis and Pyomyositis Caused by Streptococcus pyogenes: A Case Report
Objective: To report the case of a patient with streptococcemia caused by Streptococcus pyogenes progressing to necrotizing fasciitis and pyomyositis. Method: This case report was conducted in the intensive care unit (ICU) of a large public hospital in August 2023. The study was approved by a Research Ethics Committee. Results: A 15-year-old female patient was admitted to the emergency department with severe pain, edema, and a bullous lesion on the left upper limb (LUL). She rapidly progressed to septic shock due to necrotizing fasciitis with extensive soft tissue damage, and invasive streptococcemia caused by Streptococcus pyogenes was confirmed. The patient was transferred to the ICU, peripheral blood cultures were collected, and broad-spectrum antibiotic therapy was initiated. She was managed by a multidisciplinary team, including general surgery, plastic surgery, intensive care nurses, and wound care specialists. The treatment included fasciotomy and repeated mechanical debridements. Specific wound care strategies were implemented, involving the use of silver hydrofiber dressings, silicone dressings, and hydroactive gel. Subsequently, the patient was electively readmitted for a split-thickness skin graft on the LUL and continued outpatient follow-up with wound care specialists, showing excellent clinical progress. Conclusion: Invasive streptococcemia is a challenging condition due to its rapid progression and high mortality, requiring urgent and comprehensive management. Timely diagnosis, appropriate antibiotic therapy, immediate surgical intervention, and intensive multidisciplinary support, including advanced wound care, were crucial to achieving a favorable outcome.
Copyright (c) 2025 Sofia Louise Santin Barilli, Paula Buchs Zucatti, Fabiana Henriques Maciel, Adriana Alves dos Santos, Anaelí Brandelli Peruzzo, Rafaela dos Santos Charão de Almeida https://creativecommons.org/licenses/by/4.0
Challenges in the Management of Oncologic Wounds: Perspectives of Nurses from a Reference Unit in Amazonas
Objective: To explore the experiences of nurses in the management of neoplastic wounds at a cancer referral unit in the state of Amazonas. Method: This was an observational, descriptive study with a qualitative approach. The sample was selected through convenience sampling. Data collection took place after the project was approved by the Research Ethics Committee of the Amazonas State Oncology Control Center Foundation (Fundação Centro de Controle de Oncologia do Estado do Amazonas – FCECON). Bardin’s Thematic Content Analysis (2011) was used to analyze the participants’ statements, following the phases of pre-analysis, exploration of the material, categorization of statements, and treatment of results, inference, and interpretation. Results: A total of 25 oncology nurses were interviewed. After the interviews and synthesis of the statements, three main topics emerged: common characteristics of neoplastic lesions, the role of nursing in the management of these lesions, and psychosocial aspects affecting nurses working in oncology settings. Conclusion: Despite their preparation and training, the interviewees expressed feelings of helplessness in the face of the complexity of the lesions, as well as anguish, frustration, and negative emotions related to the low likelihood of healing. The main concerns regarding oncologic wounds were related to odor, bleeding, and the size of the lesion.
Copyright (c) 2025 Lorena Barros da Silveira, Jose Nilson Araújo Bezerra https://creativecommons.org/licenses/by/4.0