Avaliação de feridas crônicas em pacientes atendidos em Unidades Básicas de Saúde de Goiânia
Autor(a) principal: | |
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Data de Publicação: | 2008 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFG |
Texto Completo: | http://repositorio.bc.ufg.br/tede/handle/tde/698 |
Resumo: | Assessing patients with chronic wounds poses a challenge to professionals and doubts still persist concerning characterization of the wound infection status. We believe that the Basic Health Units are in places of reference for the public to submit chronic wounds and should have full attendance and resolution were objectives of this study: characterizing patients with chronic wounds attended as spontaneous demand in the bandage room; characterizing patients chronic wounds regarding the presence of classical signs and additional infection criteria; isolating and identifying aerobic bacteria and fungi in the samples of chronic wounds clinically signaling to infection; verifying strains susceptibility when isolated before antimicrobial agents often used in praxis as well as new antibiotics and analyzing the relationship of local factors with infection status. This is a cross-sectional study, carried out in ambulatory bandage rooms in basic health units with emergency service in the municipality of Goiânia. Data was collected from June to July, in 2007. Data was obtained through the use of structured interviews containing questions about characterization of patients and a check list for the assessment of chronic wounds through the signs and clinical symptoms indicating infection and analysis of wound samples by using swabs in accordance with Levine s technique. After consent and approval of the ethics committee, 46 patients were evaluated and 60 wound samples were assessed. Data bank was organized in Excel table and statistics analysis in SPSS- 15.0. The average age was 55 years, 37 (80.4%) male, 20 (43.5%) belonging to E social class, 23 (50%) retired people having basic sanitation items. 28 (61%) presented venous ulcerated lower limbs, 31 (67.4%) performed the bandage both in the BHU and at home. 45 (75%) out of 60 wounds were infected and 15 (25%) noninfected. Through bivariate analysis we verified an association of the infection status with the following characteristics: width depth of tissular damage, necrotic tissue and exudate amount. Among signs and symptoms, classical ones occurred in a frequency higher than 65% both in the infected and noninfected group. Regarding the additional ones, we verified variance in occurrence in both wound groups. Staphylococcus aureus was predominat in 65% of cases and was sensitive to most antibiotics tested. Among Gram-negative bacteria the most frequent were: Pseudomonas aeruginosa (23%), resistant to amoxylin +clavulanic acid, cefalexin and cefotaxim; Proteus mirabilis (16.6%) and Proteus vulgaris (15.0%), all sensitive to gentamicin, aztreonam, ciprofloxacin, and amicacin. These results indicate the need to structure an integrated net to treat patients with chronic wounds and evidence additional criteria to be employed in the elaboration of service protocols pursuing improvement of quality of assistance given in basic health units. |
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TIPPLE, Anaclara Ferreira Veigahttp://lattes.cnpq.br/4288704233343920REIS, Cleomeneshttp://lattes.cnpq.br/5103786277121402http://lattes.cnpq.br/0498414536814252MARTINS, Marlene Andrade2014-07-29T15:04:30Z2011-02-252008-04-30MARTINS, Marlene Andrade. Assessing of chronic wounds in outpatients treated at basic health unit in goiania. 2008. 147 f. Dissertação (Mestrado em Cuidado em Enfermagem) - Universidade Federal de Goiás, Goiânia, 2008.http://repositorio.bc.ufg.br/tede/handle/tde/698Assessing patients with chronic wounds poses a challenge to professionals and doubts still persist concerning characterization of the wound infection status. We believe that the Basic Health Units are in places of reference for the public to submit chronic wounds and should have full attendance and resolution were objectives of this study: characterizing patients with chronic wounds attended as spontaneous demand in the bandage room; characterizing patients chronic wounds regarding the presence of classical signs and additional infection criteria; isolating and identifying aerobic bacteria and fungi in the samples of chronic wounds clinically signaling to infection; verifying strains susceptibility when isolated before antimicrobial agents often used in praxis as well as new antibiotics and analyzing the relationship of local factors with infection status. This is a cross-sectional study, carried out in ambulatory bandage rooms in basic health units with emergency service in the municipality of Goiânia. Data was collected from June to July, in 2007. Data was obtained through the use of structured interviews containing questions about characterization of patients and a check list for the assessment of chronic wounds through the signs and clinical symptoms indicating infection and analysis of wound samples by using swabs in accordance with Levine s technique. After consent and approval of the ethics committee, 46 patients were evaluated and 60 wound samples were assessed. Data bank was organized in Excel table and statistics analysis in SPSS- 15.0. The average age was 55 years, 37 (80.4%) male, 20 (43.5%) belonging to E social class, 23 (50%) retired people having basic sanitation items. 28 (61%) presented venous ulcerated lower limbs, 31 (67.4%) performed the bandage both in the BHU and at home. 45 (75%) out of 60 wounds were infected and 15 (25%) noninfected. Through bivariate analysis we verified an association of the infection status with the following characteristics: width depth of tissular damage, necrotic tissue and exudate amount. Among signs and symptoms, classical ones occurred in a frequency higher than 65% both in the infected and noninfected group. Regarding the additional ones, we verified variance in occurrence in both wound groups. Staphylococcus aureus was predominat in 65% of cases and was sensitive to most antibiotics tested. Among Gram-negative bacteria the most frequent were: Pseudomonas aeruginosa (23%), resistant to amoxylin +clavulanic acid, cefalexin and cefotaxim; Proteus mirabilis (16.6%) and Proteus vulgaris (15.0%), all sensitive to gentamicin, aztreonam, ciprofloxacin, and amicacin. These results indicate the need to structure an integrated net to treat patients with chronic wounds and evidence additional criteria to be employed in the elaboration of service protocols pursuing improvement of quality of assistance given in basic health units.A avaliação de pacientes com feridas crônicas representa um desafio para os profissionais, e dúvidas, ainda persistem em torno da caracterização do status de infecção, nessas lesões. As Unidades Básicas de Saúde constituem-se locais de referência para a população portadora de feridas crônicas, onde deveriam ter atendimento integral e resolutividade. Objetivos deste estudo: caracterizar os pacientes com feridas crônicas, atendidos como demanda espontânea, na sala de curativos; caracterizar as feridas crônicas dos pacientes atendidos em relação à presença de sinais clássicos e critérios adicionais de infecção; isolar e identificar bactérias aeróbias e fungos das amostras de feridas crônicas, com indícios clínicos de infecção; verificar a susceptibilidade das cepas isoladas, frente aos antimicrobianos freqüentemente utilizados na prática e novos antibióticos, e analisar a relação de fatores locais, com o status de infecção. Trata-se de estudo transversal, realizado em Salas de Curativos Ambulatoriais de Unidades Básicas de Saúde (UBS), com atendimento de urgência do Município de Goiânia. Os dados foram coletados no período de junho a julho de 2007 e obtidos por meio de entrevista com roteiro estruturado, contendo questões de caracterização dos pacientes e de um check-list, para a avaliação das feridas crônicas, por meio dos sinais e sintomas clínicos indicativos de infecção, e análise de amostras de feridas utilizando o swab, mediante técnica de Levine. Após aprovação pelo Comitê de Ética e Consentimento, foram avaliados 46 pacientes, e analisadas amostras de 60 feridas. Os programas computacionais utilizados para organizar e analisar estatisticamente os dados foram: o Excel e o SPSS (versão 15.0), respectivamente. A média de idade foi de 55 anos, 37 (80,4%) eram do sexo masculino, 20 (43.5%) pertenciam à classe social E, 23 (50%) eram aposentados e possuíam itens de saneamento básico, 28 (61%) apresentaram úlceras venosas, localizadas nos membros inferiores, 31 (67,4%) realizavam o curativo nas UBS ou em domicílios. Das 60 lesões, 45 (75%) estavam infectadas e 15 (25%) não infectadas. Mediante análise bivariada, verificaram-se associação com o status de infecção as seguintes características: profundidade da extensão do dano tissular, quantidade de tecido necrótico e exsudato. Dentre os sinais e sintomas, os clássicos ocorreram numa freqüência superior a 65%, tanto no grupo de infectadas quanto não infectadas, e nos adicionais verificou-se variação na ocorrência, em ambos os grupos de feridas. Houve predominância do Staphylococcus aureus em 65% dos casos e a maioria sensível aos antibióticos testados. Entre as bactérias Gram-negativas, as mais freqüentes foram: Pseudomonas aeruginosa (23,3%), resistentes à amoxicilina+ácido clavulânico, cefalexina e cefotaxima; Proteus mirabilis (16,6%) e Proteus vulgaris (15,0%) sensíveis a gentamicina, aztreonam, ciprofloxacino e amicacina. Estes resultados indicam a necessidade de se estruturar uma rede integrada, para o atendimento dos pacientes com feridas crônicas. Também evidenciam critérios adicionais que podem ser empregados na elaboração do protocolo de atendimento, buscando a melhoria da qualidade da assistência prestada nas unidades básicas de saúde.Made available in DSpace on 2014-07-29T15:04:30Z (GMT). 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dc.title.por.fl_str_mv |
Avaliação de feridas crônicas em pacientes atendidos em Unidades Básicas de Saúde de Goiânia |
dc.title.alternative.eng.fl_str_mv |
Assessing of chronic wounds in outpatients treated at basic health unit in goiania |
title |
Avaliação de feridas crônicas em pacientes atendidos em Unidades Básicas de Saúde de Goiânia |
spellingShingle |
Avaliação de feridas crônicas em pacientes atendidos em Unidades Básicas de Saúde de Goiânia MARTINS, Marlene Andrade Úlcera da perna Pacientes ambulatoriais/enfermagem Infecção dos ferimentos Testes de sensibilidade a antimicrobianos por Disco-Difusão Lower limb Ulcer Outpatients/nursing Wounds infection Disk Diffusion Antimicrobial Susceptibility Testing CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM |
title_short |
Avaliação de feridas crônicas em pacientes atendidos em Unidades Básicas de Saúde de Goiânia |
title_full |
Avaliação de feridas crônicas em pacientes atendidos em Unidades Básicas de Saúde de Goiânia |
title_fullStr |
Avaliação de feridas crônicas em pacientes atendidos em Unidades Básicas de Saúde de Goiânia |
title_full_unstemmed |
Avaliação de feridas crônicas em pacientes atendidos em Unidades Básicas de Saúde de Goiânia |
title_sort |
Avaliação de feridas crônicas em pacientes atendidos em Unidades Básicas de Saúde de Goiânia |
author |
MARTINS, Marlene Andrade |
author_facet |
MARTINS, Marlene Andrade |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
TIPPLE, Anaclara Ferreira Veiga |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/4288704233343920 |
dc.contributor.advisor-co1.fl_str_mv |
REIS, Cleomenes |
dc.contributor.advisor-co1Lattes.fl_str_mv |
http://lattes.cnpq.br/5103786277121402 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/0498414536814252 |
dc.contributor.author.fl_str_mv |
MARTINS, Marlene Andrade |
contributor_str_mv |
TIPPLE, Anaclara Ferreira Veiga REIS, Cleomenes |
dc.subject.por.fl_str_mv |
Úlcera da perna Pacientes ambulatoriais/enfermagem Infecção dos ferimentos Testes de sensibilidade a antimicrobianos por Disco-Difusão |
topic |
Úlcera da perna Pacientes ambulatoriais/enfermagem Infecção dos ferimentos Testes de sensibilidade a antimicrobianos por Disco-Difusão Lower limb Ulcer Outpatients/nursing Wounds infection Disk Diffusion Antimicrobial Susceptibility Testing CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM |
dc.subject.eng.fl_str_mv |
Lower limb Ulcer Outpatients/nursing Wounds infection Disk Diffusion Antimicrobial Susceptibility Testing |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM |
description |
Assessing patients with chronic wounds poses a challenge to professionals and doubts still persist concerning characterization of the wound infection status. We believe that the Basic Health Units are in places of reference for the public to submit chronic wounds and should have full attendance and resolution were objectives of this study: characterizing patients with chronic wounds attended as spontaneous demand in the bandage room; characterizing patients chronic wounds regarding the presence of classical signs and additional infection criteria; isolating and identifying aerobic bacteria and fungi in the samples of chronic wounds clinically signaling to infection; verifying strains susceptibility when isolated before antimicrobial agents often used in praxis as well as new antibiotics and analyzing the relationship of local factors with infection status. This is a cross-sectional study, carried out in ambulatory bandage rooms in basic health units with emergency service in the municipality of Goiânia. Data was collected from June to July, in 2007. Data was obtained through the use of structured interviews containing questions about characterization of patients and a check list for the assessment of chronic wounds through the signs and clinical symptoms indicating infection and analysis of wound samples by using swabs in accordance with Levine s technique. After consent and approval of the ethics committee, 46 patients were evaluated and 60 wound samples were assessed. Data bank was organized in Excel table and statistics analysis in SPSS- 15.0. The average age was 55 years, 37 (80.4%) male, 20 (43.5%) belonging to E social class, 23 (50%) retired people having basic sanitation items. 28 (61%) presented venous ulcerated lower limbs, 31 (67.4%) performed the bandage both in the BHU and at home. 45 (75%) out of 60 wounds were infected and 15 (25%) noninfected. Through bivariate analysis we verified an association of the infection status with the following characteristics: width depth of tissular damage, necrotic tissue and exudate amount. Among signs and symptoms, classical ones occurred in a frequency higher than 65% both in the infected and noninfected group. Regarding the additional ones, we verified variance in occurrence in both wound groups. Staphylococcus aureus was predominat in 65% of cases and was sensitive to most antibiotics tested. Among Gram-negative bacteria the most frequent were: Pseudomonas aeruginosa (23%), resistant to amoxylin +clavulanic acid, cefalexin and cefotaxim; Proteus mirabilis (16.6%) and Proteus vulgaris (15.0%), all sensitive to gentamicin, aztreonam, ciprofloxacin, and amicacin. These results indicate the need to structure an integrated net to treat patients with chronic wounds and evidence additional criteria to be employed in the elaboration of service protocols pursuing improvement of quality of assistance given in basic health units. |
publishDate |
2008 |
dc.date.issued.fl_str_mv |
2008-04-30 |
dc.date.available.fl_str_mv |
2011-02-25 |
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2014-07-29T15:04:30Z |
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MARTINS, Marlene Andrade. Assessing of chronic wounds in outpatients treated at basic health unit in goiania. 2008. 147 f. Dissertação (Mestrado em Cuidado em Enfermagem) - Universidade Federal de Goiás, Goiânia, 2008. |
dc.identifier.uri.fl_str_mv |
http://repositorio.bc.ufg.br/tede/handle/tde/698 |
identifier_str_mv |
MARTINS, Marlene Andrade. Assessing of chronic wounds in outpatients treated at basic health unit in goiania. 2008. 147 f. Dissertação (Mestrado em Cuidado em Enfermagem) - Universidade Federal de Goiás, Goiânia, 2008. |
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http://repositorio.bc.ufg.br/tede/handle/tde/698 |
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Cuidado em Enfermagem |
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Universidade Federal de Goiás |
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