Chronic venous ulcer's therapeutic approach by specialist nurse: Experience report

Abstract

The chronic venous failure of lower limbs causes disability and represents an important problem of social-economic nature; it may lead to invalidity, worsening the life quality. Report a clinical case of chronic venous ulcer's household treatment. Clinical case description with initial assessment, therapeutic behavior and evolution, documented with photographic record and planimetry with ImageTool® software. Customer E.B., 91 years old, ambulatory with help, presenting injury in lower left limb for 50 years. In the initial assessment, presented two venous ulcers: on the left foot's back with 16.36 cm2, and on the left leg's lateral medial side region with 50.27 cm2. Chronic injuries and granulation tissue with necrosis points and slough. Bleeding aspect, with biofilm. Exudate with seropurulent, yellow aspect, moderate amount, absence of smell. Complains about intense pain. The treatment was focused on the colonization control and exudate reduction, opting by compression tape and bandage with nano crystallized silver and instrumental debridement, according to the need. After exudate control, hydrogel was used with calcium alginate and 3% papain. In eight months, there was 47% decrease in ulcer size on the left leg's lateral and medial side region and 85% on the foot's back and decrease of pain. The specialist nurse is essential in the wound's assessment process, to develop a therapeutic plan containing adequacy of the topical care, use of compressive therapy and guidance to patient and their caregivers.