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Bakgrund: Svårläkta bensår är ett omfattande och komplext problem inom vård och omsorg. Läkningsprocessen är ofta långdragen och innebär ett stort lidande för patienten med negativ inverkan på livskvaliteten. Faktorer som kan påverka sårläkningsprocessen med fokus på nutrition och dess inflytande på sårläkningen vid bensår har studerats i denna litteraturstudie. Syfte: Syftet var att beskriva nutritionens betydelse för läkning av bensår. Metod: En beskrivande litteraturstudie där resultatet inkluderar 15 artiklar med kvantitativ ansats. Artiklar söktes systematiskt genom databasen PubMed, varav två artiklar hittades via manuell sökning. Huvudresultat: Bensårspatienter föreligger risk för undernäring trots övervikt eller fetma och undernäring är ett vanligt förekommande. Det påvisas ett samband mellan risk för undernäring och sårtillslutningshastighet. Negativ association påvisades gällande sårläkningsprocessen vid brist på D-vitamin, C-vitamin, A-vitamin, zink, protein och albumin. Bensårspatienter som fick näringstillskott fick ett ökat intag av flera näringsämnen och ett positivt samband associeras med sårläkningsprocessen. Ett tudelat resultat huruvida järn påverkade bensårspatienterna tas i beaktande då en del patienter visade en överlag hög järnkonsumtion medan vissa patienter påvisade sig ha en allvarligt minskad nivå av järn i plasma. Slutsats: Resultatet i denna litteraturstudie ger en tydlig indikation på att näringsintaget spelar en väsentlig roll vid läkning av bensår. Samband mellan olika näringsbristtillstånd och försämrad sårläkning framkommer, trots att tillgänglig forskning idag är bristfällig. Det påvisas lyckade resultat gällande näringstillskott till bensårspatienter för att behandla/förebygga brister av olika näringsämnen, vilket har resulterat i en mer framgångsrik sårläkning., Background: Difficult-to-heal leg ulcers are an extensive and complex problem in healthcare. The healing process is long and involves suffering for the patient with a negative impact on their quality of life. This literature review studied factors that can influence the wound healing process with a focus on nutrition and its influence on wound healing in leg ulcers. Purpose: The aim was to describe the importance of nutrition for the healing of leg ulcers. Method: A descriptive literature study where the result contains 15 articles with quantitative approaches. Articles were systematically searched through the database PubMed, of which two articles were found by manual search. Main results: Leg ulcer patients are at risk for undernourishment despite being overweight or obese, and malnutrition is a common occurrence. A relationship between the risk for undernourishment and wound closure rate is demonstrated. A negative association was demonstrated regarding the wound healing process and deficiency of vitamin D, vitamin C, vitamin A, zinc, protein and albumin was demonstrated. Leg ulcer patients who received nutritional supplements increased the intake of several nutrients and a positive relationship is associated with the wound healing process. A two-sided result whether iron affected the leg ulcer patients is taken into account as some patients showed an overall high iron consumption while some patients were shown to have a severely reduced level of iron in plasma. Conclusion: The results of this literature study gave a clear indication that nutritional intake plays an essential role in the healing of leg ulcers. Connections between various nutritional deficiency states and impaired wound healing are emerging, despite the fact that the research available today is insufficient. Successful results have been demonstrated regarding nutritional supplementation to leg ulcer patients to treat/prevent deficiencies of various nutrients, which resulted in successful wound hea

Bakgrund: Svårläkta bensår är ett globalt hälso- och sjukvårdsproblem. Svårläkta bensår är ingen sjukdom utan ett symtom som uppstår av olika sjukdomstillstånd. Bensår är enligt definition belägna nedanför knät och nertill fotknölarna där läkningsprocessen tar längre tid än sex veckor och behandlingstiden långsam och resurskrävande. Sjuksköterskans uppgift är att tillgodose god omvårdnad vilket kan uppnås genom förståelse för patienters upplevelser samt deras situation. Syfte: Syftet med denna litteraturöversikt var att beskriva patienters upplevelser av att leva med svårläkta bensår Metod: En litteraturöversikt genomfördes utifrån Fribergs metod där elva artiklar inkluderades. Resultat: I resultatet framkom tre huvudteman: Lidande och fysiska upplevelser, emotionella och psykosociala upplevelser samt upplevelser kring omvårdnaden. Samt sex under teman: lidande, minskad mobilitet, när livet känns svårt, social isolering, vårdrelation samt upplevelser relaterat till behandling. Ett av de svåraste symtomen som orsakades av det svårläkta såret var smärta vilket orsakade både fysiska samt psykiska besvär. Symtomen upplevdes vara besvärliga samt orsakade oro, ångest och skam. Behandling samt läkningstiden var lång vilket resulterade i att vårdrelationen hade en stor betydelse för patienterna. Slutsats: Litteraturöversikten visar att livet påverkas negativt av att leva med svårläkta bensår. Sjuksköterskor saknar kunskap kring ämnet samt kunskap om patienternas livsvärld. Genom att skapa en god vårdrelation samt en god förståelse kan sjuksköterskan tillgodose bättre omvårdnad och därmed minska patienternas fysiska samt psykiska lidande., Background: Hard-to-heal leg ulcers are a global health care problem. Hard-to-heal leg ulcers are not a disease but a symptom that arises from various medical conditions. By definition, leg ulcers are located below the knee and down to the balls of the feet, where the healing process takes longer than six weeks and the treatment time is slow and resource intensive. The nurse's task is to provide good care, which can be achieved through understanding patients' experiences and their situation. Aim: The aim of this literature study was to describe patients' experiences of living with hard-to-heal leg ulcers Method: A literature review was carried out based on Friberg's method whereeleven articles were included. Results: The results revealed three main themes: Suffering and physical experiences, emotional and psychosocial experiences and experiences around nursing. As well as six sub-themes: suffering, reduced mobility, when life feels difficult, social isolation, care relationship and experiences related to treatment. One of the most severe symptoms caused by the hard-to-heal wound was pain, which caused both physical and psychological discomfort. The symptoms were experienced as troublesome and caused worry, anxiety and shame. Treatment and the healing time were long, which resulted in the care relationship having a great importance for the patients. Summary: The literature review shows that life is negatively affected by living with hard-to-heal leg wounds. Nurses lack knowledge about the subject and knowledge about the patients' life world. By creating a good nursing relationship and a good understanding, the nurse can provide better care and thereby reduce the patients' physical and psychological suffering.

Bakgrund: Svårläkta bensår är ett globalt hälso- och sjukvårdsproblem. Svårläkta bensår är ingen sjukdom utan ett symtom som uppstår av olika sjukdomstillstånd. Bensår är enligt definition belägna nedanför knät och nertill fotknölarna där läkningsprocessen tar längre tid än sex veckor och behandlingstiden långsam och resurskrävande. Sjuksköterskans uppgift är att tillgodose god omvårdnad vilket kan uppnås genom förståelse för patienters upplevelser samt deras situation. Syfte: Syftet med denna litteraturöversikt var att beskriva patienters upplevelser av att leva med svårläkta bensår Metod: En litteraturöversikt genomfördes utifrån Fribergs metod där elva artiklar inkluderades. Resultat: I resultatet framkom tre huvudteman: Lidande och fysiska upplevelser, emotionella och psykosociala upplevelser samt upplevelser kring omvårdnaden. Samt sex under teman: lidande, minskad mobilitet, när livet känns svårt, social isolering, vårdrelation samt upplevelser relaterat till behandling. Ett av de svåraste symtomen som orsakades av det svårläkta såret var smärta vilket orsakade både fysiska samt psykiska besvär. Symtomen upplevdes vara besvärliga samt orsakade oro, ångest och skam. Behandling samt läkningstiden var lång vilket resulterade i att vårdrelationen hade en stor betydelse för patienterna. Slutsats: Litteraturöversikten visar att livet påverkas negativt av att leva med svårläkta bensår. Sjuksköterskor saknar kunskap kring ämnet samt kunskap om patienternas livsvärld. Genom att skapa en god vårdrelation samt en god förståelse kan sjuksköterskan tillgodose bättre omvårdnad och därmed minska patienternas fysiska samt psykiska lidande., Background: Hard-to-heal leg ulcers are a global health care problem. Hard-to-heal leg ulcers are not a disease but a symptom that arises from various medical conditions. By definition, leg ulcers are located below the knee and down to the balls of the feet, where the healing process takes longer than six weeks and the treatment time is slow and resource intensive. The nurse's task is to provide good care, which can be achieved through understanding patients' experiences and their situation. Aim: The aim of this literature study was to describe patients' experiences of living with hard-to-heal leg ulcers Method: A literature review was carried out based on Friberg's method whereeleven articles were included. Results: The results revealed three main themes: Suffering and physical experiences, emotional and psychosocial experiences and experiences around nursing. As well as six sub-themes: suffering, reduced mobility, when life feels difficult, social isolation, care relationship and experiences related to treatment. One of the most severe symptoms caused by the hard-to-heal wound was pain, which caused both physical and psychological discomfort. The symptoms were experienced as troublesome and caused worry, anxiety and shame. Treatment and the healing time were long, which resulted in the care relationship having a great importance for the patients. Summary: The literature review shows that life is negatively affected by living with hard-to-heal leg wounds. Nurses lack knowledge about the subject and knowledge about the patients' life world. By creating a good nursing relationship and a good understanding, the nurse can provide better care and thereby reduce the patients' physical and psychological suffering.

Bakgrund: Svårläkta bensår är ett omfattande och komplext problem inom vård och omsorg. Läkningsprocessen är ofta långdragen och innebär ett stort lidande för patienten med negativ inverkan på livskvaliteten. Faktorer som kan påverka sårläkningsprocessen med fokus på nutrition och dess inflytande på sårläkningen vid bensår har studerats i denna litteraturstudie. Syfte: Syftet var att beskriva nutritionens betydelse för läkning av bensår. Metod: En beskrivande litteraturstudie där resultatet inkluderar 15 artiklar med kvantitativ ansats. Artiklar söktes systematiskt genom databasen PubMed, varav två artiklar hittades via manuell sökning. Huvudresultat: Bensårspatienter föreligger risk för undernäring trots övervikt eller fetma och undernäring är ett vanligt förekommande. Det påvisas ett samband mellan risk för undernäring och sårtillslutningshastighet. Negativ association påvisades gällande sårläkningsprocessen vid brist på D-vitamin, C-vitamin, A-vitamin, zink, protein och albumin. Bensårspatienter som fick näringstillskott fick ett ökat intag av flera näringsämnen och ett positivt samband associeras med sårläkningsprocessen. Ett tudelat resultat huruvida järn påverkade bensårspatienterna tas i beaktande då en del patienter visade en överlag hög järnkonsumtion medan vissa patienter påvisade sig ha en allvarligt minskad nivå av järn i plasma. Slutsats: Resultatet i denna litteraturstudie ger en tydlig indikation på att näringsintaget spelar en väsentlig roll vid läkning av bensår. Samband mellan olika näringsbristtillstånd och försämrad sårläkning framkommer, trots att tillgänglig forskning idag är bristfällig. Det påvisas lyckade resultat gällande näringstillskott till bensårspatienter för att behandla/förebygga brister av olika näringsämnen, vilket har resulterat i en mer framgångsrik sårläkning., Background: Difficult-to-heal leg ulcers are an extensive and complex problem in healthcare. The healing process is long and involves suffering for the patient with a negative impact on their quality of life. This literature review studied factors that can influence the wound healing process with a focus on nutrition and its influence on wound healing in leg ulcers. Purpose: The aim was to describe the importance of nutrition for the healing of leg ulcers. Method: A descriptive literature study where the result contains 15 articles with quantitative approaches. Articles were systematically searched through the database PubMed, of which two articles were found by manual search. Main results: Leg ulcer patients are at risk for undernourishment despite being overweight or obese, and malnutrition is a common occurrence. A relationship between the risk for undernourishment and wound closure rate is demonstrated. A negative association was demonstrated regarding the wound healing process and deficiency of vitamin D, vitamin C, vitamin A, zinc, protein and albumin was demonstrated. Leg ulcer patients who received nutritional supplements increased the intake of several nutrients and a positive relationship is associated with the wound healing process. A two-sided result whether iron affected the leg ulcer patients is taken into account as some patients showed an overall high iron consumption while some patients were shown to have a severely reduced level of iron in plasma. Conclusion: The results of this literature study gave a clear indication that nutritional intake plays an essential role in the healing of leg ulcers. Connections between various nutritional deficiency states and impaired wound healing are emerging, despite the fact that the research available today is insufficient. Successful results have been demonstrated regarding nutritional supplementation to leg ulcer patients to treat/prevent deficiencies of various nutrients, which resulted in successful wound hea

Bakgrund Allmänsjuksköterskor kommer ofta i kontakt med personer med venösa bensår. Behandling och vård av dessa personer sker ofta inom primärvård, öppenvård eller hemsjukvård, men även på vårdavdelningar och andra sjukvårdsinstanser. Venösa bensår är en följd av underliggande kronisk venös insufficiens. Det är därför stor risk att såren återkommer efter läkning och behandlingen måste därför i många fall bli livslång. Trots detta finns få studier som fokuserar på personers upplevelser av behandling och vård vid venösa bensår. Syfte Syftet är att beskriva personers upplevelser av behandling och vård vid venösa bensår. Metod För att sammanfatta den forskning som i dagsläget finns kring ämnet har en litteraturöversikt gjorts. Sökningar har utförts i de vetenskapliga databaserna Pub Med och CINAHL och 16 artiklar identifierades. Dessa har kvalitetsgranskats genom Sophiahemmet Högskolas bedömningsinstrument. Resultat Litteraturöversiktens tre huvudkategorier, förhoppning och uppgivenhet, att leva ett begränsat liv och att inte bli sedd som person berättar om upplevelser som många personer med venösa bensår har av behandling och vård. Personer upplever att behandling och vård på något sätt begränsar eller påverkar dem. Vårdens kontinuitet, god kommunikation, och relationen till sjuksköterskan är av betydelse för upplevelsen av behandling och vård. Det finns brister i individanpassningen av behandling och vård som påverkar personer med venösa bensårs förtroende för vården. Många personer uppger en ovisshet som gör det svårt att hantera behandlingen psykologiskt. En stark önskan om läkning av de venösa bensåren är gemensamt för många studiedeltagare. Slutsats Det fattas specifik forskning om personers upplevelser. Sjuksköterskor som behandlar personer med venösa bensår saknar kunskaper om deras tillstånd och rekommenderad behandling. I denna litteraturöversikt framkommer ett behov av att skifta fokus från läkning av det venösa bensåret till personens livskvalitet. Sj, Background Registered nurses frequently come into contact with persons living with venous leg ulcers, as these wounds are primarily treated and cared for by nurses. Persons with venous leg ulcers often experience underlying chronic venous insufficiency, which is the main cause of venous leg ulcers. This means that even once healed venous leg ulcers are likely to reoccur, and treatment is often life-long. In spite of this, very few studies and research projects focus on the person’s experiences of their ailment in relation to the treatment they receive. Aim To highlight persons’ experiences related to the treatment and care of venous ulcers. Method To summarize the research knowledge of this subject, a review of current literature was undertaken. Searches have been conducted in several online-based databases. Through the databases PubMed and CINAHL 16 articles were identified and then analyzed. Results Many persons with venous leg ulcers feel that treatment and care affects or impedes them in some way. Three core categories were identified as signifying for the result: hopefulness and uncertainty, an impaired life, and not being viewed as a person. Continuity of care, quality of communication, and the nurse-patient relationship are all key contributors to the experiences of treatment and care that persons with venous leg ulcers describe. The result implies that treatment and care of persons with venous leg ulcers is not satisfyingly individualized, which reduces the level of confidence that these persons feel for their healthcare providers. Persons with venous leg ulcers report that experiences of uncertainty make the treatment hard to handle psychologically. A strong desire for permanent healing is shared by persons with venous leg ulcers. Conclusions There is a shortage of specific research aimed at the experiences of persons with venous leg ulcers of aspects relating to their treatment and care. Many nurses lack vital knowledge regarding the treatment and care o

Bakgrund Allmänsjuksköterskor kommer ofta i kontakt med personer med venösa bensår. Behandling och vård av dessa personer sker ofta inom primärvård, öppenvård eller hemsjukvård, men även på vårdavdelningar och andra sjukvårdsinstanser. Venösa bensår är en följd av underliggande kronisk venös insufficiens. Det är därför stor risk att såren återkommer efter läkning och behandlingen måste därför i många fall bli livslång. Trots detta finns få studier som fokuserar på personers upplevelser av behandling och vård vid venösa bensår. Syfte Syftet är att beskriva personers upplevelser av behandling och vård vid venösa bensår. Metod För att sammanfatta den forskning som i dagsläget finns kring ämnet har en litteraturöversikt gjorts. Sökningar har utförts i de vetenskapliga databaserna Pub Med och CINAHL och 16 artiklar identifierades. Dessa har kvalitetsgranskats genom Sophiahemmet Högskolas bedömningsinstrument. Resultat Litteraturöversiktens tre huvudkategorier, förhoppning och uppgivenhet, att leva ett begränsat liv och att inte bli sedd som person berättar om upplevelser som många personer med venösa bensår har av behandling och vård. Personer upplever att behandling och vård på något sätt begränsar eller påverkar dem. Vårdens kontinuitet, god kommunikation, och relationen till sjuksköterskan är av betydelse för upplevelsen av behandling och vård. Det finns brister i individanpassningen av behandling och vård som påverkar personer med venösa bensårs förtroende för vården. Många personer uppger en ovisshet som gör det svårt att hantera behandlingen psykologiskt. En stark önskan om läkning av de venösa bensåren är gemensamt för många studiedeltagare. Slutsats Det fattas specifik forskning om personers upplevelser. Sjuksköterskor som behandlar personer med venösa bensår saknar kunskaper om deras tillstånd och rekommenderad behandling. I denna litteraturöversikt framkommer ett behov av att skifta fokus från läkning av det venösa bensåret till personens livskvalitet. Sj, Background Registered nurses frequently come into contact with persons living with venous leg ulcers, as these wounds are primarily treated and cared for by nurses. Persons with venous leg ulcers often experience underlying chronic venous insufficiency, which is the main cause of venous leg ulcers. This means that even once healed venous leg ulcers are likely to reoccur, and treatment is often life-long. In spite of this, very few studies and research projects focus on the person’s experiences of their ailment in relation to the treatment they receive. Aim To highlight persons’ experiences related to the treatment and care of venous ulcers. Method To summarize the research knowledge of this subject, a review of current literature was undertaken. Searches have been conducted in several online-based databases. Through the databases PubMed and CINAHL 16 articles were identified and then analyzed. Results Many persons with venous leg ulcers feel that treatment and care affects or impedes them in some way. Three core categories were identified as signifying for the result: hopefulness and uncertainty, an impaired life, and not being viewed as a person. Continuity of care, quality of communication, and the nurse-patient relationship are all key contributors to the experiences of treatment and care that persons with venous leg ulcers describe. The result implies that treatment and care of persons with venous leg ulcers is not satisfyingly individualized, which reduces the level of confidence that these persons feel for their healthcare providers. Persons with venous leg ulcers report that experiences of uncertainty make the treatment hard to handle psychologically. A strong desire for permanent healing is shared by persons with venous leg ulcers. Conclusions There is a shortage of specific research aimed at the experiences of persons with venous leg ulcers of aspects relating to their treatment and care. Many nurses lack vital knowledge regarding the treatment and care o

An ulcer is an open wound that remains unhealed even after weeks of treatment. These types of wounds require a long process of treatment due to other underlying health problems. Having an unhealing, painful and often infected wound decreases patients’ life quality significantly. The treatment includes using wound dressing applied by nurses, to protect the wound from infections, collect exudate and provide a closed and sterile environment. During a treatment, which could last for months, patients experience a lot of emotional and physical challenges. Deva is a design concept proposing the use of smart sensors in wound care treatment in a way that it will improve the communication between patients and nurses, by providing information and guidance. The ecosystem consists of a smart wound patch that will turn any wound dressing today into a “smart” one, an electrostimulation therapy sock and digital platforms where the information will be available. This way information on the wound status will be available for the patient, their family members or caregivers and the nurses.This project has been developed by interviewing nurses and wound care professionals from Turkey, Sweden and Denmark. The insights reflect the situation and the healthcare system in these countries and a wound care treatment journey might differ in other settings.

An ulcer is an open wound that remains unhealed even after weeks of treatment. These types of wounds require a long process of treatment due to other underlying health problems. Having an unhealing, painful and often infected wound decreases patients’ life quality significantly. The treatment includes using wound dressing applied by nurses, to protect the wound from infections, collect exudate and provide a closed and sterile environment. During a treatment, which could last for months, patients experience a lot of emotional and physical challenges. Deva is a design concept proposing the use of smart sensors in wound care treatment in a way that it will improve the communication between patients and nurses, by providing information and guidance. The ecosystem consists of a smart wound patch that will turn any wound dressing today into a “smart” one, an electrostimulation therapy sock and digital platforms where the information will be available. This way information on the wound status will be available for the patient, their family members or caregivers and the nurses.This project has been developed by interviewing nurses and wound care professionals from Turkey, Sweden and Denmark. The insights reflect the situation and the healthcare system in these countries and a wound care treatment journey might differ in other settings.

Leg ulcers are costly and slow to heal, and after healing, up to 70% recur. Health systems are slow to embrace an effective long-term chronic disease management and health promotion approach needed for effective management of older adults with peripheral vascular disease, who experience years of leg ulceration and recurrence cycles. This presentation will provide results of health and cost-effectiveness outcomes from three community health service models of care for adults with chronic leg ulcers resulting from peripheral venous and/or arterial disease.

Up to 5% of older adults experience chronic leg ulcers, the majority of venous and/or arterial aetiology. Although evidence exists for treatment, around 30% of patients do not respond. There is a lack of knowledge on the factors associated with, and predicting, delayed healing, including the biological processes associated with normal and abnormal wound healing. This study aimed to obtain multidisciplinary data on demographic, health, clinical, psychosocial and biological factors associated with delayed healing of leg ulcers.

This literature review aimed to provide a narrative review of evidence on validity of clinical and microbial indicators of infection and to gain insights into the diagnosis of infection in chronic leg ulcers (CLUs). A search was conducted in Cinahl, Medline, the Cochrane Library databases, Embase, Web of Science, ScienceDirect, Pubmed, PsycINFO, ProQuest dissertations, and Google Scholar from January 1990 to July 2017. The inclusion criteria were original studies, systematic reviews, and consensus documents focused on “infection” in CLUs, English language, clinical and community settings, and human. The reviewed studies were inconsistent in criteria for infection between investigated wound types and lack of specificity regarding wound types. There were few studies investigating the criteria for diagnosis of infection in leg ulcers. The identification of leg ulcer infection still remains problematic and relies on out‐of‐date and not uniform evidence. Literature in this area was mostly limited to level III and IV evidence based on The Australian National Health and Medical Research Council Levels of Evidence, or expert opinion. This literature review showed seven clinical signs and symptoms that could be diagnostic for infection in CLUs, including: new, increased, or altered ulcer pain; malodour; increased ulcer area; wound breakdown, delayed or non‐healing; and erythema and increased local temperature, whilst the microbial indicators used to diagnose infected leg ulcers were varied and regarded as less important.

Vasculitis can be a primary disorder or a cutaneous manifestation of a viral infection. The present case describes an atypical localized cutaneous varicella-zoster virus infection inducing a small vessel vasculitis in a patient with multisystem sarcoidosis. Additionally, we discuss the differential diagnoses and treatment options. Varicella-Zoster infection occurs more frequently in immunosuppressed populations and can present with uncharacteristic clinical manifestations complicating the diagnosis as in the present case.

Full Text, Thesis (PhD Doctorate), Doctor of Philosophy (PhD), School of Nursing & Midwifery, Griffith Health, Background: People living with chronic leg ulcers frequently experience moderate to severe wound-related pain with the highest level of pain occurring at dressing change. Wound- related pain is not always able to be alleviated by oral analgesics alone. Persistent poorly- controlled leg ulcer pain physiologically impacts wound healing and prevents timely, effective wound management strategies being implemented which can negatively impact wound healing and health-related quality of life (HRQoL). Topical agents such as morphine gel and ibuprofen foam are used as primary dressings as a strategy for managing chronic leg ulcer pain. Studies investigating ibuprofen foam have shown significant improvement in chronic leg ulcer pain compared to standard care. There is insufficient evidence to suggest morphine gel is effective for chronic leg ulcer pain. Topical local anaesthetics, in particular the eutectic mixture of local anaesthetics (EMLA®), have been used for decades to relieve pain associated with debridement of chronic leg ulcers. However, their effectiveness as a primary dressing for managing chronic wound-related pain is yet to be evaluated. Since there was no known evidence regarding the effectiveness of EMLA® as a primary dressing for painful chronic leg ulcers to relieve wound-related pain and its associated impact on wound healing and HRQoL this feasibility study was conducted. Study aims: The primary aim of this study was to assess the processes, resources, management and scientific aspects of the study to ensure implementation of a larger study is feasible and to generate data that could be used for future sample size calculations. Study feasibility was assessed using the following criteria for determining success: recruitment of at least 80% of eligible patients within 12 months; retention of 80% of participants during the study period and achieving at least 80% adherence to the intervention protocol. Secondary aims were to investigate the effectiveness of the

Aim: This study aimed to validate the relationships between possible predictive factors and clinically diagnosed infection in adult patients with chronic leg ulcers. Methods: This study used a sample of 636 adult participants whose ulcers were diagnosed as either venous, arterial or mixed aetiology leg ulcers and had no clinical signs of infection at recruitment. Data were extracted from recruitment to 12 weeks from six longitudinal prospective studies from 2004 to 2015. Survival analysis was used to investigate mean time-to-infection, including the Kaplan-Meier method and the Cox proportional-hazards regression model. Results: The sample included 74.7% venous, 19.6% mixed and 5.7% arterial leg ulcers. There were 101 (15.9%) participants diagnosed with infection at least once within 12 weeks of follow-up. Mean time-to-infection was 10.89 weeks (95% CI = 10.66-11.12). After adjustment for potential confounders, a Cox proportional hazards regression model found that depression, using walking aids, calf ankle ratio <1.3, wound area ≥10 cm2 and ulcers with slough tissue at recruitment were significant risk factors for wound infection. Conclusion: This study has validated the predictive ability of factors which have been found in a cross-sectional study to be significantly associated with infection in patients with leg ulcers, including venous leg ulcers, arterial leg ulcers and mixed aetiology leg ulcers. Results showed that patients with chronic leg ulcers, who either presented with depression, used walking aids, had a calf ankle ratio <1.3, a wound area ≥10 cm2 or an ulcer with slough tissue, had greater likelihood of developing infection compared to those without these factors.

Vasculitis can be a primary disorder or a cutaneous manifestation of a viral infection. The present case describes an atypical localized cutaneous varicella-zoster virus infection inducing a small vessel vasculitis in a patient with multisystem sarcoidosis. Additionally, we discuss the differential diagnoses and treatment options. Varicella-Zoster infection occurs more frequently in immunosuppressed populations and can present with uncharacteristic clinical manifestations complicating the diagnosis as in the present case.

Background: People living with chronic leg ulcers frequently experience moderate to severe wound-related pain with the highest level of pain occurring at dressing change. Wound- related pain is not always able to be alleviated by oral analgesics alone. Persistent poorly- controlled leg ulcer pain physiologically impacts wound healing and prevents timely, effective wound management strategies being implemented which can negatively impact wound healing and health-related quality of life (HRQoL). Topical agents such as morphine gel and ibuprofen foam are used as primary dressings as a strategy for managing chronic leg ulcer pain. Studies investigating ibuprofen foam have shown significant improvement in chronic leg ulcer pain compared to standard care. There is insufficient evidence to suggest morphine gel is effective for chronic leg ulcer pain. Topical local anaesthetics, in particular the eutectic mixture of local anaesthetics (EMLA®), have been used for decades to relieve pain associated with debridement of chronic leg ulcers. However, their effectiveness as a primary dressing for managing chronic wound-related pain is yet to be evaluated. Since there was no known evidence regarding the effectiveness of EMLA® as a primary dressing for painful chronic leg ulcers to relieve wound-related pain and its associated impact on wound healing and HRQoL this feasibility study was conducted. Study aims: The primary aim of this study was to assess the processes, resources, management and scientific aspects of the study to ensure implementation of a larger study is feasible and to generate data that could be used for future sample size calculations. Study feasibility was assessed using the following criteria for determining success: recruitment of at least 80% of eligible patients within 12 months; retention of 80% of participants during the study period and achieving at least 80% adherence to the intervention protocol. Secondary aims were to investigate the effectiveness of the, Thesis (PhD Doctorate), Doctor of Philosophy (PhD), School of Nursing & Midwifery, Griffith Health, Full Text

Bakgrund: Larvterapi är en alternativ behandlingsmetod i bensårsläkning. Sårläkning med larver har förekommit i mer än 70 år men vid antibiotikans introduktion minskades användandet av larvterapi. Då det idag finns problem med antibiotikaresistens introducerades larvterapi åter. Syftet med denna studie var att belysa hur larvterapi påverkar bensårsbehandlingen för patienter med kroniska bensår. Metod: En integrativ litteraturstudie genomfördes utifrån två kvalitativa och sju kvantitativa vetenskapliga artiklar. Resultat: Det som belystes var fysiologisk påverkan av bensåret såsom debridering och läkning samt upplevelsen av larvterapi såsom smärta, obehagskänslor och lukt. Studien visade att debridering vid bensår med larvterapi gav bättre resultat än med hydrogelbehandling. Larverna debriderade såren från nekrotisk vävnad så att bensårens omfång minskade drastiskt. Anmärkningsvärt var att sex av nio studier nämnde att smärta upplevdes under behandlingsprocessen men att acceptansen av larvterapi som behandlingsform var över förväntan trots smärtan. En del patienter hade initialt en negativ inställning inför larvterapi men var villiga att prova behandlingsmetoden. Larvterapi kunde förbättra patienters välbefinnande och vid smärtförekomst gick behandlingsmetoden att genomföra med hjälp av information och smärtstillande läkemedel varvid den totala läkningstiden förkortades., Background: Larval therapy is an alternative treatment method in wound healing. Wound healing with larvae has occurred for more than 70 years. The introduction of antibiotics decreased larval therapy, but though there are problems with the resistance of antibiotics, larval therapy returned. The objective of this study was to highlight the impact of larval therapy for chronic leg ulcers. Method: An integrative literature study was performed based on two qualitative and seven quantitative scientific articles. Results: The impacts of the leg ulcers that were highlighted were physiological such as debridement and healing, also the experience of larval therapy such as pain, feelings of discomfort and wound odor. The study showed that the debridement in leg ulcers with larval therapy gave better results than hydrogel treatment. The larvae debrided necrotic tissue from the wounds and decreased the wound dramatically. Remarkably, six out of nine studies mentioned pain as a big factor during treatment but the acceptance of larval therapy was beyond expectation. Although some patients were reluctant to try larval therapy, most patients were willing to go through with the treatment. Larval therapy improved the wellbeing of patients and if pain occurred during larval therapy patients were motivated with information and were relieved with painkillers so the total time of healing was shortened.

Bakgrund: Larvterapi är en alternativ behandlingsmetod i bensårsläkning. Sårläkning med larver har förekommit i mer än 70 år men vid antibiotikans introduktion minskades användandet av larvterapi. Då det idag finns problem med antibiotikaresistens introducerades larvterapi åter. Syftet med denna studie var att belysa hur larvterapi påverkar bensårsbehandlingen för patienter med kroniska bensår. Metod: En integrativ litteraturstudie genomfördes utifrån två kvalitativa och sju kvantitativa vetenskapliga artiklar. Resultat: Det som belystes var fysiologisk påverkan av bensåret såsom debridering och läkning samt upplevelsen av larvterapi såsom smärta, obehagskänslor och lukt. Studien visade att debridering vid bensår med larvterapi gav bättre resultat än med hydrogelbehandling. Larverna debriderade såren från nekrotisk vävnad så att bensårens omfång minskade drastiskt. Anmärkningsvärt var att sex av nio studier nämnde att smärta upplevdes under behandlingsprocessen men att acceptansen av larvterapi som behandlingsform var över förväntan trots smärtan. En del patienter hade initialt en negativ inställning inför larvterapi men var villiga att prova behandlingsmetoden. Larvterapi kunde förbättra patienters välbefinnande och vid smärtförekomst gick behandlingsmetoden att genomföra med hjälp av information och smärtstillande läkemedel varvid den totala läkningstiden förkortades., Background: Larval therapy is an alternative treatment method in wound healing. Wound healing with larvae has occurred for more than 70 years. The introduction of antibiotics decreased larval therapy, but though there are problems with the resistance of antibiotics, larval therapy returned. The objective of this study was to highlight the impact of larval therapy for chronic leg ulcers. Method: An integrative literature study was performed based on two qualitative and seven quantitative scientific articles. Results: The impacts of the leg ulcers that were highlighted were physiological such as debridement and healing, also the experience of larval therapy such as pain, feelings of discomfort and wound odor. The study showed that the debridement in leg ulcers with larval therapy gave better results than hydrogel treatment. The larvae debrided necrotic tissue from the wounds and decreased the wound dramatically. Remarkably, six out of nine studies mentioned pain as a big factor during treatment but the acceptance of larval therapy was beyond expectation. Although some patients were reluctant to try larval therapy, most patients were willing to go through with the treatment. Larval therapy improved the wellbeing of patients and if pain occurred during larval therapy patients were motivated with information and were relieved with painkillers so the total time of healing was shortened.

Syfte: Syftet med studien var att studera den äldre patientens upplevelse av att leva med svårläkta bensår och vad denne anser bidrar till eller förhindrar en positiv syn på sin tillvaro. Metod: Studien innehåller intervjuer med äldre personer drabbade av svårläkta bensår. En kvalitativ innehållsanalys genomfördes. Resultat: Resultatet visar att informanterna upplever smärta, oro för försämring, ångest och att den långsamma sårläkningen är påfrestande. Enligt informanterna krävs det deltagande vid sociala sammankomster och aktiviteter samt att hålla kontakt med vänner och anhöriga för att bibehålla en positiv syn på sin tillvaro. Livskvaliteten upplevs som relativt god. Liksom synen på tillvaron påverkas också den upplevda livskvaliteten av den egna situationen och då positivt genom att känna sig delaktig i ett socialt sammanhang och negativ genom förlust av självständighet. Samtliga informanter har en positiv upplevelse av den erhållna sjukvården, de tror på kontinuitet för ett bra behandlingsresultat och känsla av trygghet. Slutsats: Svårläkta bensår påverkar den äldre människan på olika områden i livet, fysiskt, psykisk och existentiellt. De äldre patienterna behöver hälso- och sjukvården samt ett socialt nätverk för att bibehålla en positiv livssyn., Aim: The aim of this study was to study the older patient's experience of living with chronic leg ulcers and what he or she considers to contribute to or impede a positive outlook on their lives. Method: The study includes interviews with elderly people suffering from chronic leg ulcers. A content analysis was performed. Results: The result shows that the informants are experiencing pain, concerns about worsening, anxiety, and that the slow wound healing are stressful. According to informants, it requires attendance at social gatherings and activities and to keep in touch with friends and loved ones to maintain a positive outlook on their lives. The quality of life is perceived as relatively good. The perception of life and the perceived quality of life effects positively by feeling involved in a social context and negatively through the loss of independence. All respondents have a positive experience of the obtained medical care, they believe in the continuity for good treatment results and sense of security. Conlusion: Slow-healing leg ulcers affects older people in different areas of life, physical, psychological and existential. The older patients need health care and a social network to maintain a positive outlook on life.

Syfte: Syftet med studien var att studera den äldre patientens upplevelse av att leva med svårläkta bensår och vad denne anser bidrar till eller förhindrar en positiv syn på sin tillvaro. Metod: Studien innehåller intervjuer med äldre personer drabbade av svårläkta bensår. En kvalitativ innehållsanalys genomfördes. Resultat: Resultatet visar att informanterna upplever smärta, oro för försämring, ångest och att den långsamma sårläkningen är påfrestande. Enligt informanterna krävs det deltagande vid sociala sammankomster och aktiviteter samt att hålla kontakt med vänner och anhöriga för att bibehålla en positiv syn på sin tillvaro. Livskvaliteten upplevs som relativt god. Liksom synen på tillvaron påverkas också den upplevda livskvaliteten av den egna situationen och då positivt genom att känna sig delaktig i ett socialt sammanhang och negativ genom förlust av självständighet. Samtliga informanter har en positiv upplevelse av den erhållna sjukvården, de tror på kontinuitet för ett bra behandlingsresultat och känsla av trygghet. Slutsats: Svårläkta bensår påverkar den äldre människan på olika områden i livet, fysiskt, psykisk och existentiellt. De äldre patienterna behöver hälso- och sjukvården samt ett socialt nätverk för att bibehålla en positiv livssyn., Aim: The aim of this study was to study the older patient's experience of living with chronic leg ulcers and what he or she considers to contribute to or impede a positive outlook on their lives. Method: The study includes interviews with elderly people suffering from chronic leg ulcers. A content analysis was performed. Results: The result shows that the informants are experiencing pain, concerns about worsening, anxiety, and that the slow wound healing are stressful. According to informants, it requires attendance at social gatherings and activities and to keep in touch with friends and loved ones to maintain a positive outlook on their lives. The quality of life is perceived as relatively good. The perception of life and the perceived quality of life effects positively by feeling involved in a social context and negatively through the loss of independence. All respondents have a positive experience of the obtained medical care, they believe in the continuity for good treatment results and sense of security. Conlusion: Slow-healing leg ulcers affects older people in different areas of life, physical, psychological and existential. The older patients need health care and a social network to maintain a positive outlook on life.

Background: Leg ulcers commonly emerge as a symptom of other comorbidities, often in older people. As a consequence of the ulcer, pain and sleep disturbances might occur. Due to the complex illness, the responsibility of treatment is unclear between health caregivers. The interaction between ulcer type, sleep and pain has not previously been investigated. This study aimed to explore pain in older men and women (65 years and older) with different diagnoses of leg ulcers and to investigate the associations of sleep disturbances and pain in people with leg ulcer diagnosis. Methods: The study used a cross-sectional design and data from the Swedish Registry of Ulcer Treatment, collected between May 2009 and December 2013. One thousand and eight hundred and twenty four people were included, and 62.9 % were women. The mean age was 83.4 years (SD 8.8). For the analyses, the chi-square test, Mann-Whitney U-test, t-test, one-way ANOVA and logistic regression was performed. Pain was measured by the Numeric Rating Scale (NRS), and sleep disturbances was assessed dichotomously. Results: We found the prevalence of pain intensity >= 5 on the NRS to be 34.8 % in those reporting pain. Additionally, the pain intensity was associated with the number of ulcers (p = 0.003). Sleep disturbances were associated with pain (p < 0.001) and were found in 34.8 % of the total sample. Although more women than men reported pain and scored higher on the NRS, no significant gender difference in sleep disturbances was found (p = 0.606). The mean NRS scores did not differ significantly between the ulcer types; however, arterial and venousarterial ulcers increased the risk of sleep disturbances, as did higher pain scores. Conclusions: The majority of the participants were of advanced age (>80 years) and frequently suffered from pain and sleep disturbances. Further research is needed regarding pain, sleep and wound healing in the oldest old with leg ulcers. Ulcer pain sometimes appears to recei

Bakalářská práce "Kvalita života osob s nehojící se ránou" je rozdělena na část teoretickou a výzkumnou. Teoretická část bakalářské práce se zabývá kvalitou života pacientů s nehojící se ránou, standardizovanými dotazníky využívanými v praxi, popisem diagnostiky a terapií nehojících se ran (především bércovými ulceracemi, syndromem diabetické nohy a dekubity). Pro výzkumnou část je zvolen dotazník vlastní tvorby zaměřený na zjištění úrovně kvality života pacientů s nehojící se ránou a na zjištění dopadů, které ovlivňují každodenní život jedince. Na základě výsledků je vytvořen edukační materiál pro pacienty s cílem pomoci jim v oblastech, které udávají jako problémové ve vztahu ke své kvalitě života., Bachelor thesis "Quality of life of people with non-healing wound" is divided into theoretical and practical part. The theoretical part deals with quality of life of patients with a nonhealing wound, standardized questionnaires used in practice, description of the diagnosis and therapy of non-healing wounds (especially leg ulcers, diabetic foot and decubitus). For the research part a questionnaire is created. The questionnaire is focused on quality of life of patients with non-healing wound and the impacts that affect the everyday lives of individuals. Based on the results the educational material for patients is created. Its aim is to assist them in areas that has been indicated as problematic in relation to their quality of life., Katedra ošetřovatelství, Hodnocení vedoucího: výborně minus Hodnocení oponenta: velmi dobře Doplňující otázky k obhajobě: 1. Jaké jsou podmínky pro získání certifikace ambulance pro léčbu ran (personální, materiálně-technické)? 2. Vysvětlete informaci uvedenou v metodice práce. Devět dotazníků bylo z hodnocení vyřazeno na základě "nedostatečných souvislostí s předchozími otázkami"? 3. Na straně 54 máte tabulky s rozdělením respondentů do skupin s narušenou psychikou a nenarušenou psychikou. Na základě jakého klíče jste je zařazovala? Obhajoba bakalářské práce s prezentací velmi dobrá, Dokončená práce s úspěšnou obhajobou

Bensår är ett ökande problem i samhället, detta som följd av att vi blir allt äldre. Bensår är svåra att läka och det är vanligt att de återkommer. Kroniska bensår definieras som sår som inte läker inom sex veckor. De vanligaste orsakerna till bensår är venös insufficiens, arteriell insufficiens eller en bladning av dessa. Syftet med litteraturstudien var att beskriva personers upplevelser av att leva med kroniska bensår. Det här arbetet har utförts som en litteraturstudie, där sökning av artiklar har gjorts i två databaser CINAHL och PubMed. Efter sökning i databaserna har 16 artiklar valts ut och granskats. Analysen av artiklar har gjorts genom att plocka ut förekommande fenomen i texten och kategorisera dessa i huvudteman med underteman. Analysen resulterade i tre huvudteman: smärta, aktivitetsbegränsningar och lukt och vätskande sår. Det finns många olika faktorer som påverkar personernas upplevelser av att leva med bensår, där smärta, rörelseförmågan och lukt och vätska från såret har en central roll. Studien visar på att många personer upplever att deras problem inte tas på allvar. Det holistiska synsättet inom vården måste förbättras och mer hänsyn bör tas till personernas existentiella, psykiska, sociala och kroppsliga upplevelser.

Introducción: la escasez de datos epidemiológicos de la úlcera de pierna en Brasil justificó este estudio. Así, esta investigación tuvo el objetivo de estimar la prevalencia de las úlceras de pierna. Material y método: estudio epidemiológico de prevalencia, por conglomerados, realizado en la ciudad de Bandeirantes – PR, Brasil, durante los meses de agosto a noviembre de 2012. Resultados: participaron en el estudio 1.499 individuos. La prevalencia fue de 6/1.000 personas, con mayor aparición en mujeres y personas mayores. Discusión y conclusión: la prevalencia encontrada fue superior a otros estudios realizados en países como España y Portugal, y el perfil de los individuos coincidió con la literatura., Introduction: the lack of epidemiological data about leg ulcers in Brazil justifies this study. So, the aim of that research was to estimate the prevalence of leg ulcers. Methods: epidemiological prevalence study, by conglomerates, performed at Bandeirantes city – PR, Brazil, between August-November 2012. Results: 1,499 individuals participated on the study. Prevalence was 6/1,000 persons, with major occurrence between women and elder people. Discussion: Prevalence found was higher than other studies like those preformed in Spain and Portugal, and the profile of the people was very similar to literature.

Objective: The aim of this study is to assess the efficiency and safety on using hydrogel carboxymethylcellulose 2%, handled at university pharmacy in treatment of patients with leg ulcers. Method: A non-controlled prospective clinic study with 20 patients took place from January to October 2010. Results: The efficiency assessment was performed through the wound area reduction and wound bed tissue alteration; the safety was assessed through observation and report of adverse events. The data showed that 33.3% of the lesions presented total healing. Regarding the safety, only 2 patients reported pain, increase of the exudate and wound infection as possible adverse reaction to the use hydrogel as dressing, according to the Naranjo algorithm. Conclusion: The results let us consider that the hydrogel 2% can be considered efficient and safe for this type of lesion., Objetivo: Avaliar a eficácia e a segurança do uso do hidrogel a 2%, manipulado na farmácia universitária, no tratamento de pacientes com úlceras de perna. Método: Estudo clínico, prospectivo, não controlado, incluindo 20 pacientes no período de janeiro a outubro de 2010. A avaliação da eficácia foi realizada através da redução e da alteração tecidual do leito da ferida. A segurança foi avaliada por observação e relato dos eventos adversos. Resultados: Os dados mostraram que 33,3% das lesões apresentaram cicatrização total. Quanto à segurança, apenas 2 pacientes apresentaram dor, aumento de exsudato e infecção da ferida como reações adversas possíveis, segundo o algoritmo de Naranjo, ao uso do hidrogel 2% como curativo. Conclusão: Os resultados permitem considerar que o hidrogel de CMC a 2% mostrou-se eficaz e seguro para o tratamento desse tipo de lesão., Objetivo: Es evaluar la eficacia y la seguridad del uso del Hidrogel 2%, manoseado en una farmacia docente, en el tratamiento de enfermos con úlceras de pierna. Método: El estudio clínico, no controlado, incluyó 20 pacientes en el periodo entre enero y octubre de 2010. Resultados: La evaluación de su eficacia fue comprobada por la reducción de la herida y de la alteración de la piel en su interior. La seguridad fue evaluada por observación y el relato de los eventos adversos. Los dados han evidenciados que 33,3% de las lesiones presentaron cicatrización total. Cuanto a la seguridad, solamente dos pacientes presentaron reacciones previsibles al uso del Hidrogel 2% como curativo. Conclusión: Se puede concluir que el Hidrogel 2% se muestra eficaz y seguro para el tratamiento de esto tipo de lesión.

Objective: The aim of this study is to assess the efficiency and safety on using hydrogel carboxymethylcellulose 2%, handled at university pharmacy in treatment of patients with leg ulcers. Method: A non-controlled prospective clinic study with 20 patients took place from January to October 2010. Results: The efficiency assessment was performed through the wound area reduction and wound bed tissue alteration; the safety was assessed through observation and report of adverse events. The data showed that 33.3% of the lesions presented total healing. Regarding the safety, only 2 patients reported pain, increase of the exudate and wound infection as possible adverse reaction to the use hydrogel as dressing, according to the Naranjo algorithm. Conclusion: The results let us consider that the hydrogel 2% can be considered efficient and safe for this type of lesion., Objetivo: Avaliar a eficácia e a segurança do uso do hidrogel a 2%, manipulado na farmácia universitária, no tratamento de pacientes com úlceras de perna. Método: Estudo clínico, prospectivo, não controlado, incluindo 20 pacientes no período de janeiro a outubro de 2010. A avaliação da eficácia foi realizada através da redução e da alteração tecidual do leito da ferida. A segurança foi avaliada por observação e relato dos eventos adversos. Resultados: Os dados mostraram que 33,3% das lesões apresentaram cicatrização total. Quanto à segurança, apenas 2 pacientes apresentaram dor, aumento de exsudato e infecção da ferida como reações adversas possíveis, segundo o algoritmo de Naranjo, ao uso do hidrogel 2% como curativo. Conclusão: Os resultados permitem considerar que o hidrogel de CMC a 2% mostrou-se eficaz e seguro para o tratamento desse tipo de lesão., Objetivo: Es evaluar la eficacia y la seguridad del uso del Hidrogel 2%, manoseado en una farmacia docente, en el tratamiento de enfermos con úlceras de pierna. Método: El estudio clínico, no controlado, incluyó 20 pacientes en el periodo entre enero y octubre de 2010. Resultados: La evaluación de su eficacia fue comprobada por la reducción de la herida y de la alteración de la piel en su interior. La seguridad fue evaluada por observación y el relato de los eventos adversos. Los dados han evidenciados que 33,3% de las lesiones presentaron cicatrización total. Cuanto a la seguridad, solamente dos pacientes presentaron reacciones previsibles al uso del Hidrogel 2% como curativo. Conclusión: Se puede concluir que el Hidrogel 2% se muestra eficaz y seguro para el tratamiento de esto tipo de lesión.

Bensår är ett ökande problem i samhället, detta som följd av att vi blir allt äldre. Bensår är svåra att läka och det är vanligt att de återkommer. Kroniska bensår definieras som sår som inte läker inom sex veckor. De vanligaste orsakerna till bensår är venös insufficiens, arteriell insufficiens eller en bladning av dessa. Syftet med litteraturstudien var att beskriva personers upplevelser av att leva med kroniska bensår. Det här arbetet har utförts som en litteraturstudie, där sökning av artiklar har gjorts i två databaser CINAHL och PubMed. Efter sökning i databaserna har 16 artiklar valts ut och granskats. Analysen av artiklar har gjorts genom att plocka ut förekommande fenomen i texten och kategorisera dessa i huvudteman med underteman. Analysen resulterade i tre huvudteman: smärta, aktivitetsbegränsningar och lukt och vätskande sår. Det finns många olika faktorer som påverkar personernas upplevelser av att leva med bensår, där smärta, rörelseförmågan och lukt och vätska från såret har en central roll. Studien visar på att många personer upplever att deras problem inte tas på allvar. Det holistiska synsättet inom vården måste förbättras och mer hänsyn bör tas till personernas existentiella, psykiska, sociala och kroppsliga upplevelser.

Introducción: la escasez de datos epidemiológicos de la úlcera de pierna en Brasil justificó este estudio. Así, esta investigación tuvo el objetivo de estimar la prevalencia de las úlceras de pierna. Material y método: estudio epidemiológico de prevalencia, por conglomerados, realizado en la ciudad de Bandeirantes – PR, Brasil, durante los meses de agosto a noviembre de 2012. Resultados: participaron en el estudio 1.499 individuos. La prevalencia fue de 6/1.000 personas, con mayor aparición en mujeres y personas mayores. Discusión y conclusión: la prevalencia encontrada fue superior a otros estudios realizados en países como España y Portugal, y el perfil de los individuos coincidió con la literatura., Introduction: the lack of epidemiological data about leg ulcers in Brazil justifies this study. So, the aim of that research was to estimate the prevalence of leg ulcers. Methods: epidemiological prevalence study, by conglomerates, performed at Bandeirantes city – PR, Brazil, between August-November 2012. Results: 1,499 individuals participated on the study. Prevalence was 6/1,000 persons, with major occurrence between women and elder people. Discussion: Prevalence found was higher than other studies like those preformed in Spain and Portugal, and the profile of the people was very similar to literature.

Objective: The study aims to compare the spectrum of leg ulcer aetiology in Skaraborg County in 1988 and 2002, an evaluation of 14 years of targeted leg ulcer intervention. Design: Cross-sectional study within the professional health-care system in Skaraborg County. Materials: In 2002, 621 leg ulcer patients were identified through a cross-sectional population survey. Methods: Half of the registered patients were randomly selected and offered clinical examination. A total of 198 patients with 246 legs underwent examination and were categorised in detail according to aetiology. Data were compared with the initial study in 1988. Results: Venous incompetence was present in 140 (57%) legs and the dominating cause in 94 (38%) of the leg ulcers, 40 (16%) due to deep venous incompetence. Arterial insufficiency was identified in 90 (37%) legs and the dominating aetiological factor in 41 legs (17%), eight (3%) being critical ischaemic ulcers. The relative risk (RR) of developing a leg ulcer in 2002 vs. 1988 was 0.77. The RR of a venous ulcer was reduced by 46%, arterial by 28%, while there was an increase in diabetic ulcers by 29% and multifactorial by 42%. Conclusion: The aetiological spectrum of leg ulcers has changed, most likely due to a new management strategy in the care of leg ulcer patients.

Bakalářská práce se zabývá problematikou chronických bércových vředů se zaměřením na výskyt chronických bércových vředů a na jejich léčbu v Pardubickém regionu. Bakalářská práce je rozdělena na část teoretickou a praktickou. Teoretická část se věnuje pojmu chronická rána, typům chronických ran dle etiologie, diagnostice, léčbě a prevenci. Výzkumná část prezentuje výsledky získané dotazníkovým šetřením od respondentů, kteří se léčí s chronickým bércovým vředem v Pardubickém regionu., The bachelor work is engaged in problems of chronic leg ulcers with a focus on the occurrence of types of chronic leg ulcers and their treatment in the Pardubice region. The bachelor work is divided into theoretical and practical part. The theoretical part deals with the concept of chronic wound types of chronic wounds by etiology, diagnosis, treatment and prevention. The research section presents the results obtained from the questionnaire survey respondents who are treated with chronic leg ulcers in the region of Pardubice., Katedra ošetřovatelství, Hodnocení vedoucího: výborně Hodnocení oponenta: velmi dobře mínus Doplňující otázky k obhajobě: 1. Jak jste zajistila anonymitu Vašeho výzkumu? 2. Popište, jakým způsobem by bylo možné zjistit výskyt bércových vředů v Pardubickém regionu. 3. Jaké je využití výsledků vaší práce pro praxi? Obhajoba bakalářské práce s prezentací velmi dobrá.

Objetivos: conocer la eficacia de los ácidos grasos hiperoxigenados (AGHO) en la prevención de las úlceras vasculares. Determinar el nivel de evidencia existente sobre el uso de ácidos grasos hiperoxigenados en la prevención de las úlceras vasculares. Material y método: se realizó una búsqueda bibliográfica en la The Cochrane Library, The Joanna Briggs Institute, PubMed-Medline y CUIDEN. Para su evaluación se han seguido las recomendaciones del sistema GRADE para la valoración de la evidencia y la fuerza de las recomendaciones. Resultados: en The Cochrane Library y en The Joanna Briggs Institute no aparece ningún documento que haga referencia a los AGHO. En el resto de bases de datos encontramos estudios observacionales que hacen referencia a las úlceras vasculares y AGHO. Conclusiones: aun no disponiendo de ensayos clínicos que evidencien su uso, se han venido utilizando durante los últimos años, con resultados satisfactorios, en el cuidado de la piel de las personas con alteraciones vasculares en los miembros inferiores. De acuerdo con la clasificación GRADE, todos los estudios arrojan una calidad de evidencia baja, por lo cual estimamos necesario la puesta en marcha de investigaciones que aporten mayor evidencia científica., Objectives: to determine the effectiveness of hyper-oxygenated fatty acids in the prevention of vascular ulcers. Determine the level of existing evidence the use of hyper-oxygenated fatty acids in the prevention of vascular ulcers. Material and Method: we performed a literature search of Cochrane Library, The Joanna Briggs Institute, PubMed, Medline and CUIDEN. For the evaluation, have followed the recommendations of the GRADE system for assessing evidence and strength of recommendations. Results: The Cochrane Library and The Joanna Briggs Institute does not see any document referring to AGHO. In all other databases are observational studies that relate to vascular ulcers and AGHO. Conclusions: although not having clinical trials demonstrating their use, in recent years, have been used successfully in skin care for people with lower limb vascular disorders. According to the classification GRADE, all studies show a low-quality evidence, which we consider necessary for the implementation of most scientific research.

Objetivos: conocer la eficacia de los ácidos grasos hiperoxigenados (AGHO) en la prevención de las úlceras vasculares. Determinar el nivel de evidencia existente sobre el uso de ácidos grasos hiperoxigenados en la prevención de las úlceras vasculares. Material y método: se realizó una búsqueda bibliográfica en la The Cochrane Library, The Joanna Briggs Institute, PubMed-Medline y CUIDEN. Para su evaluación se han seguido las recomendaciones del sistema GRADE para la valoración de la evidencia y la fuerza de las recomendaciones. Resultados: en The Cochrane Library y en The Joanna Briggs Institute no aparece ningún documento que haga referencia a los AGHO. En el resto de bases de datos encontramos estudios observacionales que hacen referencia a las úlceras vasculares y AGHO. Conclusiones: aun no disponiendo de ensayos clínicos que evidencien su uso, se han venido utilizando durante los últimos años, con resultados satisfactorios, en el cuidado de la piel de las personas con alteraciones vasculares en los miembros inferiores. De acuerdo con la clasificación GRADE, todos los estudios arrojan una calidad de evidencia baja, por lo cual estimamos necesario la puesta en marcha de investigaciones que aporten mayor evidencia científica., Objectives: to determine the effectiveness of hyper-oxygenated fatty acids in the prevention of vascular ulcers. Determine the level of existing evidence the use of hyper-oxygenated fatty acids in the prevention of vascular ulcers. Material and Method: we performed a literature search of Cochrane Library, The Joanna Briggs Institute, PubMed, Medline and CUIDEN. For the evaluation, have followed the recommendations of the GRADE system for assessing evidence and strength of recommendations. Results: The Cochrane Library and The Joanna Briggs Institute does not see any document referring to AGHO. In all other databases are observational studies that relate to vascular ulcers and AGHO. Conclusions: although not having clinical trials demonstrating their use, in recent years, have been used successfully in skin care for people with lower limb vascular disorders. According to the classification GRADE, all studies show a low-quality evidence, which we consider necessary for the implementation of most scientific research.

Perifer vaskulär insufficiens innebär arteriell och/eller venös cirkulationssvikt i nedre extremiteter, vilket kan förorsaka bensår. Vaskulär insufficiens i benen är ett ökande hälsoproblem som ofta är ett mycket smärtsamt tillstånd och kan ha stora konsekvenser för den drabbade i dennes dagliga liv. Litteraturöversikt valdes som metod för att besvara syftet; att beskriva forskning om patienters upplevelser av hur perifer vaskulär insufficiens i de nedre extremiteterna påverkar det dagliga livet. Detta utifrån Carnevalis omvårdnadsteori om dagligt liv funktionellt hälsotillstånd. Stora inskränkningar i dagligt liv på grund av sjukdomen identifierades i litteraturen. Smärtan spelade en central roll i flertalet begränsningar respondenterna mötte. Den sänkte deras mobilitet, vilket medförde social isolering och begränsningar i vardagliga aktiviteter och förändrad självbild. Smärtan orsakade även sömnrubbningar och förändrade sinnesstämningar. Flera respondenter upplevde rädslor, de med arteriell insufficiens för amputation och för tidig död, och de med venös insufficiens för situationer som kunde medföra nya sår. Ett annat återkommande fynd var brist på kunskap, smärtlindring och brister i relationen med vårdpersonal., Peripheral vascular insufficiency entails arterial and / or venous circulatory failure in the lower extremities, which can cause ulcers. Vascular insufficiency in the legs is an increasing health problem which often is a very painful condition and can have a major impact on the patient's daily life. Literature review was chosen as a method to answer the study aim; to describe research on patients' experiences of peripheral vascular insufficiency in the lower limbs and how it affects everyday life. This according to Carnevali’s theory on daily life functional health status. Major limitations in daily life because of the disease were identified in the literature. The pain was a central part of the restrictions all respondents met. It lowered mobility, leading to social isolation, limitations in activities in daily life and change in self-image. The pain also caused sleep disorders and altered moods. Several respondents experienced fears, those with arterial insufficiency of amputation and premature death, and those with venous insufficiency of situations that could cause new ulcers. Another frequent finding was a lack of knowledge, pain relief and trustful relationships with health professionals.

Objetivos: conocer la eficacia de los ácidos grasos hiperoxigenados (AGHO) en la prevención de las úlceras vasculares. Determinar el nivel de evidencia existente sobre el uso de ácidos grasos hiperoxigenados en la prevención de las úlceras vasculares. Material y método: se realizó una búsqueda bibliográfica en la The Cochrane Library, The Joanna Briggs Institute, PubMed-Medline y CUIDEN. Para su evaluación se han seguido las recomendaciones del sistema GRADE para la valoración de la evidencia y la fuerza de las recomendaciones. Resultados: en The Cochrane Library y en The Joanna Briggs Institute no aparece ningún documento que haga referencia a los AGHO. En el resto de bases de datos encontramos estudios observacionales que hacen referencia a las úlceras vasculares y AGHO. Conclusiones: aun no disponiendo de ensayos clínicos que evidencien su uso, se han venido utilizando durante los últimos años, con resultados satisfactorios, en el cuidado de la piel de las personas con alteraciones vasculares en los miembros inferiores. De acuerdo con la clasificación GRADE, todos los estudios arrojan una calidad de evidencia baja, por lo cual estimamos necesario la puesta en marcha de investigaciones que aporten mayor evidencia científica., Objectives: to determine the effectiveness of hyper-oxygenated fatty acids in the prevention of vascular ulcers. Determine the level of existing evidence the use of hyper-oxygenated fatty acids in the prevention of vascular ulcers. Material and Method: we performed a literature search of Cochrane Library, The Joanna Briggs Institute, PubMed, Medline and CUIDEN. For the evaluation, have followed the recommendations of the GRADE system for assessing evidence and strength of recommendations. Results: The Cochrane Library and The Joanna Briggs Institute does not see any document referring to AGHO. In all other databases are observational studies that relate to vascular ulcers and AGHO. Conclusions: although not having clinical trials demonstrating their use, in recent years, have been used successfully in skin care for people with lower limb vascular disorders. According to the classification GRADE, all studies show a low-quality evidence, which we consider necessary for the implementation of most scientific research.

Perifer vaskulär insufficiens innebär arteriell och/eller venös cirkulationssvikt i nedre extremiteter, vilket kan förorsaka bensår. Vaskulär insufficiens i benen är ett ökande hälsoproblem som ofta är ett mycket smärtsamt tillstånd och kan ha stora konsekvenser för den drabbade i dennes dagliga liv. Litteraturöversikt valdes som metod för att besvara syftet; att beskriva forskning om patienters upplevelser av hur perifer vaskulär insufficiens i de nedre extremiteterna påverkar det dagliga livet. Detta utifrån Carnevalis omvårdnadsteori om dagligt liv funktionellt hälsotillstånd. Stora inskränkningar i dagligt liv på grund av sjukdomen identifierades i litteraturen. Smärtan spelade en central roll i flertalet begränsningar respondenterna mötte. Den sänkte deras mobilitet, vilket medförde social isolering och begränsningar i vardagliga aktiviteter och förändrad självbild. Smärtan orsakade även sömnrubbningar och förändrade sinnesstämningar. Flera respondenter upplevde rädslor, de med arteriell insufficiens för amputation och för tidig död, och de med venös insufficiens för situationer som kunde medföra nya sår. Ett annat återkommande fynd var brist på kunskap, smärtlindring och brister i relationen med vårdpersonal., Peripheral vascular insufficiency entails arterial and / or venous circulatory failure in the lower extremities, which can cause ulcers. Vascular insufficiency in the legs is an increasing health problem which often is a very painful condition and can have a major impact on the patient's daily life. Literature review was chosen as a method to answer the study aim; to describe research on patients' experiences of peripheral vascular insufficiency in the lower limbs and how it affects everyday life. This according to Carnevali’s theory on daily life functional health status. Major limitations in daily life because of the disease were identified in the literature. The pain was a central part of the restrictions all respondents met. It lowered mobility, leading to social isolation, limitations in activities in daily life and change in self-image. The pain also caused sleep disorders and altered moods. Several respondents experienced fears, those with arterial insufficiency of amputation and premature death, and those with venous insufficiency of situations that could cause new ulcers. Another frequent finding was a lack of knowledge, pain relief and trustful relationships with health professionals.

Syftet med denna litteraturstudie är att jämföra larvterapi och konventionella metoder vid behandling av svårläkta sår utifrån följande perspektiv: upprensning av sår, duration av sårläkning och patienternas upplevelse. Polit & Becks (2006) modell användes vid arbete med denna litteraturstudie. Sökning av relevant litteratur gjordes i tre databas: PubMed, CINAHL och The Cochrane Library. Relevanta artiklar granskades med hjälp av granskningsprotokollerna modifierade av författarna efter Willman (2006). Nio olika studier har undersökts i denna litteraturstudie. Studierna utreder dels larvterapins effektivitet i upprensning av sår samt larvernas läkningsförmåga och dels hur patienterna upplever larvterapi. Detta sattes i relation till konventionella behandlingsmetoder. Resultaten är positiva i larvterapins favör. Larvterapi är ett effektivt sätt att rensa upp nekrotisk och inflammerad vävnad i svårläkta sår. Såren rensas och läker fortare med få biverkningar jämfört med konventionella behandlingar. Dessutom bildas granulationsvävnad snabbare, vilket är en förutsättning för sårets läkning. Korrekt information och involvering av patienten skapar en positiv attityd i denna behandlingsform. Ett stort behov finns för detta i sårläkningens område pga ökade restriktioner av antibiotikaanvändning och ett önskat minskat lidande hos patienter med svårläkta sår. Det finns stora möjligheter för larvterapin om den fortsätter att utforskas., The aim of this literature study is to compare larva therapy and conventional methods in treatment of ulcers on the basis of the following perspective: debridement of ulcers, duration of wound healing and patients´ experience. Polit & Becks (2006) model was used when working with this literature study. Search of relevant literature was done in three databases: PubMed, CINAHL and The Cochrane Library. Relevant articles were checked with the help of checklists modified of authors after Willman (2006). Nine different studies have been examined. The studies partly investigate the larva therapy’s effectiveness in debridement of ulcers and maggots´ capability in healing and partly how patients experience the larva therapy. This was set in relation to conventional treatment methods. The results are positive in larva therapy’s favour. Ulcers are debrided and healed quicker with few secondary effects compared to conventional treatments. Larva therapy is an effective way to debride necrotic and inflamed tissue in ulcers. Moreover new granulation tissue forms faster which is a condition for wound healing. Correct information and patients´ participation creates a positive attitude for this treatment. There is a big need for this in wound healing because of increased restrictions of use of antibiotics and desired decreased suffering for patients with ulcers. There are many possibilities with larva therapy if it continues to be researched.

Syftet med denna litteraturstudie är att jämföra larvterapi och konventionella metoder vid behandling av svårläkta sår utifrån följande perspektiv: upprensning av sår, duration av sårläkning och patienternas upplevelse. Polit & Becks (2006) modell användes vid arbete med denna litteraturstudie. Sökning av relevant litteratur gjordes i tre databas: PubMed, CINAHL och The Cochrane Library. Relevanta artiklar granskades med hjälp av granskningsprotokollerna modifierade av författarna efter Willman (2006). Nio olika studier har undersökts i denna litteraturstudie. Studierna utreder dels larvterapins effektivitet i upprensning av sår samt larvernas läkningsförmåga och dels hur patienterna upplever larvterapi. Detta sattes i relation till konventionella behandlingsmetoder. Resultaten är positiva i larvterapins favör. Larvterapi är ett effektivt sätt att rensa upp nekrotisk och inflammerad vävnad i svårläkta sår. Såren rensas och läker fortare med få biverkningar jämfört med konventionella behandlingar. Dessutom bildas granulationsvävnad snabbare, vilket är en förutsättning för sårets läkning. Korrekt information och involvering av patienten skapar en positiv attityd i denna behandlingsform. Ett stort behov finns för detta i sårläkningens område pga ökade restriktioner av antibiotikaanvändning och ett önskat minskat lidande hos patienter med svårläkta sår. Det finns stora möjligheter för larvterapin om den fortsätter att utforskas., The aim of this literature study is to compare larva therapy and conventional methods in treatment of ulcers on the basis of the following perspective: debridement of ulcers, duration of wound healing and patients´ experience. Polit & Becks (2006) model was used when working with this literature study. Search of relevant literature was done in three databases: PubMed, CINAHL and The Cochrane Library. Relevant articles were checked with the help of checklists modified of authors after Willman (2006). Nine different studies have been examined. The studies partly investigate the larva therapy’s effectiveness in debridement of ulcers and maggots´ capability in healing and partly how patients experience the larva therapy. This was set in relation to conventional treatment methods. The results are positive in larva therapy’s favour. Ulcers are debrided and healed quicker with few secondary effects compared to conventional treatments. Larva therapy is an effective way to debride necrotic and inflamed tissue in ulcers. Moreover new granulation tissue forms faster which is a condition for wound healing. Correct information and patients´ participation creates a positive attitude for this treatment. There is a big need for this in wound healing because of increased restrictions of use of antibiotics and desired decreased suffering for patients with ulcers. There are many possibilities with larva therapy if it continues to be researched.

Aim. To explore how people experienced leg ulcer care so as to inform practitioners about the patients' view as a vehicle for a changed leg ulcer care practice. Background. Great numbers of people suffer from chronic leg ulcers and many have to live with their illness for a long time. Even when the illness is controlled by medical treatment, the person with leg ulcers has to deal with physical, emotional, cognitive and social problems and long-term encounters with practitioners. Method. A Participatory Action Research approach was used. Nine older persons with chronic leg ulcers, treated in primary care, were asked about their experiences of the care. Content analysis and reflective dialogues with practitioners and persons with chronic leg ulcers was performed. The study was undertaken from autumn 2004 to spring 2005. Result. Although the persons with chronic leg ulcers experienced their encounters with practitioners as satisfying, findings illuminated low participation in their own care and low practitioner involvement in issues about their daily living with chronic illness. In addition, the participatory action research project did not proceed from problem identification towards development and change. Conclusion. Participation is about negotiation and transferring power and authority from practitioners towards patients and from researchers towards practitioners and patients. Undertaking a participatory action research project that brings sustainable change requires substantial work to involve practitioners in initiating and planning the research. Relevance to clinical practice. Participation requires true partnership. To reach participation between researchers, practitioners and patients would need a significant change in attitude of all parties as well as a change in the care culture. Changing attitudes is not enough as long as practitioners and patients are stuck in a hierarchical structure with predetermined and taken for granted roles and relations in the med

Chronic leg ulcers affect approximately 1 – 3% of the population aged over 60 years in the U.K., Europe, U.S.A. and Australia (Briggs & Closs, 2003; Margolis et al., 2002). Prevalence increases with age (Margolis et al., 2002), rising from around 0.6% of the general adult population up to 2% - 5.6% of those aged over 65 years (Bergqvist et al., 1999). With today’s ageing societies (Parker, 2005), this condition will become an increasing problem in the future. Leg ulcers often take months or years to heal and frequently recur, becoming a life long chronic condition associated with prolonged ill-health, pain, restricted mobility and decreased quality of life (Chase et al., 2000; Walshe, 1995). When planning care for people with chronic leg ulcers, a health care model is required which not only addresses the need for evidence based wound care, but also pain management, symptom management and quality of life issues associated with the condition. Prevalence of pain associated with leg ulcers is reported as ranging from around 50% (Nemeth et al., 2003) to 80% (Hareendran, 2005) and leg ulcer pain is reported to decrease energy levels (Persoon et al., 2004), interrupt sleep (Edwards et al., 2005a), affect mood (Edwards et al., 2005a) and restrict mobility (Brown, 2005) and ability to manage normal work (Edwards et al., 2005a). Mobility is often further constrained by the need to wear bulky, multilayered bandages, limiting the type of footwear and clothing able to be worn. Reduced mobility impacts on independence in activities of daily living and productivity. For example, Abbade et al. (2005) found 49.2% of patients had a functional disability impacting on daily activities and work and Persoon et al.’s (2004) review of 37 studies found restraints in work and leisure activities were one of the major limitations imposed by leg ulcers. Pain, limited mobility and embarrassment associated with leg ulcers often leads to social isolation (Ebbeskog & Ekman, 2001; Persoon e

The critical application of evidence to practice is essential to the role of any professional. For healthcare professionals seeking to provide care that will deliver the best possible outcomes for patients, it is especially important to be able to assess current evidence to guide clinical decision-making. Evidence-based practice (EBP) has become synonymous with the move within healthcare organisations to shift away from a culture of authority-based practice, where decisions are based on opinion, past practice and ritual, towards a culture where healthcare decisions are based on the best available evidence. This chapter will briefly outline the history of EBP, what is meant by evidence and where to find it. It will also cover the importance of critically appraising evidence before it is incorporated into practice. Finally, the importance of evaluating any changes to clinical practice is highlighted.

Blau syndrome is a fare autosomal dominant condition, typically defined by granulomatous polyarthritis, uveitis and skin eruption. Biopsy specimens demonstrate non-caseating granulomas in all lesions. We present a case of Blau syndrome associated with large recalcitrant leg ulcers. Biopsies taken in the leg ulcers of our patient systematically showed granulomas. Although leg ulcers have not previously been described as a part of Blau syndrome, we assume that the ulcerations in this case form part of Blau syndrome.

Chronic leg ulcers are associated with significant levels of pain, reduced mobility and long term health care treatment. The aim of this study was to investigate the effectiveness of a new community nursing model of care for clients with chronic leg ulcers on levels of pain and ulcer healing. A randomised controlled trial comparing the new model of care with standard community nursing care was conducted with a sample of 56 clients with chronic venous leg ulcers. Data were collected on admission to the study and at 12 weeks from admission. Significant improvements in levels of pain and ulcer healing were found in the intervention group receiving the new model of care. Results from this study have implications for health professionals providing care for clients with chronic leg ulcers.

Introducción: Las úlceras de pierna constituyen un importante problema de salud del que se desconoce el impacto epidemiológico en España. Por ello, desde el Grupo Nacional para el Estudio y Asesoramiento en Úlceras por Presión y Heridas Crónicas (GNEAUPP) se planteó la realización del primer estudio nacional de prevalencia de úlceras de pierna. Pacientes, material y método: Para ello se elaboró un cuestionario postal que fue enviado a todos los miembros del GNEAUPP. También se administraron cuestionarios a través de la red de ventas de Smith & Nephew España. Cada profesional participante en el estudio informaba acerca de la realidad correspondiente a su lista de usuarios, en el caso de la Atención Primaria, o a su unidad de enfermería, en el caso de los centros hospitalarios y los centros socio-sanitarios. El estudio se realizó entre octubre y diciembre de 2002. Resultados: Dentro del plazo establecido se recibió un total de 353 cuestionarios, lo que significa una tasa de respuesta del 8,82%. Doscientos veintidós (un 62,8% de los cuestionarios) procedían de profesionales de Atención Primaria, 66 (un 18,7%) de profesionales de hospitales y los 65 restantes (18,4%) de centros socio-sanitarios. Los cuestionarios recibidos representaban a usuarios de centros de Atención Primaria con una prevalencia total de úlceras de pierna en mayores de 14 años del 0,165%. Un 0,09% en úlceras venosas, un 0,06% en mixtas, un 0,013% en arteriales. En el caso de las úlceras de pie diabético se determinó una prevalencia del 0,53% en los diabéticos. Discusión: Las úlceras de pierna en España constituyen un importante problema de salud cuyas dimensiones se agravan a medida que aumenta la edad de los pacientes. En el caso de las úlceras venosas destaca la muy escasa utilización de sistemas que permitan conseguir elevadas cifras de presión. Esta última circunstancia concuerda con la severidad de las lesiones así como con variables relacionadas con su atención (tiempo asistencial, consumo de r, Introduction: Leg ulcers are an important health issue whose epidemiological impact in Spain is currently unknown. Consequently, the National Association for the Study and Counselling on Cronic and Pressure Ulcers (GNEAUPP, Grupo Nacional para el Estudio y Asesoramiento en Úlceras por Presión y Heridas Crónicas) put forward conducting the first national study on leg ulcer prevalence. Patients, material and methods: To this end, a questionnaire was posted to all GNEAUPP members. Questionnaires were also supplied via the Smith & Nephew Spain sales network. Each of the professionals participating in the survey reported on the current situation in regards with their list of patients, when located in Primary Care sites; or their wards and nurse units, if working in hospitals and nursing homes. The study was conducted between october and december, 2002. Results: Three hundred and fifty three questionnaires were submitted within the scheduled period, which accounted for a response rate of 8,82%. Two hundred and twenty two (62,8% of the questionnaires) were received from Primary Care professionals, 66 (18,7%) were submitted by hospital staff and the remaining 65 (18,4%) were sent from nursing homes. The received questionnaires reflect the situation of Primary Care site users; showing the prevalence of leg ulcers in the over 14 year-old population to be 0,165%. Of these, 0,09% are venous ulcers, 0,06% are mixed ulcers and 0,013% are arterial. As for diabetic ulcers, a prevalence of 0,53% was found among diabetic patients. Discusion: Leg ulcers are an important health issue in Spain with ever more serious dimensions as patient age increases. With regards to venous ulcers, the paucity of use of compression dressings is a striking factor. This circumstance correlates with wound severity and other variables associated to care and attention (assistance duration, resources involved, etc.). An integral approach of the leg ulcer issue in Spain calls for the identification of multidi

Leg ulcers are a chronic condition that affects a significant number of New Zealanders. While the management of the ulcers themselves has received much attention in the nursing and medical literature, little is known about what it is like to live with chronic leg ulcers, and how they impact on quality of life. A review of the nursing literature relating to leg ulcers reveals a focus on wound management, and a failure to appreciate the perspective of these patients. It is frequently stated in the nursing literature that these patients deliberately delay the healing of their ulcers to ensure continued contact with the nurses. This exploratory study utilised Heideggerian hermeneutic phenomenology to examine the experiences of five men and four women with chronic leg ulcers, revealing the comprehensive nature of the suffering that accompanies this condition. Much discomfort and distress is caused by the ulcers themselves, which is then compounded by the problems associated with the treatment regimes. The presence of ulcers impacts on virtually every aspect of daily life. Study participants had worked hard to minimise that suffering, with the differences created by the ulcers becoming part of a taken-for-granted way of being-in-the-world. They desperately wanted their ulcers to heal, and were prepared to do everything they could to achieve this. But the potential benefits of some treatment regimes must be balanced against the ongoing disruptions that such regimes would cause to their ability to lead a reasonably normal life. This study challenges the myths that surround patients with leg ulcers, and highlights the need for health professionals to move from a focus on wound management to understanding the specific needs of each individual within the context of their daily life.