RESUMO
Nonhealing wounds (stalled, healable) challenge affected individuals, wound clinicians, and society. Nonhealing may result despite local factors being corrected. The interplay between tissue degradation, increased inflammatory response, and abundant protease activity is a challenging quandary. A modified Delphi process was utilized to investigate a protease activity test and practice implications.
Assuntos
Testes Diagnósticos de Rotina/instrumentação , Peptídeo Hidrolases/análise , Sistemas Automatizados de Assistência Junto ao Leito , Ferimentos e Lesões/diagnóstico , Algoritmos , Canadá , Consenso , Técnica Delphi , Testes Diagnósticos de Rotina/métodos , Humanos , Inflamação/diagnóstico , Inflamação/enzimologia , Inflamação/patologia , Peptídeo Hidrolases/metabolismo , Fatores de Tempo , Cicatrização , Ferimentos e Lesões/metabolismo , Ferimentos e Lesões/patologiaRESUMO
PURPOSE: To provide the specialist in skin and wound care with an update in recommended management of venous leg ulcers. TARGET AUDIENCE: This continuing education activity is intended for physicians and nurses with an interest in wound care and related disorders. OBJECTIVES: After reading this article and taking this test, the reader should be able to:Editor's note: This "Best Practice Recommendations" article is reprinted with permission from Wound Care Canada, The Official Publication of the Canadian Association of Wound Care (2006;4[1]:45-55). It is the third installment of 4 articles originally published in 2006, following the latest Nursing Best Practice Guidelines from the Registered Nurses Association of Ontario (RNAO), which are updated approximately every 3 years. In 2000, the Canadian Association of Wound Care produced and had published its first best practice recommendations for the prevention and treatment of pressure ulcers. In this article, best practice recommendations are discussed for the prevention and treatment of pressure ulcers. The evidence presented is connected to the RNAO's recommendations from its review of the literature up to the writing of its 2006 guidelines. Clinical decision-making in the treatment of pressure ulcers can be guided by the algorithm that directs the clinician to identify and treat the underlying causes, to identify and manage patient-centered concerns, and to provide for good local wound care, considering adjunctive therapies or biologically active dressings when the edge of the wound is not advancing. Finally, the recommendations advise putting into place those organizational and educational activities that support the translations of the guidelines into practice.
