Manejo interdisciplinar de úlceras vasculares: compresión, tratamiento local, tratamiento complementario y coordinación interdisciplinar
2017
espanolObjetivo Conocer el manejo interdisciplinar de lesiones vasculares de miembros inferiores (MMII): compresion, tratamiento local, complementario y coordinacion interdisciplinar. Metodo Estudio observacional longitudinal retrospectivo. Se analizaron guias de practica clinica (GPC) en busca de recomendaciones para un buen manejo de las lesiones vasculares. Se determinaron las variables segun esas guias y se seleccionaron todas las historias con un diagnostico CIE de patologia vascular y uno NANDA de herida. Se comprobaron etiologia y localizacion de las lesiones y se valoraron las variables en las 31 historias resultantes. Resultados Se encontraron 3 lesiones mixtas y 28 venosas. La terapia compresiva se registro un 35,7% durante la lesion y un 21,4% durante y tras la lesion. Se pautaron antiagregantes en el 100% de las heridas mixtas y pentoxifilina en el 10,7% de las venosas. El consejo de salud en ejercicio y tabaco se encontro en el 66,7% de historias con patologia mixta. Se dio el consejo de ejercicio en lesiones venosas en un 10,7%. La localizacion se recogio en un 66,7% en lesiones mixtas y en un 21,4% en venosas. La palpacion de pulsos se registro en un 66,7% en lesiones mixtas y en un 17,9% en venosas. El registro del indice tobillo-brazo fue del 66,7% en lesiones mixtas y 7,1% en venosas. Conclusiones Las recomendaciones para ulceras venosas de las GPC se encontraron registradas en menos de la cuarta parte de las historias valoradas. La patologia arterial es llevada principalmente por cirugia vascular y la venosa por atencion primaria. EnglishObjective To know the interdisciplinary management of vascular wounds of the lower limbs: compression, local and complementary treatment and interdisciplinary coordination. Methods A retrospective longitudinal and observational study. Clinical practice guidelines (CPG) were analyzed looking for vascular wounds good management recommendations. Variables were determined according those guides, and every clinical history with an ICD's vascular disease diagnostic and a NANDA's wound diagnostic were selected. Etiology and localization of the wounds were checked and variables were analyzed on the 31 resulting histories. Results Three mixed injuries and 28 venous wounds were found. The compression therapy was recorded by 35,7% during the injury and 21,4% during and after the injury. Antiaggregants were prescribed in 100% of mixed wounds records and pentoxifylline in 10,7% of the venous ones. The health recommendations in exercise and tobacco was found in 66,7% of histories with mixed pathology. Exercise recommendation was given on venous injuries by 10,7%. The location was recorded in 66,7% in mixed wounds and in 21,4% in venous ones. The pulse palpation record was 66,7% in mixed injuries and 17,9% in venous ones. The anklebrachial pressure index was recorded in 66,7% in mixed injuries and in 7,1% in venous ones. Conclusions Recommendations of CPG for venous leg ulcers were found to be recorded in less than a quarter of the assessed histories. The arterial pathology is carried mainly by vascular surgery and the venous pathology by primary care
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