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Providing adequate care for people with venous leg ulcers (VLUs) can be a challenge. Numerous publications have discussed the importance of compression therapies on the treatment of VLUs, but few have described the necessary materials and techniques for applying the Unna boot, contributing to the underutilization of this therapy. The use of manuals is one of the strategies in the training of health professionals.

The aim of this study was to develop and validate a manual on the technique of applying the Unna boot in patients with VLUs. The manual was created to improve the education and training of health professionals in the control of chronic VLUs.

This was a descriptive study involving 3 stages. The selection of content for the manual was based on a literature review of articles in the Portuguese, Spanish, and English languages published from January 2000 through December 2018, in which 8 key terms were searched across the Cochrane Library, MEDLINE, and SciELO databases, and Google Scholar search engine. The text, illustrations, and layout design of the manual as well as a video demonstration of the technique were created. The manual then was validated for content by an expert panel using the Delphi Technique and the content validity index (CVI).

The manual showed an overall CVI of 0.98 after 2 rounds of consultation and its content, presentation, and relevance were rated as very adequate by the expert panel. The final version of the manual features 29 pages of text and illustrations and includes a video demonstration of the technique.

A manual on the technique of applying the Unna boot in patients with VLUs was developed and validated for content by an expert panel.

A manual on the technique of applying the Unna boot in patients with VLUs was developed and validated for content by an expert panel.

No definitive guidelines exist to assist clinicians in determining when a chronic wound is infected or at risk for infection, nor do guidelines exist to aid in determining the indication or duration of systemic antibiotics. The lack of widely accepted guidelines can lead to excessive and improper use of systemic antibiotics, which can contribute to adverse drug events and the rise of multidrug-resistant organisms. Bay K 8644 mw Implementing a simple tool to measure the risk of infection in patients with chronic wounds could help clinicians determine the indication and appropriate use of systemic antibiotics as well as potentially reduce the use of systemic antibiotics.

This evidence-based practice project aims to identify both chronic wounds at risk for infection and the risk factors associated with chronic wound infection, evaluate the use of systemic antibiotics in patients with chronic wounds, and reduce the use of systemic antibiotics in chronic wounds that are not infected or at risk for infection by implementing e clinicians in determining the need for antibiotics, thus helping to reduce unnecessary antibiotic exposure, which can reduce the incidence of adverse drug events and multidrug-resistant organisms.

The WAR score can help guide clinicians in determining the need for antibiotics, thus helping to reduce unnecessary antibiotic exposure, which can reduce the incidence of adverse drug events and multidrug-resistant organisms.Compression therapy is the gold standard treatment for venous leg ulcers (VLUs); however, with adjunctive pharmacological therapies and poor patient adherence using compressive dressings, clinicians are looking to find the advantage in treating VLUs. This literature review focuses on the efficacy of pharmacological agents, quality of life using agents in addition to compression therapy, and cost effectiveness to indicate the best outcomes for pharmacological treatment of VLUs. The following available venotonic, hemorheologic, and fibrinolytic agents were reviewed for oral management in treating VLUs pentoxifylline, flavonoids (diosmin, hidrosmin, rutosides, and micronized purified flavonoid fraction, Vasculera), Red-Vine-Leaf-Extract AS 195, Ruscus, Ginkgo biloba, Centella asiatica, Pycnogenol (French maritime pine bark), escin/horse chestnut extract, nutritional supplements (ie, zinc and magnesium, glycosaminoglycans [sulodexide], mesoglycans), Axaven, cilostazol, fibrinolytic enhancers (stanozolol and defibrotide), calcium dobesilate, aspirin, antibiotics (antimicrobials, doxycycline, levamisole), diuretics, cinnarizine, naftazone, and benzarone. Venous leg ulcer pharmacological treatment options were searched in the English language from February 2020 to March 2020 using numerous databases and sites, such as PubMed. Drugs used adjunctively with compression therapy that facilitate healing in long-standing or large VLUs include micronized purified flavonoid fraction, pentoxifylline, sulodexide, and mesoglycan.

Natural agents with antioxidant and anti-inflammatory properties are safer than synthetic agents and may improve wound healing.

The purpose of this study is to evaluate the in vivo wound healing potential of an ointment prepared from Trifolium repens hydroethanolic extract (T repens) concerning excisional wounds in a rat model.

Seventy-two adult Wistar rats were divided into 4 groups a control group and 3 groups of animals treated with 1.5% T repens, 3% T repens, and 6% T repens. A full-thickness wound with an area of 314 mm2 was created in each rat. To investigate the effect of T repens on wound healing, the wound area, histological analyses (eg, angiogenesis, fibroblast, fibrocyte, mast-cell distribution), intracytoplasmic carbohydrate storage, and B-cell lymphoma 2-like protein 4 (BAX), B-cell lymphoma 2 (Bcl-2), and p53 gene expression in the wound tissue were evaluated for 21 days. Antioxidant activity was further measured by 2,20-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid) (ABTS) and 2,2-Di(4-tert-octylphenyl)-1-picrylhydrazyl (DPPH) assays.

The animals in the treated groups showed higher wound contraction ratios (P ⟨ .05), angiogenesis, fibroblast, fibrocyte, and mast-cell distribution and intracytoplasmic carbohydrate storage compared with the control group (P ⟨ .05). Moreover, the topical administration of T repens increased the messenger ribonucleic acid (mRNA) level of Bcl-2 and reduced the BAX and p53 mRNA levels (P ⟨ .05). These findings further revealed the strong antioxidant activity of T repens.

The topical administration of T repens accelerated wound healing by increasing angiogenesis; fibroblast, fibrocyte, and mast-cell distribution; intracytoplasmic carbohydrate storage; and modulation in genes involved in apoptosis in a rat model.

The topical administration of T repens accelerated wound healing by increasing angiogenesis; fibroblast, fibrocyte, and mast-cell distribution; intracytoplasmic carbohydrate storage; and modulation in genes involved in apoptosis in a rat model.