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Authors
Abstract(s)
Introdução: As úlceras de pressão constituem um enorme problema de saúde pública,
com um grande impacto na qualidade de vida dos doentes, estando associadas a altas taxas
de morbilidade e mortalidade. O tratamento destas lesões é complexo e envolve várias
abordagens, com o objetivo de promover o controlo da infeção, otimizar o processo de
cicatrização e melhorar a condição geral do doente. A presente dissertação tem como
objetivo a análise das diferentes abordagens terapêuticas das úlceras de pressão na
população adulta, nomeadamente os diferentes tipos de pensos, agentes tópicos e agentes
biofísicos.
Metodologia: Foi realizada uma pesquisa nas bases de dados eletrónicas MEDLINE e
Cochrane, considerando apenas artigos escritos em inglês, espanhol ou português e sem
restrições quanto à região e ano de publicação. A data da última pesquisa foi 9 de outubro
de 2022. Nesta revisão sistemática foram incluídos randomized controlled trials (RCT) que
focassem as abordagens terapêuticas das úlceras de pressão, em meio hospitalar e/ou com
acesso constante a um profissional de saúde. A qualidade metodológica dos estudos foi
avaliada utilizando a ferramenta de avaliação do risco de viés Revised Cochrane risk-of-bias
tool for randomized trials (RoB 2).
Resultados: Foram obtidos, inicialmente, 323 resultados, sendo que, após remoção de
duplicados foram obtidos 242 resultados. Após uma análise do título e resumo, foram
excluídos 139 estudos, que não respeitavam os critérios de inclusão. Após uma leitura
integral de cada estudo, foram excluídos 86 artigos, obtendo um total de 17 estudos para
incluir no presente trabalho. Relativamente às abordagens terapêuticas avaliadas, aquelas
focadas na utilização de agentes biofísicos, em particular, a terapia de estimulação elétrica,
a terapia de ultrassons e a terapia de pressão negativa, demonstraram ser mais vantajosas
no tratamento das úlceras de pressão. A utilização de fatores de crescimento parece
também potenciar mais a cicatrização deste tipo de úlceras, assim como a utilização de
agentes biológicos, como o colagénio. Os pensos de espuma de hidropolímero e os pensos
de hidrocolóide parecem ser vantajosos em relação às compressas humedecidas com
solução salina. Estas compressas poderão ser vantajosas quando associadas a outras
terapias, mas não parecem oferecer tantos benefícios quando utilizadas isoladamente.
Discussão/Conclusão: As terapêuticas focadas na utilização de agentes biofísicos,
fatores de crescimento e agentes biológicos como o colagénio parecem ser abordagens
promissoras. Considera-se importante o desenvolvimento de mais estudos, com protocolos
uniformes e padronizados de modo a permitir melhorar a investigação e o conhecimento sobre as várias abordagens terapêuticas disponíveis para o tratamento das úlceras de
pressão.
Introduction: Pressure ulcers are considered to be a huge public health problem, with a great impact on patients’ quality of life, being associated with high rates of morbidity and mortality. The treatment of these lesions is complex and involves several approaches, with the aim of promoting infection control, optimizing the healing process and improving the patient's general condition. This dissertation aims to analyze the different therapeutic approaches for pressure ulcers in the adult population, namely the different types of dressings, topical agents and biophysical agents. Methodology: A search was carried out using the electronic databases MEDLINE and Cochrane, considering only articles written in English, Spanish or Portuguese and without restrictions regarding region and year of publication. The date of the last search was October 9th, 2022. This systematic review included randomized controlled trials (RCT) that focused on therapeutic approaches for pressure ulcers, in a hospital environment and/or with constant access to a health professional. The methodological quality of the studies was assessed using the Revised Cochrane Risk-of-bias tool for randomized trials (RoB 2). Results: Initially, 323 results were obtained and, after removing duplicates, a total of 242 studies were screened. After an analysis of the title and abstract, 139 studies that did not meet the inclusion criteria were excluded. After analysing the full text of each one of these studies, 86 articles were excluded, leaving a total of 17 studies to be included in the present work. Regarding the therapeutic approaches evaluated, those focused on the use of biophysical agents, in particular, electrical stimulation therapy, ultrasound therapy and negative pressure therapy, proved to be more effective in the treatment of pressure ulcers. The use of growth factors also seems to enhance the healing ability of this type of ulcers, as does the use of biological agents, such as collagen. Hydropolymer foam dressings and hydrocolloid dressings appear to be advantageous over saline dressings. These saline dressings may be advantageous when associated with other therapies, but do not seem to offer as many benefits when used individually. Discussion/Conclusions: Therapeutic approaches focused on the use of biophysical agents, growth factors and biological agents, such as collagen, seem to be promising treatment options. It is considered important to develop more studies, with uniform and standardized protocols in order to improve research and knowledge about the various therapeutic approaches available for the treatment of pressure ulcers.
Introduction: Pressure ulcers are considered to be a huge public health problem, with a great impact on patients’ quality of life, being associated with high rates of morbidity and mortality. The treatment of these lesions is complex and involves several approaches, with the aim of promoting infection control, optimizing the healing process and improving the patient's general condition. This dissertation aims to analyze the different therapeutic approaches for pressure ulcers in the adult population, namely the different types of dressings, topical agents and biophysical agents. Methodology: A search was carried out using the electronic databases MEDLINE and Cochrane, considering only articles written in English, Spanish or Portuguese and without restrictions regarding region and year of publication. The date of the last search was October 9th, 2022. This systematic review included randomized controlled trials (RCT) that focused on therapeutic approaches for pressure ulcers, in a hospital environment and/or with constant access to a health professional. The methodological quality of the studies was assessed using the Revised Cochrane Risk-of-bias tool for randomized trials (RoB 2). Results: Initially, 323 results were obtained and, after removing duplicates, a total of 242 studies were screened. After an analysis of the title and abstract, 139 studies that did not meet the inclusion criteria were excluded. After analysing the full text of each one of these studies, 86 articles were excluded, leaving a total of 17 studies to be included in the present work. Regarding the therapeutic approaches evaluated, those focused on the use of biophysical agents, in particular, electrical stimulation therapy, ultrasound therapy and negative pressure therapy, proved to be more effective in the treatment of pressure ulcers. The use of growth factors also seems to enhance the healing ability of this type of ulcers, as does the use of biological agents, such as collagen. Hydropolymer foam dressings and hydrocolloid dressings appear to be advantageous over saline dressings. These saline dressings may be advantageous when associated with other therapies, but do not seem to offer as many benefits when used individually. Discussion/Conclusions: Therapeutic approaches focused on the use of biophysical agents, growth factors and biological agents, such as collagen, seem to be promising treatment options. It is considered important to develop more studies, with uniform and standardized protocols in order to improve research and knowledge about the various therapeutic approaches available for the treatment of pressure ulcers.
Description
Keywords
Agentes Biofísicos Agentes Biológicos Fatores de Crescimento Terapêutica Úlceras de Pressão