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Authors
Abstract(s)
Introdução
As feridas crónicas e complexas exibem um tratamento difícil constituindo um dos mais antigos
desafios para o médico. Dificuldades na cicatrização destas feridas provocam várias consequências
como o aumento dos custos na saúde, o aumento do tempo de hospitalização e altas taxas de
morbilidade com diminuição da qualidade de vida dos doentes.
Os fatores que influenciam a cicatrização têm de ser controlados e o leito da ferida preparado. O
modelo TIME, criado em 2002, é uma ferramenta clínica usada nos dias de hoje na abordagem das
feridas crónicas.
Múltiplas opções foram desenvolvidas para uma melhor cicatrização. Esta dissertação aborda a arte
da terapia de pressão negativa na abordagem de feridas crónicas e complexas com ilustrações de
casos clínicos de abdómen aberto e pé diabético.
Objetivo
Revisão bibliográfica com estudo de casos clínicos sobre a utilização da terapia de pressão negativa
no tratamento de feridas crónicas e complexas.
Métodos
A recolha bibliográfica desta tese alicerçou-se nas bases de dados virtuais disponibilizadas pela
Universidade aos estudantes, nomeadamente o Uptodate e a Sciencedirect. A pesquisa foi efetuada
com os termos “Terapia de pressão negativa”, “Ferida”, “Cicatrização”, “Abdómen aberto”, “Pé
diabético”, nos idiomas português, francês, espanhol e inglês.
Resultados e Discussão
Introduzido por Argenta et al. em 1997, esta técnica requer um preenchimento que proporciona
ação entre o dispositivo e o corpo humano. São usadas esponjas intensamente porosas com conexões
espaciais, que sofrem efeitos micromecânicos pelo dispositivo de pressão negativa, gerando pressões
subatmosféricas distribuídas equitativamente pela ferida, protegida com um revestimento oclusivo,
resultando em ondulações do tecido e estiramento das células, o que induz um aumento da
proliferação celular. Existem esponjas de diferentes tipos no mercado, que potenciam a formação
de tecido de granulação e atacam as taxas de infeção.
Foi analisado 1 caso clinico de uma ferida de abdómen aberto e 3 casos clínicos de feridas complexas
no pé diabético com avaliação dos resultados obtidos e ilustrações. Conclusão
Os casos clínicos analisados revelaram que a terapia por pressão negativa tem efeitos positivos na cicatrização de feridas complexas, sendo uma abordagem bastante segura e eficaz diminuindo o tempo de internamento e economizando recursos.
Introduction Chronic wounds demonstrates to be a hard treatment and an earliest challenge to the clinicians. Non-healing wounds has various consequences such as rising health costs , increased length of hospital stay , and high rates of morbidity with decreased quality of life for patients . Factors that influence wound healing must be controlled and the wound bed preparation must be achieved. The TIME model created in 2002 is a clinical tool used these days in chronic wound approach. Multiple options were developed for better healing results. This dissertation discusses the art of negative pressure wound therapy in chronic wound approach with illustrations of complex cases like open abdomen and diabetic foot. Goal Study review on the use of negative pressure wound therapy in the treatment of complex wounds: case series. Methods The literature review of this thesis was based on virtual databases provided by the University to students and in particular Uptodate and Sciencedirect. The research was conducted using the terms "negative pressure therapy", "wound", "wound healing", "open abdomen", "diabetic foot", in Portuguese, French, Spanish and English. Results and Discussion Introduced by Argenta et al in 1997 this technique requires a fill that induces action between the machine and the human body. Extensively porous sponges are used with spatial connections, suffering micromechanical effects by the negative pressure device generating subatmospheric pressures evenly distributed through the wound protected with an occlusive coating resulting in stretching of the tissue cells which leads to an increase of proliferation cell. There are different types of sponges on the market which enhance the formation of granulation tissue and decreases rates of infection. 1 clinical case of an open abdomen wound was analyzed such as 3 clinical cases of complicated wounds in diabetic foot with evaluation of results and illustrations. Conclusion The clinical cases revealed that negative pressure wound therapy has positive effects on the healing of complex wounds being a very safe and effective approach to reduce the length of hospitalization and saving resources.
Introduction Chronic wounds demonstrates to be a hard treatment and an earliest challenge to the clinicians. Non-healing wounds has various consequences such as rising health costs , increased length of hospital stay , and high rates of morbidity with decreased quality of life for patients . Factors that influence wound healing must be controlled and the wound bed preparation must be achieved. The TIME model created in 2002 is a clinical tool used these days in chronic wound approach. Multiple options were developed for better healing results. This dissertation discusses the art of negative pressure wound therapy in chronic wound approach with illustrations of complex cases like open abdomen and diabetic foot. Goal Study review on the use of negative pressure wound therapy in the treatment of complex wounds: case series. Methods The literature review of this thesis was based on virtual databases provided by the University to students and in particular Uptodate and Sciencedirect. The research was conducted using the terms "negative pressure therapy", "wound", "wound healing", "open abdomen", "diabetic foot", in Portuguese, French, Spanish and English. Results and Discussion Introduced by Argenta et al in 1997 this technique requires a fill that induces action between the machine and the human body. Extensively porous sponges are used with spatial connections, suffering micromechanical effects by the negative pressure device generating subatmospheric pressures evenly distributed through the wound protected with an occlusive coating resulting in stretching of the tissue cells which leads to an increase of proliferation cell. There are different types of sponges on the market which enhance the formation of granulation tissue and decreases rates of infection. 1 clinical case of an open abdomen wound was analyzed such as 3 clinical cases of complicated wounds in diabetic foot with evaluation of results and illustrations. Conclusion The clinical cases revealed that negative pressure wound therapy has positive effects on the healing of complex wounds being a very safe and effective approach to reduce the length of hospitalization and saving resources.