Introduction: Thermography is a surface thermal radiation measurement technique whose application has been expanding in the healthcare field. The unhealed wound is a serious public health problem because it intervenes in the quality of life of patients and may cause emotional and psychological losses. The wound temperature can provide quantitative data that allow for the healing process to be monitored. The aim of this study was to verify whether thermography can be used as a method to evaluate the healing of pressure ulcers. Methods: Eight participants with sacral pressure ulcers were recruited and randomly divided into two groups: A (control) and B (experimental). Both groups received standard treatment for a period of four weeks, which consisted of a daily cleaning of the pressure ulcers with physiological saline (sodium chloride 0.9%) followed by an alginate hydrogel dressing. The group B received light-emitting diode (LED) phototherapy in addition to standard treatment, three times a week, yielding a total of 12 sessions. Photographs and thermograms of each pressure ulcer were obtained in all sessions in both groups. Results: Pressure ulcers treated with LED phototherapy were healed. The pressure ulcer area of group B decreased over the 12 treatment sessions, whereas the pressure ulcer area of group A increased. The ulcer temperature of group B was higher than that of group A during the treatment (temperature difference up to 7.6%). Discussion: The present study suggests a relationship between the temperature and area of pressure ulcers and proposes thermography as an adjunctive method for the evaluation of healing processes.
The high incidence of wounds by second intention and the high costs associated with their treatment give rise to the need for the development of wound dressings that protect not only the wounds themselves but that are also able to promote cell proliferation and skin regeneration. Moreover, it is also very important that no damage to the new regenerated tissue is generated while removing the dressing. In this work, a novel wound dressing, which would be able to favor tissue repair and be removed at an appropriate scheduled moment by means of an external stimulus without promoting extensive damage to the new tissue, was produced and tested. Polyurethane membranes were modified by grafting polymers based on poly(n-isopropylacrylamide) (P-N-IPAAm). P-N-IPAAm undergoes a phase transition at approximately 32°C, which changes its behavior from hydrophilic (below 32°C) to hydrophobic. It was hypothesized that, by reducing the temperature near the wound dressing to values lower than 32°C, the detachment of the dressing would become more effective. The wound dressings containing P-N-IPAAm grafts were tested in vivo by covering excisional wounds produced in mice. The produced dressings were placed in direct contact with the lesions for 3 days. Results showed that the hypothermia due to anesthesia required to remove the dressings from mice lowered the local temperature to 28°C and favored the detachment of the wound dressings containing P-N-IPAAm grafts. Histological analyses showed that lesions covered by dressings presented less intense inflammatory events and denser connective tissue than did the wounds without dressings. The wounds covered by polyurethane membranes with P-N-IPAAm grafts showed signs of more intense re-epithelization and angiogenesis than did the lesions covered by polyurethane without grafts.
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