Objetiva-se descrever o caso clínico de uma paciente com Necrólise Epidérmica Tóxica, tendo como enfoque oacompanhamento da evolução das lesões cutâneas; discutir o acompanhamento da evolução da doença e o uso dascoberturas disponíveis para a realização dos curativos; e analisar a eficácia do tratamento empregado com Polihexanidabetaina (PHMB) e placas de hidrofibra com prata. Trata-se de um relato de caso realizado em um hospital federal do estadodo Rio de Janeiro sob autorização por escrito da paciente. O curativo era realizado diariamente, pela Comissão Terapêuticade Feridas (CTF) e médicos da Cirurgia Plástica. No curativo do corpo, que apresentava áreas com descolamento total daepiderme e muito friáveis inicialmente foi utilizada como cobertura primária Sulfadiazina de prata a 1%. Conduta que foimantida por 07 dias, não havendo melhora aparente do quadro. Foi então realizada antissepsia com o PHMB e utilizadasplacas de hidrofibra em todo o corpo. Após 15 dias, na terceira troca do curativo, evidenciou-se melhora significativa, nãosendo necessário uso de hidrofibra. Concluí-se que ficou clara a eficácia do tratamento empregado e evidente a importânciado uso da cobertura adequada para cada demanda, sendo vantajoso e benéfico para todas as partes envolvidas.Palavras-chave: Doenças Autoimunes; Lúpus Eritematoso Sistêmico; Ferimentos e Lesões. ABSTRACTThe aim is to describe the clinical case of a patient with Toxic Epidermal Necrolysis focusing on the evolution ofcutaneous lesions; to discuss the disease progression and the use of covers available for the curative; and to analyzethe effectiveness of the treatment employed with Polihexanide Betaine Solution (PHMB) and Hydrofiber plates withSilver. This is a case report held in a federal hospital in the state of Rio de Janeiro. The patient in question authorizedthis report through The Free Informed Consent Form, according to Resolution 466/12. The curative was performeddaily, in the Surgical Center by the Therapeutic Committee of Wounds (TCW) and Medical Plastic Surgery. In thebody curative, which presented areas with complete detachment of the epidermis initially friable was performedprimary cover with Silver Sulfadiazine 1% cream. This conduct was maintained for 07 days. There was no apparentimprovement. Then antisepsis was performed with PHMB and was used plates throughout the body. After 15 days,in the third dressing exchange, a significant improvement was evidenced, not requiring the use of Hydrofiber. Itconcludes that the efficacy of the treatment used was clear and it is evident the importance of using the appropriatecoverage for each demand, being advantageous and beneficial to the patient, the teams involved and the institution.Keywords: Autoimmune Diseases; Lupus Erythematosus, Systemic; Wounds and Injuries.
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