Curativo com filme e gel de biopolímero de celulose bacteriana no tratamento de feridas isquêmicas após revascularização de membros inferiores.

Abstract

RESUMO Objetivo: avaliar o uso do curativo de filme e gel de biopolímero de celulose bacteriana no tratamento de pacientes com feridas isquêmicas submetidos à revascularização dos membros inferiores. Métodos: ensaio clínico randomizado realizado no ambulatório de Angiologia e Cirurgia Vascular do Hospital das Clínicas da Universidade Federal de Pernambuco, entre janeiro de 2017 e dezembro de 2018. Foram acompanhados 24 pacientes após revascularização de membros inferiores, divididos em dois grupos: Experimental, tratado com filme e gel de biopolímero de celulose bacteriana, e Controle, tratado com ácidos graxos essenciais. Os pacientes foram acompanhados em consultas semanais para troca dos curativos e o processo de cicatrização das feridas foi avaliado em um período de 90 dias. Resultados: a redução da área das feridas isquêmicas no período de 30 dias foi de 4,3cm2 (55%), em média, para o grupo experimental, e de 5,5cm2 (48,5%) para o grupo controle (p>0,05). A taxa de cicatrização completa, em 90 dias, foi de 34,8%, sendo 50% no grupo experimental e 18,2% no grupo controle (p=0,053). Conclusão: o filme de biopolímero de celulose bacteriana associada a gel pode ser utilizado como curativo no tratamento de feridas isquêmicas de pacientes submetidos à revascularização de membros inferiores

Bacterial cellulose an effective material in the treatment of chronic venous ulcers of the lower limbs

“…Hypertension was the most common comorbidity observed in the studied groups, as it was present in more than 50% of patients. This data corroborates with other studies, demonstrating that this is a highly prevalent morbidity in patients with CVU, followed by heart diseases and DM [ 37 – 40 ]. The coexistence of these diseases is considered a risk factor for it negatively influences the healing process of CVU [ 39 , 40 ].…”

“…This data corroborates with other studies, demonstrating that this is a highly prevalent morbidity in patients with CVU, followed by heart diseases and DM [ 37 – 40 ]. The coexistence of these diseases is considered a risk factor for it negatively influences the healing process of CVU [ 39 , 40 ]. These diseases cause micro and macrovascular changes, increase fluid overload and vascular resistance, reducing peripheral tissue perfusion and exacerbating the signs and symptoms of an already installed CVU [ 21 , 22 , 37 , 39 – 41 ].…”

“…The healing rate obtained in this study was similar to others [ 26 , 38 – 40 ] and higher than the percentage found in pioneering research, with the application of BC multiperforated film in CVU. The study in question obtained a cure rate of 14.28% and in the non-healed lesions it did not show a reduction rate, but there was superficialization of the wounds [ 26 ].…”

“…The coexistence of these diseases is considered a risk factor for it negatively influences the healing process of CVU [39,40]. These diseases cause micro and macrovascular changes, increase fluid overload and vascular resistance, reducing peripheral tissue perfusion and exacerbating the signs and symptoms of an already installed CVU [21,22,37,[39][40][41]. A previous study observed that among patients with CVU with activity times over 18 months, 63% had DM [38], and also that DM favors the installation of infections [37].…”

“…Collagenase dressings, sunflower oil, Unna boots and silver sulfadiazine are widely described in the literature [26,37,40,[44][45][46][47][48][49].…”