Epidemiologia e tratamento das úlceras de pressão: experiência de 77 casos

Abstract

Prolonged tissue compression due to sitting, lying or wearing braces in a healthy person results in discomfort and pain due to local ischemia The normal protective pathways are interrupted in paraplegics, tetraplegics, or the signals are ignored in severely debilitated, elderly or chronic ill patients. The pressure sore develops in these patients. Few papers have been done in Brazil about pressure sores, despite economic problem involved with. The purpose of this paper is to evaluate the epidemiology, treatment and complications of pressure sores in the Hospital das Clínicas (University of São Paulo) from February 1997 to March 1999 in the Orthopedics Institute. A prospective study has been done. Data were evaluated as to the gender, age, sites, classification, type of treatment employed, length of stay and complications. The treatment was evaluated by the success rate and recurrence rate . The average follow-up period was 1 year and a half, ranging from 6 months to 2 years. 77 pressure sores in 45 patients were appraised. 36 men and 9 women, age range 17-64, mean 34,78 years. Of the patients, 100% had severe spinal cord injuries, and most of them victims of gun shot (60%). 93,3% of the wound were chronic (present longer than 3 months). 77,92% were treated by surgical procedures, and most of them with myocutaneous flaps (45%). The success rate changed with the site of the lesion: 80% trochanter, 84% sacrum and 66,6% ischium. The recurrence rate was 25%. The complication rate also changed with the site of the lesion: 84% trochanter, 64% sacrum and 50% ischium.

Prevalence of pressure ulcers among the elderly living in long-stay institutions in São Paulo

“…Given this sample size, the study had a statistical power of 89% to detect an absolute difference of 3% with a 95% confidence interval, assuming a prevalence of pressure ulcers of 18.5% in LSIEs in Brazil. 14,15 For the purpose of this study, the LSIEs were identified by the letters A, B, C, D, E and F in order to maintain confidentiality.…”

Complex Wounds

“…Surgical treatment is the main option, and includes debridement of necrotic tissues, use of negative pressure 64 (vacuum) to better prepare the wound bed, and providing definite closure with stable transplants, mostly local, wellvascularized transplants. 65 Prevention must be enforced using well-known scale protocols already reported. The Braden scale is the most popular in our hospitals, and it has been translated into Portuguese.…”

Brief hospitalization protocol for pressure ulcer surgical treatment: outpatient care and one-stage reconstruction

“…Over the last years it was observed an increase of referred patients to our ambulatory with pressure le- 10 .…”