WINNERS OF THE "DR. WALTER SOARES PINTO" E-POSTER AWARD AT=
THE
SGAWCM 2021 – SOBRATAFE GLOBAL ADVANCED WOUND CARE MEETING 2021
GANHADORES DO PRÊMIO “DR. WALTER SOARES PINTO” DE E-POSTER NO
SGAWCM 2021 – SOBRATAFE GLOBAL ADVANCED WOUND CARE MEETING 2021
MODALITY: ACADEMICS
397580 - MEROPENEM PHARMACOKINETICS CHAN=
GES
DURING THE SEPTIC SHOCK WITH IMPACT ON COVERAGE BASED ON PK/PD APPROACH IN
CRITICALLY BURN PATIENTS
Claudia G Messiano1 * Els=
on M
Silva Junior2 * João Manoel da Silva Junior2 * Edvald=
o V
Campos2 * Amanda M R R Oliveira=
2
* Aline S Gomides2 * Ga=
briela
A Ferreira2 * Thiago C Oliveira2 * David de Souza Gom=
ez2
* Silvia R C J Santos1
1
Clinical Pharmacokinetics Center, School of
Pharmaceutical Sciences, University of Sao Paulo, Brazil.
2
Division of Plastic Surgery and Burns, HCFMUSP,
Medical School; University of Sao Paulo/SP, Brazil
Introduction: Physiological change that occurs during the time
course septic shock in burn patients can alter pharmacokinetics (PK) of
hydrophilic beta-lactam agents, which could impact the desired outcome in I=
CU
patients undergoing meropenem therapy [1]. Rational of study was to investi=
gate
PK changes during the time course of therapy of septic shock in burn patien=
ts
receiving meropenem 1g q8h by 3hrs-extended infusion that could impact the
desired outcome. Methods: Ethical approval was obtained, and the con=
sent
forms were signed before the study starts. Ten burn patients undergoing
intensive care therapy with preserved renal function were included. Cultures
were collected prior to starting the antimicrobial therapy. Blood was sampl=
ing
(1.5 mL/each) at the steady state, at the 3rd and at the 5th of infusion st=
arts
1g q8h, for drug serum measurement by liquid chromatography in three
consecutive periods as follows: Set 1 at the 3rd day, S=
et
2 at 10th day, Set 3 at 17th day [2]. PK data was based on noncompartimental
data analysis in burn patients by comparison with results previously descri=
bed
in healthy volunteers [3]. Furthermore, pharmacokinetics data obtained from
each patient were compared between Sets. Predictive index of drug effective=
ness
was based on %fDT>MIC for therapeutic target considered of 100%=
fDT>MIC.=
Results:
Characteristics of patients (7M/3F) included were as follows: 37 yrs, 75 kg, 34% total burn surface area, SAPs score 5=
3,
medians. Inhalation injury, mechanical ventilation and vasopressors
requirements occurred in 8/10 patients undergoing therapy of septic shock w=
ith
meropenem 1g q8h, extended 3hr infusion. Patients received 42 mg/kg (39-43
mg/kg) daily dose equivalent to dose regimen of 14.5 mg/kg (13-14 mg/kg) q8=
hr,
medians (quartiles). It was shown a prolongation of elimination half-life a=
nd
increases by trice on the volume of distribution at the earlier stage of se=
ptic
shock (Set 1) with positive impact on drug effectiveness. It is important to
highlight that PK changes were reduced in the subsequent period (Set 2); in=
Set
3 data from patients were comparable with values reported in healthy
volunteers. Then, target was attained for all septic burn patients in Set 1=
and
in Set 2 against gram-negative strains up to MIC 4mg/L and reduced to 8/10
patients in Set 3. Conclusion: It is important to highlight that
meropenem 1g q8h must be prescribed at the onset of septic shock with the
strategy of extended infusion, since the antimicrobial coverage will be
guaranteed up to 9-10 days of therapy. Consequently, desired outcome was
impacted by meropenem PK-changes during the time course of septic shock in =
burn
patients (Sets 1-2) by eradication of pathogens isolated, and cure of
infection. Then, drug prescription soon and PK/PD approach is an important
strategy to avoid microbial resistance. =
Keywords: Pharmacokinetics Changes; Septic Shock; Outcome; Serum Mon=
itoring
of the Meropenem; PK/PD Approach.
_____________
REFERENCES
1Carlier M. et al. Assays for therapeutic drug
monitoring of beta-lactâmics antibiotics:A structure review. Int. J. Antimicrob. Agent. 2015;46:367-75.
2 Jaruratanasirikul S,=
Sriwinyajan S. Stability of meropenem in normal saline
solution after storage at room temperature. Southeast Asian J Trop Med Publ=
ic
Health. 2003;34(3):627–9.
3 Santos SRCJ,
Sanches-Giraud C, De Souza FF. Gómez DS. Campos RV, Azevedo R, Ferreira M,
Nascimento J. PhatmacoKinetic-pharmacpdymamic correlation for meropenem applied to a burn child
using a bioanalytical liquid chromatographic method. Rev Portuguesa de Farmacoterpia. 2011;3(4): 224-32.
MODALITY: CASE RE=
PORT
OF GREAT SCIENTIFIC RELEVANCE
420065
- =
USE
OF LOW-LEVEL LIGHT AND PHOTODYNAMICS THERAPIES IN THE TREATMENT OF PIODERMA
GANGRENOUS INJURY
Maria Elena Echevarría Guanilo1 * Pa=
ulo
Roberto Boeira Fúculo
Junior1 * Alexsandra Martins da Silva1 * Guilherme Lu=
iz Pacher Schmitz1 * Marlei Sangalli1 * Luis
Gustavo Ferreira da Silva2 * Leonardo Franco Pereira2=
.
1 Federal University of Santa Catarina – UFSC <=
/span>
2
University Hospital Professor Polydoro Ernani d=
e São
Thiago
Objective: To report the treatment of a patient with pyoderma gangrenous lesio=
n by
using low-level light and photodynamic therapies. Case report: Male,=
36
years old, attended at a plastic surgery outpatient service, showing a 14x8=
cm
lesion on the inner side of the right leg and a second one of 34.5x17.5cm on
the anterior surface of the left leg. He reports that the lesion started fr=
om a
superficial hemorrhagic pustule, which appeared after skin trauma and evolv=
ed
into a red-purple ulcerated lesion with the predominance of necrotic tissue,
irregular margins, erythematous-violet and high borders, with an intense
inflammatory process and complaint of severe pain. Past history includes
rheumatoid arthritis and Klinefelter syndrome. The patient was treated by a
rheumatology, endocrinology, plastic surgery and nursing team, from 3/20/20=
20
to 3/5/2021 that provided him with the pharmacological needs due to autoimm=
une
disease (infliximab), with analgesic (tramadol hydrochloride and
paracetamol/codeine) due to intense pain (Numerical scale pain assessment 0=
to
10 =3D 9 / constant and throbbing), with broad-spectrum antibiotic therapy =
due to
different conditions of infection of the lesions, who in addition required
hospitalization and dressings (once a week) by the nursing team and received
guidelines for home care. During this period, he had difficulties to adapt
himself to the therapy with topical agents and autolytic enzymatic debridem=
ent
or with hydro-fiber coatings with silver or foam with anti-inflammatory. In=
one
year, there was a reduction in the extent of the lesions to 25x9cm and 9x8c=
m,
of lesions with irregular surface, abundant exudate, intense edema (3+/4+) =
and
the need for three hospitalizations and three debridem=
ents
in the operating room. 7 On 3/12/2021, the adjuvant treatment with 100mw
low-intensity laser has started through weekly application of combined ther=
apy
of 01 Joule Infrared (808nm) and 01 Joule Red (660 nm), on every 1cm from t=
he
edges and in the granulation tissue, followed by application of 1% methylene
blue and irradiated with a red LED board for 10 minutes, and the choice of =
foam
cover with silver of adhering silver. After two cycles of 10 laser applicat=
ions
once a week, the following results has been obtained: lesion dimensions
decreased to 17.6x4.3cm (left leg) and 3.3x2.3cm (right leg), flat and regu=
lar
surface, without need for further hospitalization or surgical approach,
significant reduction of exudate (medium to small amount), pinkish and hydr=
ated
edges, perilesional/scar tissue with positive qualitative assessment regard=
ing
elasticity, hydration, and oiliness. The patient presents decreased edema in
the legs (+/4+) and pain reduction (from nine to pain 4, when dressings are
applied and zero during the day). Conclusion: It stands out the
importance of the multidisciplinary approach and the use of adjuvant treatm=
ent
in the healing of complex injuries.
Keywords: Low-Level Light Therapy; Photodynamic Therapy; Wounds and Injuries;
Pyoderma Gangrenosum.
REFERENCE
1. , ,
MODALITY: EXPERIMENTAL WORK
403313 - OZONE THERAPY TRANSCUTANEOUS VER=
SUS
FOTOBIOMODULATION IN TREATING BURN
Juliana Balbinot Reis Girondi1 * Fel=
ipe
Duarte1 * Julia Grisard de Bem1 * Ca=
rla do
Rosário1 * Milena Ronise Calegari
1&nb=
sp;
Federal University of Santa Catarina
Objective: to compare the use of photobiomodulation with
ozone therapy in the treatment of burns. Method: case study of a
40-year-old man without comorbidities presenting second-degree thermal burns
caused by cooking oil in the left lower limb. Patient with severe pain, tre=
ated
in May 2021 (10 days after the injury) at the plastic surgery team outpatie=
nt
clinic (physician and residents, nurse and nursing students) of a teaching
hospital in southern Brazil. Lesion measuring 748 cm² (44X17) in the antero=
lateral
tibial regionextensive to the dorsum of the foo=
t,
toes and calf with 80% granulation and 20% sloughing; delimited, regular and
adhered edges; perilesional area with maceration. Hygiene and instrumental
debridement¹ was performed, weekly treatment was
started with Low Intensity Laser (LLL) in 25 cm from the upper region of the
lesion, frequency 660nm 1J by punctual technique (40 points), radiance 10J;=
and
in the remainder of the wound, an ozone bag was used, dos and 90 mcg for 30=
minutes.
As primary coverage, hydrofiber with silver was=
used
and, in the final stage of healing, gauze with petrolatum. At home, the
dressings were performed by the wife, as instructed by the nursing team. A
total of five consultations were carried out, from the third onwards, only
ozone therapy was maintained, and after the fourth, the dose was changed fr=
om
90 mcg to 20 mcg. At outpatient discharge, the use of a 20-mmHg compression
stocking was prescribed. The research was approved by the ethics committee =
for
research with human beings. Results: In the area where it was applie=
d only
ozone transcutaneous by lowering bag was 30 cm 2 of total area after the fi=
rst application,
better vascularization, epithelialization and quality of the regenerated ti=
ssue.
In total, five sessions of ozone therapy were performed with total tissue
repair and outpatient discharge within four weeks. Conclusion: In the
case described it is inferred that the Ozone therapy transcutaneous a bag
showed better results the treatment of patients with burn especially having
antimicrobial activity, given the exponential risk for these patients to
infections and by decreasing oxidative stress due to the action on cytochro=
me C
oxidase through its byproducts: reactive oxygen species (ROS) and lipid
oxygenation products (LOPs). New clinical studies are suggested with expans=
ion
of the investigated sample and in new care contexts.
Keywords: Stomatherapy; Burns; Ozone; Low Intensity Light Thera=
py.
REFERENCE
403315
- =
OZONE
THERAPY IN THE THERAPEUTIC APPROACH TO THE MANAGEMENT OF LEUKOCYTOCLASTIC
VASCULITIS
Juliana Balbinot Reis Girondi1 * Fel=
ipe
Duarte1 * Julia Grisard de Bem1=
* Carla do Rosário1 * Milena Ronise
Calegari1 * Lucia Nazareth Amante1 * Cilene Fernandes
Soares1 Aldanea Norma de Souza Silve=
strin1
1 Federal University of
Santa Catarina.
Objective: To report a case of leukocytoclastic
vasculitis treated with transcutaneous ozone therapy. Method: case s=
tudy
of a 74-year-old woman with type II Diabetes Mellitus, Systemic Arterial
Hypertension, Depression and a history of allergy to diclofenac and
ceftriaxone. Possible control of capillary blood glucose at home ranging
between 150-200 mg/dl. Referred to the plastic surgery outpatient service
(physician and residents, nurses and nursing students) of a teaching hospit=
al
in southern Brazil for the treatment of leukocytoclast=
ic
vasculitis in the lower limbs with a to clarify. In the first visit, in May
2021, he presented intense pain and lesions that permeated the entire lengt=
h of
the feet and ankles of both limbs, with the presence of ruptured blisters,
large amounts of slough and seropurulent exudate, purpura and necrotic regi=
ons.
No conditions to measure the lesions by the extension and clinical status of
the patient. Wound hygiene was performed with polyhexa=
methylene
biguanide solution and instrumental debridement. Weekly treatment started w=
ith
transcutaneous ozone per bag, dose 90 mcg for 30 minutes. As primary covera=
ge, hydrofiber with silver was used in the first visit, a=
nd
foam with adhesive-edged silver and gauze with petrolatum in the others. At
outpatient discharge, maintenance of hydration and general health care were
prescribed. The research was approved by the ethics committee for research =
with
human beings. Results: In the second visit in June 2021, patient with
improvement in general condition and pain control. Significant reduction in
injured areas: left limb with lesion in the malleolar region 4x3 (12 cm
Keywords: Stomatherapy; Ozone; Cutaneous Leukocytoclastic
Vasculitis.
REFERENCE
MODALITY: HEALTH PROFESSIONALS BASIC CAREER WORK
397070
- =
ASSOCIATION
OF HYPERBARIC OXYGEN THERAPY AND LASER THERAPY IN THE HEALING OF ACHILLES
TENDON RUPTURE
Rauza Bretas Beck1
1 Institute of Hyperbar=
ic
Medicine of Brazil
Introduction: Achilles tendon injury can result in poor
quality of life for the patient due to its functional mobility. In addition=
, it
is a great challenge for the health team to work on the regeneration of this
injury and functional rehabilitation. Among the new technologies available =
for
the treatment of wounds is hyperbaric oxygen therapy (HBOT), which consists=
of
the application of 100% oxygen in hyperbaric chambers, aiming at systemic h=
yperoxia
in the body, accelerating the healing process. Laser therapy also emerges a=
s a
new technology in the treatment of wounds which, together with hyperbaric
effects, enhances local action by acting on cellular and biochemical events=
. Objective:
To describe the benefits of the association of hyperbaric oxygen therapy and
laser therapy in the healing of Achilles tendon rupture. Method: Thi=
s is
a qualitative research of the type experience report.
The case was experienced by a nurse in a private HBOT clinic/RS. The ethical
precepts were met, the patient signed the informed consent authorizing her
images and case report. Result: A 56-year-old female patient, with a
history of hypertension and controlled Diabetes Mellitus, underwent 3 surge=
ries
after the Achilles tendon rupture and 3 more surgeries after starting treat=
ment
with HBOT for complete removal of the nylon thread, which was causing a
rejection by the body itself. The last surgery was performed on 20/06/21, in
which the lesion measured 8.0x 2.0 cm with granulation tissue in the center=
and
a medium amount of serous exudate. After performing 53 sessions of HBOT, the
lesion was cleaned with heated SF0.9%, and the 1st session of laser therapy=
was
performed using 0.5 joules of red laser in the path of the points and 2 jou=
les
of infrared at cardinal points in the granulation region. The wound was clo=
sed
with rayon gauze, sterile gauze and bandage. The same procedure was repeate=
d on
27/06/21, 02/07/21, 09/07/21/, 16/07/21 and 30/07/21. On 08/07/21 the stitc=
hes
were removed. The treatment was completed with 6 sessions of laser therapy =
and
72 sessions of HBOT with good progress on the lesion, epithelialized tissue,
measuring 0.5 cm without exudate. Conclusion: Favorable developments
were found when combining the two measures, enhancing what the therapeutic
literature has been showing in relation to the benefits of the combine
measures. Exposure to high concentrations of O² increase oxygen saturation,
forming neoangiogenesis and fibroblast prolifer=
ation.
This added to the stimulation of local laser therapy increase the productio=
n of
adenosine triphosphate (ATP), accelerating the healing process.
Keywords: Hyperb=
aric
Oxygenation; Lasers; Healing.
REFERENCE
MODALITY: HEALTH PROFESSIONALS CASE SERIES
382924
- =
ASSOCIATION
BETWEEN ANTIMICROBIAL PHOTODYNAMIC THERAPY AND PHOTOBIOMODULATION IN THE HE=
ALING
PROCESS OF SKIN WOUNDS IN DOG (CANIS LUPUS FAMILIARIS)
Fernando Alzamora F=
ilho1
* Miriam Pinto Cavalcante2 * Larissa Oliveira Nepomuceno
1- =
Departamento de Ciências Agrárias e Ambientais,
Curso de Medicina Veterinária da Universidade Estadual de Santa Cruz (UESC),
Ilhéus, BA, Brasil. E-mail: fafilho@uesc.br.
2-Médica Veterinária, BA, Brasil.
3-Discente do Curso de Medicina Veterinária da
UESC, bolsista do Projeto Iniciação à Docência. Ilhéus – Bahia.
4-Discente do Curso de Medicina Veterinária da
Universidade do Grande Rio - Duque de Caxias, RJ, Brasil.
5-Centro de Cirurgia Experimental, Departamento=
de
Cirurgia. Faculdade de Medicina. Universidade Federal do Rio de Janeiro (UF=
RJ),
Rio de Janeiro, RJ, Brasil
Introduction: Wounds are common in Veterinary Medicine and they can be of different
forms and origins. The healing process is complex and can be influenced by
local and systemic factors, interfering with the different stages of healin=
g.
Treatment depends on the type of wound to restore the injured tissue. Laser
therapy can be used alone or associated with other therapies and the effect=
s on
tissue damage are analgesia, inflammation modulation, angiogenesis and tiss=
ue
regeneration. Antimicrobial photodynamic therapy (aPDT=
)
consists of the use of light, photosensitizer and oxygen, which generate
reactive oxygen species and singlet oxygen, causing the microorganism to di=
e.
The objective was to publicize the use of laser therapy in a dog's skin wou=
nd. Material
and Methods: Female Border Collie, 3 years old, weighing 18 kg, suffered
trauma with skin laceration on the left thoracic limb. The edges were sutur=
ed,
but there was dehiscence of the stitches within 24 hours. Second-intensity
healing was recommended. Zinc oxide ointment (Alantol<=
/span>=
Ò) was administered daily, and antibiotic and
anti-inflammatory for 5 days, cefadroxil (Cefa =
Sid=
Ò) and Meloxicam (Meloxivet=
Ò), respectively, were administered. On physical
examination, a wound with a swollen and reddish border, an ulcerated area w=
ith
devitalized tissue, serous exudate and 8.8 cm2 of injured area. It was deci=
ded
to associate photobiomodulation. The laser
irradiation dosimetric parameters were calculat=
ed
according to the injured area and the sessions were three times a week. =
Results:
Due to the high degree of contamination of the wound, =
aPDT
was performed in the first session, red laser (λ =3D 660 nm), energy of 9J/point, pre-irradiation time of five minut=
es and
0.01% methylene blue. After 48 hours of the 1st session, the lesion showed a
reduction in edema and erythema, granulation tissue in the wound bed, absen=
ce
of exudate and a reduction of 3.8 cm2 in the injured area. The
second session was with red laser (RL) and infrared (λ =3D 808nm) (IRL), with the energy used being 0.5
J/point and 1 J/point, respectively. The 3rd session was introduced aPDT, because the patient had contaminated and injure=
d the
granulation tissue and at the edge of the lesion, they were irradiated with
IRL, five points of 1J of energy. The next four sessions were with RL in the
open area, energy of 0.5J/point and IRL in the edge, energy of 1J/point, wi=
th
an interval between sessions of 48 hours. He observed a reduction in the op=
en
area, with the wound edge shifting to the center. On the 14th day, the heal=
ing
process was almost entirely completed, with a crust area of 0.4 cm2.
Conclusion: Low-intensity laser therapy was effective in resolving t=
he
skin wound, modulating inflammation and accelerating tissue repair, in addi=
tion
to corroborating the conventional therapy used initially, enhancing its eff=
ect.
Keywords: Healin=
g; Photochemotherapy;
Laser Therapy; Skin; Trauma.
REFERENCE
1&nb=
sp;
Bagnato VS, Kurachi C, Blanco=
KC,
Inada NM. 2017. Antimicrobial Phot=
odynamic
Therapy. In: Hamblin MR, Sousa MVP, Agrawal T.
(Eds). Handbook of Low-Leve=
l Laser
Therapy. Singapore: Pan Stanford ublis=
hing,
pp.273-283.
2
Andrade FSSD, Clark RMO, Ferreira ML.
2014. Effects of low-level laser therapy on wound
healing. Revista do Col=
égio
Brasileiro de Cirurgiões. 41(2): 1=
29-33.
3&nb=
sp;
Kaviani=
A, Djavid G=
E, Ataie-Fashtami L, Fateh M, Geodis M, Salami M, Zand N, Kashef N,
4&nb=
sp;
Langella LG, Casalechi HL,
=
388491- MANAGEMENT OF SURGICAL WOUND DEHISCE=
NCE
IN A SPECIALIZED WOUND CARE CENTER: A CASE SERIES
Evelin Santos Figueiredo Lima¹ * Arthur César
Pacheco Lopes2,3 * Tammila de Lima A=
lmeida4
* Ana Flávia Novaes² * Luciana Moreira Lopes4 * Laís Oliveira Li=
ma Barbosa2
* Joubert Felipe Luz Costa Brito2 * =
Mariana
Masimessi Fernandes2 * Raquel Araujo=
da
Silva Carneiro2 * Thiago de Carvalho Milet¹ * Bianca Tanajura
Oliveira Bastos³
1-&n=
bsp;
Health Department of the State of Bahia.
2-&n=
bsp;
Federal University of Bahia.
3-&n=
bsp;
Cicatrimed Comprehensive Wound Treatment
4-&n=
bsp;
Santo Agostinho Health Faculty.
Introduction: Surgical wound healing is the result of an orderly sequence of
physiological events. A mechanical failure or failure in wound healing at t=
he
surgical site may evolve with the emergence of complications such as suture
dehiscence. Specialized wound care has revolutionized the healthcare landsc=
ape.
This revolution also extends to the treatment of surgical wound dehiscence,
which is a prevalent health problem. Objective: The aim of this study
was to describe a series of cases of patients with surgical wound dehiscence
admitted to Cicatrimed, a center specialized in
wounds in the city of Vitória da Conquista, Bahia. Methods: The work=
was
structured based on the CARE case report guideline. Demographic information,
symptoms, and patient history were used to describe the cases. The therapeu=
tic
tools used were described using schedules. The evolution of the wounds was
described using images and clinical characteristics. Results: We
described 7 cases of postoperative suture dehiscence in patients with the
following diagnoses: post-abdominoplasty dehiscence, mammoplasty with
prosthesis insertion, saphenectomy, hand trauma=
and
secondary amputation of diabetes mellitus. In all, there are remarkably sat=
isfactory
results with multidisciplinary treatment, hyperbaric oxygen therapy and oth=
er
wound care technologies. Conclusions: Its
concluded that the specialized and comprehensive treatment of wounds has a
potentially favorable role in the care of patients with surgical wound
dehiscence, given the positive results from the use of different therapeutic
instruments and, unfortunately, still not widespread in the care environmen=
t as
a whole.
Keywords: Surgical wound healing; suture dehiscence; multidisciplinary treatme=
nt
REFERENCE
1&nb=
sp;
Radowsky JS. et al. Preclosure
spectroscopic differences between healed and dehisced traumatic wounds.
2&nb=
sp;
ramczykowski T, Schildhauer, T.
Amputation und Prothesenversorgung – die untere ExtremitätZeitschrift für Orthopädie und Unfallchirurgie, 2017. Disponível em: http://dx.doi.o=
rg/10.1055/s-0042-122394.
3&nb=
sp;
Sandy-Hodgetts
K, Carville K, Leslie GD. Surgical wound dehiscence: a conceptual framework=
for
patient assessment. Journal of wound care. Mar. 2018; 2=
7( 3):
119–26.
4&nb=
sp;
Sanford Guide. Sanford Guide to Antimicrobial Therapy.
5&nb=
sp;
Seidelman JL. et al. Serious superficial incisional surgical site infections (SSISSIs): A
proposed surveillance definition. Infection control and hospital epidemiolo=
gy:
the official journal of the Society of Hospital Epidemiologists of America.
2019; 40(11).
6&nb=
sp;
Shah
J. Hyperbaric oxygen therapy. The journal of the American College of Certif=
ied
Wound Specialists. Apr. 2010; 2(1):
7&nb=
sp;
Smith
CM. Debridement for Surgical Wounds. Critical care nurse, 2015; 35(4):75–6.=
8&nb=
sp;
Molnar
JA, Vlad LG, Gumus T. Nutrition and Chronic Wou=
nds: Improving Clinical Outcomes. Plastic and
reconstructive surgery. 2016;138( 3S): 71S.
9&nb=
sp;
Nascimento LD. et al. Clinical and microbiological profile of diabetic f=
oot
ulcers infected with Staphylococcus aureus in a regional general hospital in
Bahia, Brazil. The international journal of lower extremity wounds, p.
153473462110507, 6 nov. 2021.
10&n=
bsp;
Neaman
KC, Hansen JE. Analysis of complications from abdominoplasty: a review of 2=
06
cases at a university hospital. Annals of plastic surgery. 2007;58(3): 292–=
98.
11&n=
bsp;
Robert
N. Negative pressure wound therapy in orthopaedic
surgery. Orthop Traumatol Surg Res=
2017
Feb;103(1S):S99-S103. doi:
10.1016/j.otsr.2016.04.018. Epub 2016 Dec 30.
12&n=
bsp;
Negut I, Grumezescu V, G=
rumezescu
AM. Treatment Strategies for Infected Wounds. Molecules. 2018; 23(9):
13&n=
bsp;
Gao
J. et al. Negative pressure wound therapy for surgical site infections: A
systematic review and meta-analysis. Journal of advanced nursing. 2021; 77(=
10):
MODALIDATY: HEALTH PROFESSIONALS FOR CLINICAL WORK=
409402
- =
ADVANCED
WOUND HEALING WITH APPLICATION OF PRODUCTS WITH DIVERSIFIED PROPOLIS
Claudia
Rodriguez1 * Adrian Marichal1 *
Adrian Ramos1 * Carla Burguez1<=
/sup>
1 Wound Unit RAP (Prima=
ry
Care Network) Canelones ASSE (State Health Services Administration) City Las
Piedras, Uruguay
Introduction: In the understanding that we have in our country the industry and t=
he
raw material of elaboration of products derived from propolis, based on the
evidence published in scientific articles that refer to the anti-inflammato=
ry
activity of propolis which is linked to the ability of its constituent
polyphenols (flavonoids and aromatic acids) to inhibit NF-kB (nuclear
transcription factor kappa-b) and reducing the levels of inflammatory
mediators, this produces a decrease in inflammation, pain and microbial loa=
d,
it is then that for this reason it was decided to clinically verify the
efficacy of this product in complex wounds by conducting a descriptive,
prospective crosssectional study. Objective:=
Demonstrate the efficacy of this active in controlling bacterial load,
immunomodulation, pain, and wound healing. Methods: Descriptive,
Prospective with cross-sectional. The method that will be used is the
observation and assessment of the users, collection of data from the electr=
onic
medical record, individualized assessment instruments for each wound, wound
measurements (MOWA, ACETATE) and EVA as a pain scale. Tolerance test. In=
clusion
criteria: Users who present Venous Ulcer, Pressure Ulcer and Diabetic F=
oot.
Results: The study began on 2/1/2019, a cut is made on 1/6/21. Total=
30
months. To date we have total patients 163 is broken down as follows:
Abandonments because external reasons 5 users. Allergies 9 users. Deaths 11
(Cancer, Stroke, AMI, COVID) Referrals to Second Nivel of Care 8 users. Num=
ber
of Completed Patients 130. Conclusion: So far
we can say that if it is clinically verifiable the effectiveness of the
products with propolis reduces pain, inflammation and therefore favors heal=
ing
with a humid environment. It was possible to verify with practical scientif=
ic
evidence the different combinations and uses of the products. The combinati=
on
of Propolis Dressings with propolis in 2% Ointment has allowed to maintain a
humid environment since the dressing absorbs the component and keeps the wo=
und
moist and in turn does not allow adhesion to the tissues in formation of the
wound and therefore does not produce pain. In addition to the effectiveness
against biofilm that was demonstrated by laboratory wound cultures. The
combination of Calcium Alginate dressings moistened in Propolis Lotion has
favored in the prolonged release of propolis in the bed does not allow adhe=
sion
because it is gelled and is also used under Unna boot therefore its change
allows us to space up to 4 days. The use of Corticodre=
ss
dressings has allowed us to lower hypergranulation
and in some cases when propolis produces pain in combination with Propolis
Ointment it has allowed us to lower the pain and be able to act on the biof=
ilm
together.
Keywords: Propol=
is;
Pain; Inflammation; Immunomodulation; Cicatrization.
________
REFERENCE
1- Pharmacological bases of the topical therapeutic
use of propolis in burns (Q) and chronic ulcers (UC) of the skin. Dr. Newton
Ross, former Associate Professor of Medicine and former Adjunct Professor of
Pharmacology and Therapeutics. University of the Republic. Montevideo, Urug=
uay.
2- Leoni H, Artero G. =
Perafán M. The VJ Tower. Use of non-stick dressings i=
n the
healing of wounds and areas that give and receive skin grafts. Argentine
Journal of Plastic Surgery 2007
3-Leoni HT, Duh MN, Olivero Vila F, Yohena R. Use of topical immunomodulators in vasculitic ulcers. Revista Argentina de Cirugía
Plástica 2011;17(2):76-81.
4- Kumazawa S, et al.
Studies of the constituents of Uruguayan propolis. J Agric Food Chem 2002;50:4777-82.
5- Marinel.lo Roura J, Verdú Soriano J
(Coord.). National Consensus Conference on Lower Extremity Ulcers
(C.O.N.U.E.I.). Consensus document 2018. 2nd ed. Madrid: Ergon; • Polit,
Denise. Scientific Research in Health Sciences, Intera=
mericana
McGraw Hill.
388016
- =
CLINICAL
PARAMETERS FOR ASSESSMENT SKIN OILINESS IN SURGICAL PATIENTS
Karla P. P. dos Santos1 * Suzinara B. S. De Lima1 * Lidiana
B.T. D. Silveira1 * Bruna R. Pozzebon1 * Rhea S. de Á. S2 * Thaís D. Eberhardt=
3
1
Universidade Federal de Santa Maria
2
Colégio Politécnico da Universidade Federal de Santa Maria
3 =
Universidade
de Passo Fundo
Objective: To evaluate the skin oiliness of the cutaneous sites (heel and inste=
p)
of patients in the operating room. Method: This is a secondary analy=
sis
of a randomized clinical trial (RCT) carried out at a university hospital in
southern Brazil from March 2019 to February 2020, with patients undergoing
elective cardiac and gastrointestinal surgery. The variable oiliness was
collected at the beginning of surgery - baseline, measured in the center of=
the
heel and instep, using a bioelectrical impedance skin analyzer and the
measurement was given in percentage (%). The analysis was performed by
protocol, with the aid of the Statistical Package for Social Sciences (SPSS)
version 21 software. A descriptive analysis of the data was performed, the
normality of the variables was tested using the Shapiro-Wilk test. To assess
the relationship between skin oiliness and skin sites, the Wilcoxon test was
performed (absence of normal distribution, paired data). To assess the
correlation of skin oilinesss between cutaneous
sites, Spearman's test was performed. Values of r from 0.90 to 1.00 were
considered a very high correlation; high from 0.70 to 0.90; moderate from 0=
.50
to 0.70; low from 0.30 to 0.50; and insignificant from 0.00 to 0.301.
A significance level of 5% was considered. The study was approved by the Et=
hics
Committee with a Certificate of Presentation for Ethical Review
77103617.6.0000.5346 and registered on the platform of the Brazilian Regist=
ry
of Clinical Trials (ReBEC), being approved unde=
r the
identifier RBR-5GKNG5. Results: One hundred and =
thirty
five patients were analyzed, 270 heels and 270 insteps, with 91 (67.=
4%)
patients undergoing cardiac surgery and 44 (32.6%) gastrointestinal; the
majority (n=3D107; 79.3%) had some comorbidity. The median of skin oiliness=
on
the heel (22.6%) and on the instep (29.2%) showed a statistically significa=
nt
difference (p-value <0.001) and a low positive correlation (r=3D0.339; p=
-value
<0.001). Conclusion: It was identified that the oiliness of the h=
eel
is lower than that of the instep. Furthermore, the correlation is positive
between the cutaneous sites, that is, the greater the heel skin oiliness, t=
he
greater the instep skin oiliness. In this sense, the nursing team can use t=
he
instep oiliness as a comparison region for the heel oiliness. It is notewor=
thy
that the skin oiliness can reduce the skin tolerance to external forces suc=
h as
friction, favoring the development of pressure injuries2.
Keywords:
Perioperative Nursing. Pressure Ulcer. Skin. Heel.
REFERENCE
1. Mukaka MM. A guide to appropriate use of Correlation coefficient in medica=
l research.
Malawi
Medical Journal. Sep 2012; 24(3):69-71. Disponível em: https://www.ncbi.nlm=
.nih.gov/pmc/articles/PMC3576830/.
Acesso em: 20 jul 2021.
2. Bunsell AR. (Ed.). Handbook of Properties of Textile =
and
Technical Fibres. 2nd. ed.2018.