Effects of therapeutic ultrasound and paraffin with or without vacuum massage on biomechanical properties of grafted skin after burn: a randomized controlled trial.

OBJECTIVE: This study aimed to compare the effects of therapeutic ultrasound and paraffin with or without vacuum massage on the biomechanical properties of grafted skin after a burn. METHODS: A total of 44 patients with deep second- and third-degree burns, with a mean age of 35.89 (±11.53) years, who visited the Hospital Burn Unity, were included in the study. The therapeutic interventions were randomly defined by drawing lots, with a crossover design (crossover), and a minimum interval of 7 days (washout) between interventions. Skin biomechanical parameters such as distensibility (R0) and viscoelasticity (R6) were noninvasively evaluated by Cutometer before and after 0, 10, 20, and 30 min of intervention with therapeutic ultrasound and paraffin alone, as well as associated with negative pressure therapy of the skin (vacuum therapy). In this study, all groups showed increased distensibility (R0) in the period immediately after the application of the resources and a progressive reduction in the effects in the consecutive tests. Participants with skin grafts showed a decrease in viscoelasticity (R6) in all groups, except therapeutic paraffin and therapeutic ultrasound and vacuum massage. CONCLUSION: The biomechanical properties of grafted skin after a burn are altered after therapeutic intervention with ultrasound alone or associated with vacuum massage, such as intervention with paraffin associated with vacuum massage, for both parameters evaluated, skin distensibility (R0) and skin viscoelasticity (R6). However, the same did not occur for the intervention with isolated paraffin. There was no significant difference between the interventions therapeutic ultrasound and therapeutic paraffin.

Effects of therapeutic ultrasound and paraffin with or without vacuum massage on biomechanical properties of grafted skin after burn: a randomized controlled trial

SUMMARY OBJECTIVE: This study aimed to compare the effects of therapeutic ultrasound and paraffin with or without vacuum massage on the biomechanical properties of grafted skin after a burn. METHODS: A total of 44 patients with deep second- and third-degree burns, with a mean age of 35.89 (±11.53) years, who visited the Hospital Burn Unity, were included in the study. The therapeutic interventions were randomly defined by drawing lots, with a crossover design (crossover), and a minimum interval of 7 days (washout) between interventions. Skin biomechanical parameters such as distensibility (R0) and viscoelasticity (R6) were noninvasively evaluated by Cutometer before and after 0, 10, 20, and 30 min of intervention with therapeutic ultrasound and paraffin alone, as well as associated with negative pressure therapy of the skin (vacuum therapy). In this study, all groups showed increased distensibility (R0) in the period immediately after the application of the resources and a progressive reduction in the effects in the consecutive tests. Participants with skin grafts showed a decrease in viscoelasticity (R6) in all groups, except therapeutic paraffin and therapeutic ultrasound and vacuum massage. CONCLUSION: The biomechanical properties of grafted skin after a burn are altered after therapeutic intervention with ultrasound alone or associated with vacuum massage, such as intervention with paraffin associated with vacuum massage, for both parameters evaluated, skin distensibility (R0) and skin viscoelasticity (R6). However, the same did not occur for the intervention with isolated paraffin. There was no significant difference between the interventions therapeutic ultrasound and therapeutic paraffin.

Covid-19 pandemic and the motivations for demanding health service in indigenous villages.

OBJECTIVE: To discuss the fundamental aspects in the establishment of preventive measures to tackle covid-19 among indigenous people in view of the motivations for seeking health care in villages of the Terra Indígena Buriti, Mato Grosso do Sul, Brazil. METHODS: Theoretical-reflective study based on assumptions of the National Health System and previous ethnographic research that enabled the identification of the motivations to seek health care in Buriti villages. RESULTS: Indigenous people seek health centers for health care programs assistance, treatment of cases they cannot resolve and to chat. Such motivations were the basis for discussing the indigenization process in the confrontation of the new coronavirus pandemic in indigenous lands. FINAL CONSIDERATIONS: The motivations for seeking health care show the physical and social vulnerability of the Terena ethnicity. The effectiveness of the social isolation measure in the villages depends on the dialogue with indigenous leaders, professional engagement and intersectoral actions.

School reintegration of pediatric burn survivors: An integrative literature review.

BACKGROUND: The school is an essential context for children's social interaction with peers and to develop academic skills. Therefore, a fast reintegration can help children with burns to normalize their life. Thus, school reintegration is an important outcome after burns. The aim of this review was to systematically synthesize the literature addressing school reintegration programs of pediatric burns survivors. METHODS: Five electronic databases were searched independently by two reviewers. The search yielded 13 eligible publications. A qualitative content analysis was conducted. RESULTS: The two themes identified centered around (1) the roles, obstacles, and support for the different stakeholders (i.e., the child, parents and teacher) and (2) the contents of the school reintegration programs in which subthemes such as purpose, planning, essential elements, team, and effect were distinguished. The results show that return to school should start as soon as the child is admitted to the hospital and the program should acknowledge the different stakeholders' needs and tailor the program to these needs. CONCLUSION: The review emphasizes the necessity of an integrated school reintegration program empowering both the child, the parents and the teachers and tailored to the child's specific situation. Furthermore, it offers recommendations for further improvement of the field.

A integralidade e suas interfaces no cuidado ao idoso em unidade de terapia intensiva / La integralidad y sus interfaces en el cuidado al anciano en unidad de terapia intensiva / The comprehensive approach and its interfaces in care for the elderly in the intensive care unit

A integralidade visa ações que respondam às demandas e necessidades da população, nos diferentes níveis de atenção e complexidade. As unidades de terapia intensiva são centros preparados para atender pacientes graves ou potencialmente graves que necessitem de assistência especializada e contínua. Com o envelhecimento populacional, a demanda por leitos de unidades de terapia intensiva tem sido crescente entre os idosos. O objetivo deste trabalho foi refletir sobre o princípio da integralidade em saúde, por meio de propostas conceituais realizadas por estudiosos do assunto e contextualizá-lo no cuidado intensivo ao paciente idoso. Conclui-se que a busca pela melhoria da qualidade da assistência nas unidades de terapia intensiva ocorre por meio do cuidado humanístico, atendendo às necessidades físicas e não físicas. Apesar dos aspectos científicos e aparatos tecnológicos serem importantes, o paciente precisa sentir que, muito mais do que a técnica, existe a compaixão, o respeito, o companheirismo e a sabedoria.

Comprehensive care aims at actions that meet the demands and needs of the population at the different levels of care and complexity. Intensive Care Units are centers prepared to treat critical and potentially critical patients in need of continuous, specialized medical care. Population aging has caused increasing demand from the elderly for beds in Intensive Care Units. This study examines the principle of comprehensiveness in health care, through conceptual proposals by experts on the subject, and contextualizes it in intensive care for elderly patients. It was concluded that the endeavor to improve the quality of care in Intensive Care Units occurs through humanized care addressed to physical and non-physical needs. Although scientific knowledge and technological apparatus are important, the patient needs to feel that, over and above technique, their care offers compassion, respect, companionship and wisdom.

La integralidad propone acciones que respondan a las demandas y necesidades de la población, en los diferentes niveles de atención y complejidad. Las unidades de terapia intensiva son centros preparados para atender pacientes graves o potencialmente graves que necesiten de asistencia especializada y continua. Con el envejecimiento poblacional, la demanda por lechos de unidades de terapia intensiva ha sido creciente entre los ancianos. El objetivo de este trabajo fue reflexionar sobre el principio de la integralidad en salud, por medio de propuestas conceptuales realizadas por estudiosos del asunto y contextualizarlo en el cuidado intensivo en la asistencia al anciano. Se concluye que la búsqueda por la mejora de la calidad de la asistencia en las unidades de terapia intensiva ocurre a través del cuidado humanístico al enfermo, atendiendo a sus necesidades físicas y no físicas. Aunque los aspectos científicos y los aparatos tecnológicos sean importantes, el paciente necesita sentir que, mucho más que la técnica, existe la compasión, el respeto, el compañerismo y la sabiduría.

Comunicação: instrumento básico da enfermagem para cuidar da mãe do neonato sob fototerapia / Communication: basic nursin instrument to look after mother of newborn under phototherapy

Este estudo teve como objetivo conhecer o processo de comunicação entre a equipe de saúde e as mães dos neonatos sob fototerapia à luz dos pressupostos da Teoria Humanística. Caracteriza-se como um estudo descritivo, qualitativo norteado pelo Processo da Enfermagem Fenomenológica, implementado com 25 mães de neonatos sob fototerapia, em Fortaleza-CE. Coletaram-se os dados de janeiro a março de 2005 mediante de observação participante e entrevista em dosi momentos distintos antes e após a implemetação de um programa educativo. Das falas extraídas na primeira fase, identificou-se o tema comunicação, e os sub-temas: comunicação prejudicada com a equipe de saúde, ausência de comunicação da equipe de saúde e, na segunada fase, o sub-tema: reações da mãe após comunicação efetiva da enfermeira. Concluiu-se que a comunicação efetiva da enfermeira contribuiu para o estar-melhor das mães com os filhos sob fototerapia.