Evolução cicatricial de uma deiscência de ferida operatória em esternotomia / Healing evolution of surgical wound dehiscence in sternotomy

Objetivo: Descrever a evolução cicatricial de uma deiscência de ferida operatória em esternotomia de uma paciente em pós-operatório de troca valvar mitral e aórtica. Métodos: Estudo descritivo, do tipo estudo de caso, desenvolvido na clínica médica de um Hospital Unversitário da rede EBSERH, em uma paciente com deiscência de ferida operatória em esternotomia. Os dados foram obtidos por meio da avaliação direta da lesão, avaliação fotográfica e dos registros escritos no prontuário da paciente no período de julho a setembro de 2021. O estudo foi aprovado pelo comitê de ética em pesquisa do Hospital Universitárioda Universidade Federal do Piauí -HUUFPI (Número do Parecer: 5.726.375). Resultados: A paciente evoluiu com redução das medidas da área da lesão deiscente, proliferação de bom tecido de granulação e aproximação das bordas da lesão, com a utilização da Terapia por Pressão Negativa e coberturas adequadas a cada fase do processo de cicatrização. Conclusão: O conhecimento acerca do processo de cicatrização de feridas associado ao uso de produtos e tecnologias, como a Terapia por Pressão Negativa, foram fundamentais no tratamento da deiscência de ferida operatória, evitando uma nova abordagem cirúrgica, bem como reduzindo custos e tempo de internação hospitalar. Descritores: Deiscência da Ferida Operatória; Cuidados de Enfermagem; Cicatrização.

Objective: To describe the healing evolution of surgical wound dehiscence in a sternotomy patient during the postoperative period of mitral and aortic valve replacement.Methods: A descriptive survey of the case study type, developed in the medical clinic of a University Hospital from the EBSERH network on a patient with surgical wound dehiscence in sternotomy. The data were obtained through direct evaluation of the lesion, photographic assessment and written records in the patient's medical chart from July to September 2021. The study was approved by the Research Ethics Committee of the University Hospital belonging to the Federal University of Piauí (Hospital Universitário da Universidade Federal do Piauí, HU-UFPI) (Opinion number: 5,726,375). Results:The patient evolved with a reduction in the measurements of the dehiscent lesion area, proliferation of good granulation tissue and approximation of the lesion edges, with use of Negative Pressure Therapy and adequate dressings for each phase of the healing process. Conclusion: Knowledge about the wound healing process associated with the use of products and technologies, such as Negative Pressure Therapy, was fundamental in the treatment of surgical wound dehiscence, avoiding a new surgical approach, as well as reducing costs and hospitalization time. Descriptors:~Surgical Wound Dehiscence; Nursing Care; Wound Healing.

Effects of Low-Power Light Therapy on the Tissue Repair Process of Chronic Wounds in Diabetic Feet.

OBJECTIVE: To analyze the efficacy of the therapeutic use of Low-Level Laser Therapy (LLLT) on the tissue repair process of chronic wounds in patients with diabetic feet through the analysis of Pressure Ulcer Scale for Healing (PUSH) scales, pain and the measurement done using the ImageJ© software. METHODS: This clinical trial was carried out with 18 patients 30-59 years of age, who had chronic wounds on their foot due to complications of diabetes mellitus. The patients were randomly allocated in two different groups of equal numbers: Control and Laser Groups. The LLLT equipment used in the research has a wavelength of 660 nm, 30 mW power, continuous mode emission, 6 J/cm2 dosimetry, 48/48 h in a 4-week period. Measurement and the aspect of wounds were noted in the PUSH scale and the pain was evaluated weekly. The Mann-Whitney U nonparametric test was used to compare groups. RESULTS: The Laser Group presented a significant increase of the tissue repair index when compared with the Control Group, with a significant statistical difference (p < 0.013). There was no significant difference between the groups in all the weeks using the PUSH scale. CONCLUSIONS: The use of LLLT on chronic wounds in a diabetic foot demonstrated efficacy on the progression of the tissue repair process in a short period.