Patient satisfaction and quality of life in breast reconstruction: assessment of outcomes of immediate, delayed, and nonreconstruction.

OBJECTIVES: This study was conducted aiming to assess the quality of life and satisfaction of women who had mastectomy treated with and without breast reconstruction. RESULTS: A total of 81 women who had mastectomy were included, of whom 53 (65.4%) underwent breast reconstruction. Quality of life was not significantly better in the reconstruction group than the nonreconstruction group. Satisfaction with the surgically operated breast, whether reconstructed or not, was positively correlated with quality of life (p = 0.004). There was no significant difference in quality of life between women with immediate and late reconstruction. This study showed that the satisfaction of patients with the operated breast, reconstructed or not, is more important in quality of life than whether the breast was reconstructed or not. When we analyzed the quality of life of women who had mastectomy who were dissatisfied with their unreconstructed breasts, we observed that nonreconstruction had a negative impact on the quality of life.

Implantação de nova tecnologia para otimização do atendimento em ambulatório de queimados, sem adição de custos / Implementation of a new technology to improve the treatment of outpacients burn, without adding costs

As evidências científicas ainda são insuficientes para determinar se os tipos de curativos contendo prata diferem entre si quanto ao tempo para completar a epitelização da ferida, a proporção de lesões epitelizadas, dor e percentual de infecção. Objetivos: Analisar o custo, efetividade e segurança dos curativos de prata nanocristalina e da sulfadiazina de prata 1% no trata¬mento ambulatorial de pacientes queimados. Método: Estudo observacional analítico em um único centro com pacientes adultos entre 18 e 55 anos, independentemente do sexo, que apresentavam queimaduras de segundo grau, em regime ambulatorial, sem a necessidade de tratamento cirúrgico. Será comparado o custo para realização dos curativos à base de prata nanocristalina e sulfadiazina de prata a 1%. Resultados: Os resultados obtidos esclarecerem que há diferenças entre os curativos à base de prata e o curativo à base de prata nanocristalina é custo efetivo, proporcionando economia substancial à instituição. Conclusão: Os curativos de prata nanocristalina são custo efetivos e proporcionam uma diminuição de custos médicos e não médicos, podendo ser padronizado pelas instituições como alternativa para tratamento de pacientes queimados ambulatoriais.

The scientific evidences are still insufficient to determine whether the types of dressings containing silver differ from each other in the time to complete epithelialization of the wound, the proportion of epithelialized lesions, pain and percentage of infection. Objectives: To analyze the cost effectiveness and safety of nanocrystallinesilver dressings and silver sulfadiazine 1% in the outpatient treatment of burn patients. Method: Analytical study in a single enter with adult patients between 18 and 55 years, regardless of gender who had second degree burns in an outpatient setting, without the need of a surgical treatment. It will be compared the cost of carrying out dressing of the base nano¬crystalline silver and the silver sulfadiazine 1%. Results: The results clarify that there are differences between the silverbased dressings and the dressings is nanocrystalline silver-based costeffective providing substantial savings to the institution. Conclusion: The nanocrystalline silver dressings are cost effective and provide a reduction in medical costs and non-medical ones, it may be standardized by the institutions as an alternative for the treatment of burn patients and outpatients.

Curativo de espuma e silicone suave: uma alternativa para o tratamento de queimadura em mãos / Dressings and soft silicone foam: an alternative for the treatment of burns in hand

Introdução: Queimaduras são lesões da pele causadas por trauma externo,podendo ser de origem térmica, química ou elétrica. Áreas como face, genitália,mãos e pés necessitam de cuidados específicos e entram em critério deacompanhamento em unidade de queimados. Particularmente, a queimadura de mão consiste no fator com maior impacto no retorno desses pacientes ao trabalho, devido às graves limitações, pela importante função que o membro exerce nas atividades diárias, elevado tempo de tratamento e sequelas funcionais. Relato do caso: No caso em estudo, optamos por realizar curativoantimicrobiano de espuma e silicone suave em paciente com queimadura desegundo grau em mão. Conclusão: Proporcionou-se conforto durante o usoe as trocas de curativo, absorção do exsudato, controle da infecção, início dos movimentos e fisioterapia precoce do membro afetado, sem necessidade deimobilização e sem prejuízo de suas atividades habituais, preservando a função motora e sensitiva, bem como se evitando sequelas funcionais.

Introduction: Burns are skin lesions caused by external trauma maybe of thermal, chemical or electrical. Areas such as face, genitals, hands and feet need special care and enter criteria in monitoring in the burn unit. Particularly the burning of the hand is the factor with greatest impact in these patients return to work due to severe limitation to patients, the important role that the member has on daily activities, treatment time and high functional sequelae. Case report: In our study wechose to perform healing and antimicrobial soft silicone foam, in a patient with second-degree burn on hand. Conclusion: It was provide comfort during use and the dressing changes, absorption of exudate, infection control, and the early movements of the affected limb earlyphysiotherapy, without immobilization and without prejudice to their usual activities while preserving motor and sensory function, avoiding functional sequelae.