Contribuição da fotobiomodulação na cicatrização de úlceras de perna e impacto psicossocial gerado pelas feridas

Abstract

Considered a public health problem, chronic ischemic leg ulcers affect 5% of the adult population in the Western world and generate high costs for health services as they involve home care, prolonged hospitalizations and complex treatments, in addition to being associated with high rates of recurrence, which accounts for depression and negatively impacts quality of life. In this sense, the general objective of the study was to compare the effect of adjuvant photobiomodulation versus conventional treatment alone on the healing of leg ulcers. The study was developed at the Wound Outpatient Clinic in the city of Montes Claros/Minas Gerais - Brazil, in the years 2022 and 2023. As products of this study, two articles were constructed, a unicentric and randomized clinical trial, consisting of 17 people with leg ulcers difficult to heal, which were divided into an intervention group and received photobiomodulation associated with conventional treatment, and a control group which received only the conventional treatment already used by the service, the second, descriptive-exploratory and transversal with a quantitative approach consisting of 32 patients with venous, mixed and other leg ulcers subjected to conventional treatments and photobiomodulation. Adults with leg ulcers that had been active for at least six weeks, who were cognitively capable of responding to the instruments and who agreed to participate voluntarily were included. Before collection, the researchers were calibrated using the kappa index, and a pilot study was also carried out for two months with three people with chronic injuries to standardize the photobiomodulation application technique. Data were collected using a questionnaire with sociodemographic data, a form with clinical data and lifestyle habits and validated instruments, the validated instrument for wound assessment, adapted version Push 3.0, the Beck Depression Inventory (BDI), the quality of life assessment instrument The World Health Organization Quality of Live WHOQOL-bref, and the “Fantastic Lifestyle”. For data analysis, the Statistical Package for the Social Sciences (SPSS) software, version 20.0, was used, with descriptive analyzes of all variables investigated using simple, relative, mean and standard deviation frequencies, normality test for the characteristic variables of the lesion, to compare the lesion variables on day 1 of collection and on day 30, the Wilcoxon test was used; to compare the means of the lesion area variable on day 1 and on day 30, the “test” was used. t” of Student, to analyze the variable symptoms of depression with the independent variables, Prevalence and Crude Prevalence Ratio were calculated, in this case, the variables that showed a p-value ≤ 0.20 were entered into the multiple model, also calculating the Prevalence Ratio. Adjusted prevalence. Approved by the Research Ethics Committee under CAAE 96928518.7.0000.5146 and opinion nº 4,332,499. The results showed that after the application of adjuvant photobiomodulation, the clinical indicators, quantity of exudation and area of the lesion, showed statistically significant differences in the intervention group in relation to the control group, which contributes to accelerating the healing process. In relation to depressive symptoms, these were related to the location of the injury as they made it difficult to carry out activities, mainly impacting locomotion and lifestyle.