Dor, cicatrização e qualidade de vida de pacientes com úlceras de perna tratados com laserterapia de baixa intensidade: um estudo prospectivo

Abstract

Considered a public health problem, leg ulcers affect 1% to 2% of the global adult population and their treatment requires assistance from a multidisciplinary team and causes significant social and economic impacts for patients and health systems. The primary objective of this thesis was to analyze the effectiveness of Low-Level Laser Therapy (LLLT) as an adjuvant technology in the treatment of painful symptoms associated with difficult-to-heal leg ulcers in patients treated at a specialized public service.The secondary objectives were to compare the quality of life (QoL) of patients who received complementary LLLT versus conventional treatment alone and to correlate sociodemographic, clinical, and topical treatment variables with the QoL of patients with difficult-to-heal leg ulcers. The study was clinical, prospective, randomized and comparative, developed in a referral outpatient wound clinic in the city of Montes Claros, Minas Gerais, during the years 2021 to 2023. Seventeen patients with leg ulcers, aged ≥ 18 years, participated in the study and were randomly allocated into the “experimental” (intervention with LLLT plus conventional treatment) and “control” (conventional treatment) groups. Red laser at a wavelength of 660 nm was used three times a week, at a dose of 4 J/cm2, for four weeks. Sociodemographic, behavioral, and clinical data of each patient were collected using structured forms and records in the medical records. The Pressure Ulcer Scale for Healing (PUSH) was used to assess the wounds. The intensity of pain associated with the injury was assessed using the Verbal Numeric Scale (VNS) method, and the World Health Organization Quality of Life-Bref (WHOQOL-BREF) instrument was used to analyze QoL. Descriptive analyses of the variables were performed, with Student's t-test to compare the means of pain intensity, general QoL and lesion area at the first and last follow-up assessments. Product 1 aimed to identify the effects of low-intensity laser on the healing of chronic wounds. Product 2 aimed to analyze the efficacy of LLLT as an adjuvant technology in the treatment of painful symptoms and on the QoL of patients with difficult-to-heal leg ulcers. The analysis at the end of the experimental period showed that the group treated with LLLT presented a significant reduction in pain (p-value = 0.004) when compared to the control group. No significant differences were found in the general QoL scores between the groups. The physical domain showed the lowest mean (54.2 ± 10.5) among the domains evaluated by the WHOQOL-BREF. It is concluded that LLLT has been shown to be a therapy with tissue repair and analgesic capacity, favorable for use in combination with other standard care recommended in the treatment of skin lesions. These findings contribute to a better analysis of the scientific evidence on the application of new technologies in the health field for the treatment of patients with chronic wounds, especially those with leg ulcers