Laserterapia e qualidade de vida de pacientes com úlceras vasculogênicas e pé diabético

Abstract

Skin lesions represent an important global public health problem, as they entail high costs to health services, social, social security and individual impacts, in addition to being frequently related to recurrences and prolonged and complex treatments, impairing the quality of life of affected patients. In this sense, the general objective of the study was to compare the influence of adjuvant laser therapy versus treatment with spcial dressings alone on the healing score and parameters lesion area, amount of exudate, and tissue type of venous ulcer and diabetic foot lesions. 32 patients with difficult-to-heal wounds participated in the research, undergoing treatment at the wound clinic In the study referring to the u1 product, a single-center, randomized clinical trial was conducted. In product 2 a descriptive-exploratory and cross sectional study was conducted with a quantitative approach, the studies were carried out in the municipality of Montes Claros - Minas Gerais - Brazil, at the wound outpatient clinic of the municipality's care network, the study population related to product 1 was composed of 17 patients with venous ulcers and 15 with a diagnosis of diabetic foot attended in a service, They were divided into the intervention group, which received the laser intervention associated with the conventional treatment used by the service, and the control group, which received only the conventional treatment already used by the service. The study population related to product 2 consisted of 18 patients diagnosed with venous ulcers who underwent conventional treatment and laser therapy in the years 2021 to 2023, the inclusion criteria were to have had a skin lesion of the venous or diabetic foot ulcer type for at least four weeks, to be 18 years of age or older, and to be regularly attending treatment on the days scheduled for care and as criteria Participants with chronic lesions of other etiologies were adopted. In relation to product 1, the variables investigated were: sociodemographic characteristics (gender, age, skin color, marital status, years of schooling, professional activity and income), behavioral characteristics (performed physical exercises in the last three months and participates in religious activity), clinical conditions (BMI [body mass index], associated diseases, type of treatment and lifestyle), characteristics of the lesion (time and region) and PUSH scale with its components (area, amount of exudate and type of tissue). In relation to the study associated with product 2, the variables investigated were: sociodemographic characteristics (gender, age, skin color and years of schooling), behavioral characteristics (performed physical exercises in the last three months, participated in religious activities and ingested alcoholic beverages), clinical conditions (type of treatment and intensity of pain) and characteristics of the lesion (time, region, area, amount of exudate and type of tissue). Sociodemographic and behavioral variables, clinical conditions, and lesion characteristics were considered independent variables. The variable quality of life (Wound-Qol) was the dependent variable, categorized by ≤ mean and > mean. The studies were approved by the Research Ethics Committee of the State University of Montes Claros. Two scientific articles were prepared, in the first one comparing the influence of adjuvant laser therapy versus conventional treatment alone on the healing score and parameters lesion area, amount of exudate and type of tissue of skin lesions such as venous ulcer and diabetic foot. After the use of laser therapy, the clinical conditions of the wounds, total lesion area, amount of exudate and type of tissue improved at the end of the treatment, in relation to the score of the PUSH instrument there were better averages on day 30, the final period of treatment, also indicating better healing with the use of laser, although no significant difference was recorded between the components of the scale and the use of adjuvant laser therapy showed better healing outcomes in the intervention group of patients with diabetic foot. The second article aimed to evaluate the quality of life of patients with venous ulcers and associated factors, thus, the daily life and psychological domains obtained the highest levels of impairment, impairing the overall score of general quality of life, and the highest scores were concentrated in the "body and financial" domain. Self-reported lack of physical activity, alcoholism, and injury exudate were associated with quality of life. The results of the studies can contribute to a better organization of care services for people with skin lesions based on an efficient technology capable of being handled by properly trained professionals, also considering the impact of lesions on the quality of life of these people