Eï¬cácia da fototerapia associada í sulfadiazina de prata no tratamento de úlceras venosas crônicas
DOI:
https://doi.org/10.33233/fb.v10i6.1575Abstract
Introdução: Várias são as propostas terapêuticas para úlceras de perna venosas crônicas (UVCs), como curativos, ultra-som, aparelhos fotobioestimuladores (laser/LED) e outros. Objetivo: Analisar a eficácia da fototerapia (LED 641/891 nm) com curativo diário de sulfadiazina de prata 1% creme (SDZ) para úlceras venosas crônicas. Métodos: Estudo randomizado, duplo-cego, com aparelho fototerápico com 2 sondas: 1 (LED 641 nm/18mW) e 2 (1 LED 641 nm e 32 LED 891 nm/131 mW). Selecionaram-se 20 pacientes (n = 32 úlceras) do Ambulatório de Úlceras CSE–FMRP–USP, constituindo-se grupos: G1-sonda 1+SDZ; G2-sonda 2+SDZ e G3-SDZ, seguidos por 90 dias. Aplicaram-se sobre as úlceras, as sondas pontualmente (1,5 J/cm2, 30 seg/5cm2, 2x/semana) e posterior curativo SDZ. Quinzenalmente, foram fotografadas e avaliadas pelo software Image Jâ, mensurando-se as áreas [total, de esfacelo (E); e de tecido de granulação (G)], calculando-se índices de cicatrização das úlceras [ICU = (Ai-Af)/Ai)] e relação E/G. Resultados: G2 apresentou redução significante no 30º e 90º dia (p < 0,01) quando comparado ao G3. Considerando a freqüência das úlceras pequenas com ICU > 0,4, G2 alcançou este índice em 75% das úlceras no 30º e 90º dias, enquanto 33% do G1, somente no 60º. Conclusão: A fototerapia (LED"™s) associada í SDZ acelerou processo de cicatrização das UVCs (G1/G2), comparada ao creme isoladamente (G3), pelos ICUs e pela relação E/G.
Palavras-chave: fototerapia, úlcera da perna, úlcera varicosa, cicatrização de feridas.
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