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Bavaresco T, Lucena ADF. Low-laser light therapy in venous ulcer healing: a randomized clinical trial. Rev Bras Enferm 2021; 75:e20210396. [PMID: 34787240 DOI: 10.1590/0034-7167-2021-0396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 06/08/2021] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES to compare the effect of adjuvant low-laser light therapy versus conventional treatment alone on venous ulcer healing. METHODS this is a randomized clinical trial with 40 patients randomized equally to a control group (topical and compressive treatment) and intervention group (adjuvant low-laser light therapy). Outcomes of interest were Wound Healing: Secondary Intention and Tissue Integrity: Skin & Mucous Membranes, as described in the Classification of Nursing Outcomes/NOC. RESULTS groups with similar sociodemographic and clinical characteristics. Eighty-two ulcers were assessed, with an average duration of 1 to 5 years, in 1,066 nursing consultations, with a statistically significant difference in the time and number of healed ulcers (intervention group). There was a significant improvement in the nursing outcomes under study and in eight clinical indicators. CONCLUSIONS low-laser light therapy improves and reduces tissue regeneration time, contributing to advances in wound treatment.
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Affiliation(s)
- Taline Bavaresco
- Universidade Federal do Rio Grande do Sul. Porto Alegre, Rio Grande do Sul, Brazil
| | - Amália de Fátima Lucena
- Universidade Federal do Rio Grande do Sul. Porto Alegre, Rio Grande do Sul, Brazil.,Hospital de Clínicas de Porto Alegre. Porto Alegre, Rio Grande do Sul, Brazil
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Osmarin VM, Bavaresco T, Hirakata VN, Lucena ADF, Echer IC. Venous ulcer healing treated with conventional therapy and adjuvant laser: is there a difference? Rev Bras Enferm 2021; 74:e20201117. [PMID: 34287493 DOI: 10.1590/0034-7167-2020-1117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 02/23/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to evaluate the effects of venous ulcer healing in patients after six months of conventional treatment and adjuvant low-power laser therapy. METHODS prospective cohort study nested in a randomized clinical trial with 38 patients, allocated into an intervention group (conventional treatment and adjuvant laser therapy) and a control group (conventional treatment). Patients were followed up as outpatients, sociodemographic and clinical variables were collected, and indicators of the outcomes Wound healing: secondary intention (1103) and Tissue integrity: skin and mucous membranes(1101) of the Nursing Outcomes Classification. Generalized estimating equations, Kaplan-Meier tests, and robust Poisson regression were used in the analysis. RESULTS the clinical indicators Decreased wound size and Scar formation showed a statistically significant difference in the intervention group, higher number of healed wounds, lower rate, longer time to relapse. CONCLUSIONS laser therapy adjuvant to conventional treatment returned better results in healing and lower recurrence rates after six months of intervention.
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Affiliation(s)
| | - Taline Bavaresco
- Universidade Federal do Rio Grande do Sul. Porto Alegre, Rio Grande do Sul, Brazil
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Santos CTD, Barbosa FM, Almeida TD, Einhardt RS, Eilert AC, Lucena ADF. Indicadores da Nursing Outcomes Classification para avaliação de pacientes com lesão por pressão: consenso de especialistas. ESCOLA ANNA NERY 2021. [DOI: 10.1590/2177-9465-ean-2020-0155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivos selecionar os indicadores dos resultados de enfermagem Integridade tissular: pele e mucosas (1101) e Cicatrização de feridas: segunda intenção (1103) da Nursing Outcomes Classification e construir suas definições conceituais e operacionais para a avaliação de pacientes com lesão por pressão. Métodos estudo de consenso de especialistas realizado em hospital universitário em setembro/2018. Participaram no estudo 10 enfermeiros com experiência na utilização da Nursing Outcomes Classification e no cuidado ao paciente com lesão por pressão. A coleta de dados ocorreu por meio de encontro presencial com os especialistas. Resultados Foram selecionados 17 indicadores da Nursing Outcomes Classification para a avaliação do paciente com lesão por pressão, com uma concordância de 100% entre os especialistas. São eles: Branqueamento, Eritema, Sensibilidade, Perfusão tissular, Hidratação/ Descamação, Espessura, Necrose, Odor desagradável na ferida, Pele com bolhas, Pele macerada, Descolamento Sob as bordas da Ferida, Inflamação Da Ferida, Exsudato/Drenagem, Granulação, Tunelamento, Formação de cicatriz e Tamanho da ferida. Conclusão e implicações para a prática os indicadores selecionados permitiram a elaboração de um instrumento que auxiliará na avaliação de pacientes com lesão por pressão de forma acurada. Esse instrumento subsidiará o enfermeiro na tomada de decisão diagnóstica e terapêutica da lesão por pressão.
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Affiliation(s)
| | | | | | | | | | - Amália de Fátima Lucena
- Universidade Federal do Rio Grande do Sul, Brasil; Universidade Federal do Rio Grande do Sul, Brasil
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Girlane Sousa Albuquerque Brandão M, Aline Moreira Ximenes M, de Oliveira Ramalho A, Saraiva Veras V, Moreira Barros L, Moura de Araújo T. Efeitos da laserterapia de baixa intensidade na cicatrização de úlceras nos pés em pessoas com diabetes mellitus. ESTIMA 2020. [DOI: 10.30886/estima.v18.844_pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objetivo: Identificar os efeitos da laserterapia de baixa intensidade na cicatrização do pé diabético. Método: Revisão sistemática nas bases de dados PubMed, LILACS, SciELO, CINAHL, Cochrane, Web of Science e Scopus, em que foram identificados 73 artigos, dos quais seis foram incluídos na amostra final, após verificação dos critérios de elegibilidade. Resultados: Os artigos apontaram como efeitos da laserterapia a efetividade na progressão do processo de reparo tecidual do pé diabético, alívio da dor, ação antiinflamatória, aumento da perfusão tecidual da lesão e melhora da resposta vascular e do sistema nervoso. Conclusão: O laser é uma terapia adjuvante que pode acelerar o processo de cicatrização da lesão, diminuir a dor, melhorar a neovascularização e, assim, minimizar o risco de complicações, como amputação do membro inferior e melhora da qualidade de vida de pessoas com diabetes e integridade da pele prejudicada.
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Affiliation(s)
| | | | | | - Vivian Saraiva Veras
- Universidade da Integração Internacional da Lusofonia Afro-Brasileira – Departamento de Enfermagem – Redenção (CE), Brazil
| | - Lívia Moreira Barros
- Universidade da Integração Internacional da Lusofonia Afro-Brasileira – Departamento de Enfermagem – Redenção (CE), Brazil
| | - Thiago Moura de Araújo
- Universidade da Integração Internacional da Lusofonia Afro-Brasileira – Departamento de Enfermagem – Redenção (CE), Brazil
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Girlane Sousa Albuquerque Brandão M, Aline Moreira Ximenes M, de Oliveira Ramalho A, Saraiva Veras V, Moreira Barros L, Moura de Araújo T. Effects of low-level laser therapy on the healing of foot ulcers in people with diabetes mellitus. ESTIMA 2020. [DOI: 10.30886/estima.v18.844_in] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective: Identify the effects of low-level laser therapy on the healing of diabetic foot. Method: Systematic review of the PubMed, LILACS, SciELO, CINAHL, Cochrane, Web of Science and Scopus databases, in which 92 articles were identified and six were included in the final sample after the eligibility criteria. Results: The articles pointed out as effects of laser therapy the effectiveness in the progression of the tissue repair process of the diabetic foot, pain relief, anti-inflammatory action, increased tissue perfusion of the lesion and improvement of the vascular response and the nervous system. Conclusion: Laser is an adjuvant therapy that can accelerate the wound healing process, relieve pain, improve neovascularization, and thus minimize the risk of complications, such as lower limb amputation and improvement of quality of life for people with diabetes and impaired skin integrity.
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Affiliation(s)
| | | | | | - Vivian Saraiva Veras
- Universidade da Integração Internacional da Lusofonia Afro-Brasileira – Departamento de Enfermagem – Redenção (CE), Brazil
| | - Lívia Moreira Barros
- Universidade da Integração Internacional da Lusofonia Afro-Brasileira – Departamento de Enfermagem – Redenção (CE), Brazil
| | - Thiago Moura de Araújo
- Universidade da Integração Internacional da Lusofonia Afro-Brasileira – Departamento de Enfermagem – Redenção (CE), Brazil
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Bavaresco T, Pires AUB, Moraes VM, Osmarin VM, Silveira DT, Lucena ADF. Low-level laser therapy for treatment of venous ulcers evaluated with the Nursing Outcome Classification: study protocol for a randomized controlled trial. Trials 2018; 19:372. [PMID: 30001202 PMCID: PMC6044085 DOI: 10.1186/s13063-018-2729-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 06/07/2018] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Different methods are available for the treatment of venous ulcers. Most current approaches focus on a combination of topical and compressive therapy. Adjuvant low-level laser therapy may be helpful in lesions with a protracted healing course, but evidence for its use is still limited. This paper describes the protocol of a randomized controlled trial designed to compare the effect of adjuvant low-level laser therapy versus conventional venous ulcer tissue repair, evaluated by a nurse using clinical indicators from the Nursing Outcomes Classification (NOC). METHODS/DESIGN For this prospective randomized controlled trial, 40 adult patients of both sexes with active venous ulcers will be recruited. Subjects will be selected by the sealed-envelope method without any annotation or external identification that might refer to the type of study group. At the time of unblinding, a label with the description of the group to which the patient belongs (that is, control or intervention) will be found inside the envelope. Conventional treatment (topical medication and compressive therapy) will be offered to both groups. Additionally, the intervention group will receive adjuvant low-level laser therapy. All patients will be followed weekly until ulcer healing or for a maximum of 16 weeks. Evaluation of tissue repair will be based on 14 clinical indicators drawn from NOC for wound healing (secondary intention) and tissue integrity (skin and mucous membranes). The primary endpoint will be decreased wound size and scar formation. This laser therapy is expected to enhance the quality, speed, and effectiveness of the treatment of venous ulcers, a chronic condition. This should reduce associated costs to the health service and allow patients to resume their daily activities sooner. DISCUSSION This randomized clinical trial will use a validated method to investigate the effect of a novel intervention for the treatment of venous ulcers. TRIAL REGISTRATION ClinicalTrials.gov, NCT03229330 . Registered on July 2017.
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Affiliation(s)
- Taline Bavaresco
- Nursing School at Universidade Federal do Rio Grande do Sul, São Manoel, 963, Rio Branco, Porto Alegre, 90620-110, Brazil. .,, Caxias do Sul, Brazil.
| | - Ananda Ughini Bertoldo Pires
- Nursing School at Universidade Federal do Rio Grande do Sul, São Manoel, 963, Rio Branco, Porto Alegre, 90620-110, Brazil
| | - Vítor Monteiro Moraes
- Nursing School at Universidade Federal do Rio Grande do Sul, São Manoel, 963, Rio Branco, Porto Alegre, 90620-110, Brazil
| | - Viviane Maria Osmarin
- Nursing School at Universidade Federal do Rio Grande do Sul, São Manoel, 963, Rio Branco, Porto Alegre, 90620-110, Brazil
| | - Denise Tolfo Silveira
- Nursing School at Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, São Manoel, 963, Rio Branco, Porto Alegre, 90620-110, Brazil
| | - Amália de Fátima Lucena
- Nursing School at Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, São Manoel, 963, Rio Branco, Porto Alegre, 90620-110, Brazil.,Hospital de Clínicas de Porto Alegre, Ramiro Barcelos, 2350, Santa Cecilia, Porto Alegre, RS, 90035-903, Brazil
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Gomes TF, Pedrosa MM, de Toledo ACL, Arnoni VW, dos Santos Monteiro M, Piai DC, Sylvestre SHZ, Ferreira B. Bactericide effect of methylene blue associated with low-level laser therapy in Escherichia coli bacteria isolated from pressure ulcers. Lasers Med Sci 2018; 33:1723-1731. [DOI: 10.1007/s10103-018-2528-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 04/25/2018] [Indexed: 01/09/2023]
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da Silva MB, Barreto LNM, Panato BP, Engelman B, Figueiredo MS, Rodríguez-Acelas AL, Almeida MDA. Clinical Indicators for Evaluation of Outcomes of Impaired Tissue Integrity in Orthopedic Patients: Consensus Study. Int J Nurs Knowl 2018; 30:81-86. [PMID: 29489065 DOI: 10.1111/2047-3095.12204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To select outcomes from the Nursing Outcomes Classification (NOC) to evaluate impaired tissue integrity in patients undergoing orthopedic surgeries, and develop conceptual and operational definitions for their indicators. METHODS A consensus study involving 10 nurses from clinical practice. A 100% consensus was established in the outcomes selection. FINDINGS Wound Healing: Primary intention (1102) with two indicators: (110214) Scar formation, and (110201) Skin approximation were selected. Four indicators were grouped to evaluate inflammatory signs together with foul wound odor and six for drainage. CONCLUSIONS These indicators direct the outcomes evaluation for wound healing. IMPLICATIONS FOR NURSING PRACTICE Support to the definition the priority interventions in nursing process documentation.
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Affiliation(s)
| | - Luciana Nabinger Menna Barreto
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil, Doctorate Student of the Nursing Graduate Program at the School of Nursing, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Bruna Paulsen Panato
- Nursing Graduate Program at the School of Nursing, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Bruna Engelman
- Nursing Graduate Program at the School of Nursing, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Mazzo A, Miranda FBG, Meska MHG, Bianchini A, Bernardes RM, Pereira Junior GA. Teaching of pressure injury prevention and treatment using simulation. ESCOLA ANNA NERY 2017. [DOI: 10.1590/2177-9465-ean-2017-0182] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective: To describe the construction of a high-fidelity clinical scenario simulation of "Pressure injury patient nursing care". Method: Report the experience of constructing a high-fidelity clinical scenario simulation based on the literature and on Bloom's taxonomy. Learning objectives, prior study material, fidelity, clinical case, necessary resources, problem solving, face and content validity, debriefing and evaluation were considered. Results: The scenario included cognitive, psychomotor and affective aspects; role-playing and the moulage technique were used, and it was positively evaluated by the students. Conclusion: The construction of planned, structured and validated simulated clinical scenarios brings learners closer to the clinical practice, allowing the development of the skills required for the prevention and treatment of pressure injuries. Implications for practice: Well-designed simulated clinical settings simulate nursing care training with fidelity to patients with pressure injury.
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Li Y, Yao M, Wang X, Zhao Y. Effects of gelatin sponge combined with moist wound-healing nursing intervention in the treatment of phase III bedsore. Exp Ther Med 2016; 11:2213-2216. [PMID: 27313666 PMCID: PMC4888027 DOI: 10.3892/etm.2016.3191] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 03/24/2016] [Indexed: 12/28/2022] Open
Abstract
Pressure sore pertains to tissue damage or necrosis that occurs due to lack of adequate nutrition following long-term exposure to pressure and decreased blood circulation. The aim of the study was to examine the effects of gelatin sponge combined with moist wound-healing nursing intervention in the treatment of phase III bedsore. In total, 50 patients with phase III bedsore were included in the present study. The patients were randomly divided into the control (n=25) and observation (n=25) groups. Patients in the control group received conventional nursing, while those in the observation group received gelatin sponge combined with moist wound healing nursing. The effects of the two nursing methods were compared and analyzed. The results showed that the improvement rate of the observation group was significantly higher than that of the control group (P<0.05). The Branden score and area of pressure sore of the observation group were significantly lower than those of the control group (P<0.05). The frequency and time of dressing change and the average cost of hospitalization of the observation group were significantly lower than those of the control group (P<0.001). In conclusion, gelatin sponge combined with moist wound-healing nursing intervention may significantly improve the treatment of phase III bedsore.
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Affiliation(s)
- Yanling Li
- Department of Neurology, Liaocheng People's Hospital, Liaocheng, Shangdong 252000, P.R. China
| | - Meiying Yao
- Department of Nephrology, Liaocheng People's Hospital, Liaocheng, Shangdong 252000, P.R. China
| | - Xia Wang
- Outpatient Office, Liaocheng Third People's Hospital, Liaocheng, Shangdong 252000, P.R. China
| | - Yanqing Zhao
- Department of Cardiology, Liaocheng Third People's Hospital, Liaocheng, Shangdong 252000, P.R. China
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