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Previous issue date: 2011-04-27 / Introdução: A úlcera de perna causa sofrimento aos pacientes, afetando seu quotidiano devido a(o): dor, isolamento social, autoimagem e autoestima prejudicadas. Objetivo: Avaliar a qualidade de vida, autoestima, capacidade funcional e dor em pacientes com úlcera venosa pósenxerto de pele. Métodos: Estudo multicêntrico, comparativo e controlado, realizado nos ambulatórios: de Cirurgia Plástica do Hospital São Paulo e de Feridas do Conjunto Hospitalar de Sorocaba. Casuística: 50 pacientes - Grupo Controle; 50 - Grupo Estudo. Aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal de São Paulo. Coleta de dados: julho- 2008 a dezembro-2010. Grupo Controle: coleta de dados no momento da inclusão no estudo, aos 30, 90 e 180 dias subsequentes. Grupo Estudo: primeira coleta no pré-operatório - 30, 90 e 180 dias após o enxerto. Instrumentos: Short Form-36, Escala de autoestima Rosenberg/UNIFESP–EPM, Health Assessment Questinnaire-20 (HAQ-20), Escala Numérica de dor, questionário de Dor de Mc Gill. Análises estatísticas: Teste t Student, o TesteKruskal- Wallis, Teste Qui-Quadrado de Independência, considerando-se os níveis de significância p ≤ 0,05. Resultados: avaliação inicial do paciente com úlcera venosa: escores do SF-36 baixos: média 18,10 - Grupo Controle e 32,34 - Grupo Estudo. Um mês após enxerto, pacientes Grupo Estudo apresentaram escores mais elevados no SF-36 (71,38) comparados ao GC (18,42). Após 90 e 180 dias, aumento dos escores no GE comparados ao Grupo Controle(p=0,0001). Escore médio no HAQ-20: 2,42 - Grupo Controle e 2,65 - Grupo Estudo. Grupo Estudo: melhora nos escores após 90 dias e 180 dias do enxerto (p=0,0001). Pela Escala de Autoestima Rosenberg/UNIFESP–EPM, na inclusão dos pacientes no estudo, escore médio no Grupo Controle: 25,50, Grupo Estudo: 25,86. Após 90 dias e 180 dias, Grupo Estudo: melhor escore comparado ao Grupo Controle (p=0,0001). Pela Escala Numérica e pelo Questionário de Dor de Mc Gill, os dois grupos apresentaram dor durante a primeira coleta de dados. Grupo Estudo: após 90 dias e 180 dias de pós-operatório, houve declínio da dor (p=0,0001). Conclusão: Pacientes com úlcera venosa após enxerto de pele melhoraram qualidade de vida, autoestima, capacidade funcional e dor. / Objective: To assess quality of life, self-esteem, functional capacity and pain in patients with venous ulcer after skin graft. Methods: Clinical, multicenter, analytical, prospective, comparative, controlled and non-randomized study. This study was carried out in the plastic surgery outpatient clinic of Hospital São Paulo and in the Wound Outpatient clinic at Conjunto Hospitalar de Sorocaba. The case series was formed by 50 patients in the Control Group (CG) and 50 patients in the Study Group (SG) both with diagnosis of venous ulcer and indication for skin graft. The study was approved by the Research Ethics Committee at the Universidade Federal de São Paulo, under authorization #: 0945/08. Data collection was carried out from July 2008 and December 2010. In the CG, data collection was carried out at the time patients were included in the study, and then 30, 90 and 180 days after the first collection. In the SG, the first collection was carried out in the preoperative period and then 30, 90 and 180 days after skin graft. All patients of the CG were operated on after 180 days. Inclusion criteria were: being over 18 years old and having a diagnosis of venous ulcer with referral for skin coverage with skin graft. Exclusion criteria were: Skin lesions that were not completely characterized as venous ulcer, patients with clinical conditions that contraindicated surgery, and patients that had already undergone skin graft. The instruments used for data collection were: Short Form- 36, the Rosenberg self-esteem scale/UNIFESP–EPM, the Health Assessment Questionnaire-20 (HAQ-20), the Numeric Pain Scale, and the Mc Gill pain questionnaire. For statistical analysis, we have used Students’ t test, Kruskal-Wallis test and the Chi-square test of independence. It was fixed in 0.05 or 5% (p ≤ 0.05). Outcomes: In the initial assessment of patients with venous ulcer, the SF-36 scores were low, with a mean score of 18.10 in the CG, and 32.34 in the SG. One month after skin graft was carried out, patients in the SG presented higher scores in the SF-36 (71.38) compared to the CG (18.42). After 90 and 180 days there was also an increase in the scores of the SG compared to the CG (p=0.0001). Mean scores in the HAQ-20 was 2.42 in the CG and 2.65 in the SG, and in the SG there was an improvement in the scores 90 and 180 days after skin graft was carried out (p=0.0001).As for the Rosenberg self-esteem scale/UNIFESP–EPM, in the inclusion of patients in the study, the mean score was 25.50 in the CG, and 25.86 in the SG, and after 90 days and 180 days the SG presented better score compared to the CG (p=0.0001). As for pain assessment using the Numeric Scale and the McGill pain questionnaire, both groups of patients presented pain during the first data collection, however, in the SG 90 and 180 days after surgery, patients presented less pain (p=0.0001). Conclusion: Patients with venous ulcers, that underwent skin graft presented improvement in the quality of life, self-esteem, functional capacity and less pain. / TEDE / BV UNIFESP: Teses e dissertações
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.unifesp.br:11600/10079 |
| Date | 27 April 2011 |
| Creators | Salomé, Geraldo Magela [UNIFESP] |
| Contributors | Universidade Federal de São Paulo (UNIFESP), Ferreira, Lydia Masako [UNIFESP] |
| Publisher | Universidade Federal de São Paulo (UNIFESP) |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | 117 f. |
| Source | reponame:Repositório Institucional da UNIFESP, instname:Universidade Federal de São Paulo, instacron:UNIFESP |
| Rights | info:eu-repo/semantics/openAccess |
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