Caracterização do tratamento de feridas complexas em um Hospital Geral

Abstract

The treatment of wounds is one of the oldest concerns of medicine. The wounds affect the general population, regardless of gender, age or ethnicity, determining a high rate of people with changes in skin integrity, what constitutes a serious public health problem in Brazil. The statistics that prove this fact are very scarce. This work aimed to characterize the treatment of complex wounds in a hospital from February to March 2013. This is exploratory, longitudinal, descriptive research, being the patients accompanied in two stages: at the entrance at the hospital and at the exit, and the data collected were quantitative and statistically evaluated. The study was put into action through a form with data collected from medical records of explanatory variables and outcome variables, which were confronted. Results: in a universe of 2010 inpatients in a tertiary hospital we found 668 patients with wounds, mainly surgical, being 107 patients with complex wounds, of which 84 were studied and subdivided in injured by trauma (FT = 45.2%), complicated surgical wounds (FOC = 21.4%), diabetic wounds (FD = 14.3%), pressure ulcers (UP = 14.3%) and venous ulcers (UV = 14.3%). The study noted that the treatment is still conservative and there is surgical intervention failure, notably the debridement, which contributed to the severe outcome in that 80% of the patients left the hospital with their wounds, most without adequate debridement. Discussion: the study was compared with 10 reference articles found in the literature, with 6 studies of wound cases of various etiologies and 4 studies of wounds that group as cases of plastic surgery, according to their results in the wounds treatment. Conclusion: it was expressed the need to involve the teams of surgical specialties with the coordination of plastic surgery, to study the new classification of complex wounds and to build a treatment protocol for these wounds, understanding that its treatment is potentially surgical and that must be accomplished through continuous and early debridement and prompt cover with flaps and grafts.