RESUMO
Introdução: Este trabalho objetiva descrever a evolução da cicatrização e o tratamento realizado em pacientes com úlceras de perna no ambulatório de feridas, utilizando o instrumento Pressure Ulcer Scale for Healing - PUSH. Métodos: Trata-se de pesquisa na modalidade estudo de caso, realizada com quatro pacientes. Os dados foram colhidos em um Hospital Estadual do interior de São Paulo, nos anos 2009 e 2010, por meio de fotografias digitais e da escala de evolução de feridas Pressure Ulcer Scale for Healing. Os itens avaliados são: área da ferida, quantidade de exsudato e aparência do leito da ferida. Resultados: Na primeira avaliação, o primeiro caso apresentava escore total 16; o segundo e o terceiro casos, escore total 13; e o quarto caso, escore total 15. Na segunda avaliação, o primeiro caso apresentava escore total 13; o segundo, escore total 7; o terceiro, escore total 6; e o quarto, escore total 11. Na última avaliação, o primeiro caso apresentava escore total 4 e no segundo, terceiro e quarto casos, o escore total foi zero. A aplicação da Escala Pressure Ulcer Scale for Healing na avaliação dos 4 pacientes deste estudo possibilitou aos enfermeiros realizar a prescrição da cobertura ideal para o processo cicatricial da lesão. Conclusão: Concluiu-se que o referido instrumento facilita sobremaneira a atuação da enfermagem na avaliação e na escolha da cobertura ideal para a promoção da epitelização da lesão, uma vez que tem por base a avaliação de parâmetros importantes durante o processo dinâmico do cuidar de feridas.
Introduction: This work describes the evolution of wound healing and outpatient treatment of patients with leg ulcers using the Pressure Ulcer Scale for Healing (PUSH) tool. Method: This research was performed as a case study with four patients. The data were gathered at a State Hospital in the countryside of the State of São Paulo from 2009 to 2010 through digital photographs and the PUSH wound evolution scale. The wound area, amount of exudate and appearance of the wound bed were assessed. Results: In the first assessment, the first case presented with a total score of 16; the second and third cases, 13; and the fourth case, 15. In the second assessment, the first case presented with a total score of 13; the second, 7; the third, 6; and the fourth, 11. In the last assessment, the first case presented a total score of 4, and the second, third and fourth cases, 0. The application of the PUSH to assess the four patients in this study allowed nurses to perform the optimal wound dressing prescribed for the healing process. Conclusion: It was concluded that the aforementioned tool greatly facilitates nursing performance in assessing and choosing the optimal dressing to promote the epithelialization of the wound, which is based on the assessment of important parameters during the dynamic process of wound care.
Assuntos
Humanos , Masculino , Feminino , Idoso , História do Século XXI , Úlcera Varicosa , Cicatrização , Ferimentos e Lesões , Relatos de Casos , Impotência Vasculogênica , Estudo de Avaliação , Perna (Membro) , Cuidados de Enfermagem , Úlcera Varicosa/cirurgia , Úlcera Varicosa/patologia , Ferimentos e Lesões/cirurgia , Ferimentos e Lesões/patologia , Impotência Vasculogênica/cirurgia , Perna (Membro)/cirurgia , Cuidados de Enfermagem/métodosAssuntos
Pesquisa Biomédica/história , Impotência Vasculogênica/cirurgia , Procedimentos Cirúrgicos Urológicos Masculinos/história , História do Século XX , Humanos , Impotência Vasculogênica/diagnóstico por imagem , Impotência Vasculogênica/história , Masculino , Ultrassonografia , Procedimentos Cirúrgicos Urológicos Masculinos/métodosRESUMO
INTRODUCTION: The corpora cavernosa are cylindrical vessels containing fluid under pressure. Thus, if cavernous wall resistance decreases, the radius increases and internal pressure decreases (LaPlace's law). We reasoned that if we decrease the corpus cavernosum radius, by excising a strip from each tunica albuginea, intracavernous pressure would increase during erection. MATERIALS AND METHODS: We treated with this procedure, four patients (mean age 41.5) with long-standing erectile dysfunction due to veno-occlusive dysfunction, non-responders to phosphodiesterase-5 inhibitors and intracavernous PGE1 injection. RESULTS: Two months post-surgery, intracavernous PGE1 (40 mcg) induced a satisfactory erection in two patients and a 45 percent and 58 percent tumescence in the other two. PGE1 responders also responded to 100 mg sildenafil. After 100 mg sildenafil and 20 mg tadalafil, the two non-responders had erections that enabled penetration but were short lasting. CONCLUSION: The procedure described could be more effective than cavernous revascularization operations. The results seem to confirm the mathematical assumptions.
Assuntos
Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Tecido Elástico/patologia , Impotência Vasculogênica/cirurgia , Pênis/cirurgia , Velocidade do Fluxo Sanguíneo , Tecido Elástico/fisiopatologia , Impotência Vasculogênica/fisiopatologia , Período Pós-Operatório , Pênis/irrigação sanguíneaRESUMO
INTRODUCTION: The corpora cavernosa are cylindrical vessels containing fluid under pressure. Thus, if cavernous wall resistance decreases, the radius increases and internal pressure decreases (LaPlace's law). We reasoned that if we decrease the corpus cavernosum radius, by excising a strip from each tunica albuginea, intracavernous pressure would increase during erection. MATERIALS AND METHODS: We treated with this procedure, four patients (mean age 41.5) with long-standing erectile dysfunction due to veno-occlusive dysfunction, non-responders to phosphodiesterase-5 inhibitors and intracavernous PGE1 injection. RESULTS: Two months post-surgery, intracavernous PGE1 (40 mcg) induced a satisfactory erection in two patients and a 45% and 58% tumescence in the other two. PGE1 responders also responded to 100 mg sildenafil. After 100 mg sildenafil and 20 mg tadalafil, the two non-responders had erections that enabled penetration but were short lasting. CONCLUSION: The procedure described could be more effective than cavernous revascularization operations. The results seem to confirm the mathematical assumptions.
Assuntos
Tecido Elástico/patologia , Impotência Vasculogênica/cirurgia , Pênis/cirurgia , Adulto , Velocidade do Fluxo Sanguíneo , Tecido Elástico/fisiopatologia , Humanos , Impotência Vasculogênica/fisiopatologia , Masculino , Pessoa de Meia-Idade , Pênis/irrigação sanguínea , Período Pós-OperatórioRESUMO
PURPOSE: We now know that outflow restriction is essential for maintaining a rigid erection, which can be achieved after satisfactory smooth muscle relaxation. The aim of this study was to assess retrospectively the efficacy of penile vein surgical ligation in patients with a follow-up of at least 3 years. MATERIALS AND METHODS: Thirty-two men with impotence due to cavernovenous occlusive disease underwent penile vein ligation for management of organic erectile dysfunction. Cavernovenous occlusive disease was diagnosed by gravity cavernosometry. RESULTS: Long-term evaluation revealed sustained potency without adjunctive therapy in only 7 patients (21.87%). Twenty-five patients (78.12%) did not show any improvement in the erectile mechanism. Associated complications included penile shortening in 4 (12.5%), hypoesthesia of the glans area in 2 (6.25%), and Peyronie's disease in 1 (3.2%). CONCLUSION: Based on these data, we conclude that the long-term success of penile vein ligation is poor.