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Advisor(s)
Abstract(s)
Contexto: As úlceras de perna de origem venosa afetam cerca de 1% da população e 3%
das pessoas com mais de 80 anos, nos países desenvolvidos. A terapia compressiva,
nomeadamente a de curta tração (SSB - short-stretch compression bandaging), está
recomendada no seu tratamento, evidenciando eficácia na taxa de cicatrização e redução do
tamanho da ferida. Não existe ainda suficiente evidência das vantagens da terapia SSB face
às outras metodologias ao nível da dor, qualidade de vida e custo do tratamento.
Objetivo: Comparar a eficácia da terapia compressiva SSB com outros tipos de compressão
ou com tratamentos sem compressão ao nível da dor, qualidade de vida e custo do
tratamento em pessoas com úlcera de perna de etiologia venosa.
Métodos: Realizou-se uma revisão sistemática da literatura, cumprindo os princípios
propostos pelo Cochrane Handbook. A pesquisa realizou-se na EBSCO, PubMed, SciELO,
no Google Académico e em repositórios nacionais, e em resumos de congressos da
especialidade, publicados entre Janeiro de 2012 (data de anterior revisão) e Novembro de
2016. Estabeleceram-se como critérios de inclusão adultos com úlcera de perna de origem
venosa, sujeitos a tratamento com SSB, avaliados relativamente à qualidade de vida, dor e
custo. Foram incluídos estudos randomizados e controlados (RCT’s) e aplicadas grelhas de
avaliação crítica aos artigos incluídos.
Resultados: Incluíram-se 4 RCT’s, sendo que 3 comparam SSB com ligaduras de
compressão de quatro camadas e 1 com ligaduras de compressão de três camadas, que
englobaram um total de 977 doentes. Destes quatro estudos: 2 analisaram a qualidade de
vida, não se evidenciando diferenças significativas entre o SSB e de múltiplas camadas; 2
evidenciaram tendência para maior redução da dor com a curta tração, embora sem
diferença estatisticamente significativa; 2 comparam o custo do tratamento, contudo as
conclusões são completamente contraditórias, um refere menos custo para a SSB e outro
para a múltiplas camadas.
Conclusões: Não existe evidência de que a terapia de curta tração seja mais eficaz do que
outros sistemas de compressão no alivio da dor, qualidade de vida e custo, no tratamento de
úlcera venosa da perna. São necessários mais RCT’s, que usem instrumentos de avaliação
uniformes para permitir conclusões mais sólidas, nomeadamente através de meta-análise.
Abstract Context: The venous Leg ulcer (VLU) affect about 1% of the population and 3% of people over 80 years old in developed countries. Compression therapy, whith short-stretch compression bandaging (SSB), is recommended in its treatment, demonstrating efficacy in the rate of healing and reduction of wound size. There is still not enough evidence of the advantages of SSB therapy compared to other methodologies in terms of pain, quality of life and cost of treatment. Objectives: To compare the efficacy of SSB compression therapy with other types of compression or with uncompressed in the pain, quality of life and treatment costs in people with venous leg ulcers. Methods: A systematic review of the literature was carried out, supported by the principles proposed by the Cochrane Handbook. The research was conducted at EBSCO, PubMed, SciELO, Google Scholar and national repositories, and abstracts of specialty congresses, published between January 2012 (date of previous revision) and November 2016. They were established as criteria of Inclusion of adults with venous leg ulcers, who were treated with SSB, evaluated for quality of life, pain and cost. Randomized controlled trials (RCTs) were included and critical grids were applied to included articles. Results: Four RCTs were included, 3 of which compared SSB with four-layer compression bandages and 1 with three-layer compression bandages, which comprised a total of 977 patients. Of these four studies: 2 analyzed the quality of life, not evidencing significant differences between the SSB and of multiple layers; 2 showed a trend towards greater reduction of pain with short traction, although without statistically significant difference; 2 compare the cost of treatment, however the conclusions are completely contradictory, one refers less cost to the SSB and another to the multiple layers. Conclusions: There is no evidence that SSB is more effective than other compression systems in relieving pain, quality of life, and cost in treating venous leg ulcer. More RCTs are needed, which use standardized assessment tools to allow for more robust conclusions, including through meta-analysis.
Abstract Context: The venous Leg ulcer (VLU) affect about 1% of the population and 3% of people over 80 years old in developed countries. Compression therapy, whith short-stretch compression bandaging (SSB), is recommended in its treatment, demonstrating efficacy in the rate of healing and reduction of wound size. There is still not enough evidence of the advantages of SSB therapy compared to other methodologies in terms of pain, quality of life and cost of treatment. Objectives: To compare the efficacy of SSB compression therapy with other types of compression or with uncompressed in the pain, quality of life and treatment costs in people with venous leg ulcers. Methods: A systematic review of the literature was carried out, supported by the principles proposed by the Cochrane Handbook. The research was conducted at EBSCO, PubMed, SciELO, Google Scholar and national repositories, and abstracts of specialty congresses, published between January 2012 (date of previous revision) and November 2016. They were established as criteria of Inclusion of adults with venous leg ulcers, who were treated with SSB, evaluated for quality of life, pain and cost. Randomized controlled trials (RCTs) were included and critical grids were applied to included articles. Results: Four RCTs were included, 3 of which compared SSB with four-layer compression bandages and 1 with three-layer compression bandages, which comprised a total of 977 patients. Of these four studies: 2 analyzed the quality of life, not evidencing significant differences between the SSB and of multiple layers; 2 showed a trend towards greater reduction of pain with short traction, although without statistically significant difference; 2 compare the cost of treatment, however the conclusions are completely contradictory, one refers less cost to the SSB and another to the multiple layers. Conclusions: There is no evidence that SSB is more effective than other compression systems in relieving pain, quality of life, and cost in treating venous leg ulcer. More RCTs are needed, which use standardized assessment tools to allow for more robust conclusions, including through meta-analysis.
Description
Keywords
Custos e análise de custos Dor Pensos e ligaduras de compressão Qualidade de vida Revisão Tracção Úlcera da perna Úlcera varicosa Compression bandages Costs and cost analysis Leg ulcer Pain Quality of life Review Traction Varicose ulcer