Fatores prognósticos em pacientes com úlcera de pressão atendidos no serviço de cirurgia plástica do Hospital Universitário

Dissertação (mestrado profissional) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-Graduação em Cuidados Intensivos e Paliativos, Florianópolis, 2016.Introdução: As úlceras de pressão, apesar das melhorias em cuidados médicos, surgem com frequência entre pacientes internados e pacientes com lesão medular. Objetivos: Descrever as características epidemiológicas dos pacientes com úlcera de pressão tratados no serviço de Cirurgia Plástica do Hospital Universitário da Universidade Federal de Santa Catarina e avaliar fatores associados com recorrência e cura. Métodos: Estudo de coorte histórico, analítico transversal, realizado entre 1997 e 2016. Resultados: Foram incluídos no estudo 60 indivíduos portadores de úlceras de pressão com 38,1 ± 16,5 (37,0) anos de idade, 83% eram homens e 87% declaravam-se de cor branca. A maioria dos pacientes (67%) era portador de paraplegia, amputação ou trauma de membros inferiores com sequelas motoras, 12% eram portadores de tetraplegia. Foram submetidos à cirurgia plástica 78% dos pacientes. O tempo médio de acompanhamento foi de 1,8 ? 2,5 anos. Cura das lesões foi observada em 42% pacientes. Recorrência das lesões ocorreu em 25% dos pacientes e observou-se que recorrência associou-se a localização das lesões. Os pacientes cujas lesões recorreram apresentavam um maior número de consultas e maior tempo de tratamento. Os indivíduos cujas úlceras curaram apresentavam menor número de lesões, maiores índices de massa corporal, maiores médias de hemoglobina e uma maior proporção foi submetida à cirurgia. Conclui-se, portanto, que o índice de massa corporal mais próximo a normalidade, a localização e o número de lesões são fatores prognósticos que devem ser levados em consideração pela equipe médica.Abstract : Introduction: Despite improvements in medical care, pressure sores often arise among hospitalized patients and those with spinal cord injury. Objectives: To describe the epidemiological characteristics of pressure ulcers in patients treated in the Plastic Surgery Service of the University Hospital of the Federal University of Santa Catarina (UFSC) and evaluate factors associated with recurrence and healing. Methods: A cross-sectional analytical, historical cohort study was conducted between 1997 and 2016. Results: The study included 60 individuals with pressure sores who were 38.1 ± 16.5 (37.0) years of age, 83% of them were men and 87% declared themselves white. Most patients (67%) presented with paraplegia, amputation or trauma of the lower limbs with motor sequelae, 12% suffered from quadriplegia. Plastic Surgery was performed in 78% of patients. The mean follow-up time was 1.8 ± 2.5 years. Healing of the lesions was observed in 25 patients (42%). Recurrence of the lesions occurred in 25% of patients and it was associated with localization of the lesions. The patients whose pressure sores recurred, had a larger number of lesions and longer treatment. Individuals whose ulcers had healed presented fewer lesions, higher body mass index and a higher proportion of patients underwent surgery. In conclusion, body mass index close to normality, the location and number of lesions are prognostic factors that must be taken into account by the medical team

Rhinophyma: a surgical treatment option

INTRODUCTION: Rhinophyma is a condition involving chronic inflammation of the nose and is characterized by progressive hypertrophy and hyperplasia of sebaceous glands and connective tissue. Rhinophyma leads to an appearance of nasal elephantiasis, which is caused by the congestion of dermis vessels. Its etiology is mostly associated with alcohol abuse. Rhinophyma is considered by some researchers to be an advanced stage of acne rosacea. Here, we report a case of rhinophyma that was surgically treated with decortication and electrocoagulation at the Plastic Surgery Service of the University Hospital of the Federal University of Santa Catarina. METHODS: A review of medical and photographic records of a case of rhinophyma was conducted. RESULTS: The patient was underwent surgical treatment with favorable outcomes. CONCLUSION: There are several treatments for rhinophyma, with decortication and electrocoagulation being an excellent therapeutic option

PROGNOSTIC FACTORS IN PATIENTS WITH PRESSURE SORES IN A UNIVERSITY HOSPITAL IN SOUTHERN BRAZIL

<div><p>ABSTRACT Objective: Despite advances in medical care, patients who are hospitalized or have spinal cord injuries often develop pressure sores. The objective of this study was to describe the epidemiological characteristics of pressure sores and evaluate factors associated with recurrence and cure. Methods: In this historical cohort study, clinical and laboratory data were collected from medical records between 1997 and 2016. Results: Sixty individuals with pressure ulcers were included; mean patient age was 38.1±16.5 (37.0) years, 83.3% were men, and 86.8% identified as white. Most patients (85.1%) had paraplegia, amputation, or trauma of the lower limbs with motor sequelae; the remainder (14.9%) were quadriplegic. Most (78.3%) underwent surgery, and the mean follow-up time was 1.8±2.5 years. The lesions were cured in 25 patients; they recurred in 25% of the patients, and recurrence was seen to be associated with the location of the lesions. Patients with recurrent lesions had more medical consultations and a longer treatment time. Individuals whose ulcers had healed had fewer lesions, higher body mass index (BMI), and a higher proportion of these patients underwent surgery. Conclusions: BMI and location and number of lesions are prognostic factors. Level of Evidence IV, Case Series.</p></div