Quality of life profile and correlated factors in chronic leg ulcer patients in the mid-west of São Paulo State, Brazil

BACKGROUND: Chronic leg ulcer may have an impact on patients' quality of life.OBJECTIVES:This study aimed to identify the impact of leg ulcers on patient's quality of life using the Dermatology Life Quality Index and to define the main factors correlated with this perception.METHOD:Cross-sectional, non-probabilistic sampling study. We included patients with chronic leg ulcers being treated for at least 3 months. A sociodemographic and clinical survey was conducted to assess the profile of the ulcers. We administered a screening for depressive symptoms and the Dermatology Life Quality Index. We performed a descriptive statistical analysis, chi-square test and Mann-Whitney test for categorical data, Pearson for numeric variables, and multiple regression for categorical data.RESULTS:Forty-one patients were assessed. Their mean age was 61.78 years. Venous ulcers (48.8%) were the most prevalent. Seventy-three percent of the sample perceived no impact/low impact on quality of life in the past week, and 26.8% perceived moderate/high impact. A multiple regression analysis identified the causes of lesion, pain related to the ulcers, time of onset, and severity of the depressive symptoms as the variables that had an influence on quality of life.CONCLUSIONS:The majority of the sample perceived low or no impact of the condition on the quality of the life. The variables etiology of the lesion (p<0.001), pain related to the ulcers (p=0.001), time of onset (p=0.006), and severity of the depressive symptoms (p<0.001) had an influence on the quality of life, suggesting the need for further studies with more robust designs to confirm the causal relationship between these characteristics and quality of life

Implante de queratinócitos autólogos em úlceras de membros inferiores de pacientes com seqüelas de hanseníase

The occurrence of ulcers in leprosy is mainly due to the existence of numb areas that can easily undergo trauma and burns and thereafter become secondarily infected. This study aimed to treat ulcers in lower limbs of patients with leprosy sequelae through the implantation of autologous keratinocytes. The study consisted of fourteen patients (six with a single ulcer, four with more than one ulcer in the same limb and four with ulcers in both limbs) with a total of 31 ulcers. A fragment of healthy skin was collected and subjected to enzymatic digestion to obtain keratinocytes, which were then cultured for four weeks. The resulting keratinocytes were implanted in ulcers in combination with fibrin glue. Patients were followed for two months and the ulcers were monitored weekly during this time. Ulcers measuring ≤ 9.0 cm high x 5.0 cm wide (23 ulcers) decreased by 68.8% ± 27.1%, with nine of them showing complete healing. Larger ulcers decreased by 50.0% ± 31.9%, with two of these healing completely. Thus, implantation of autologous keratinocytes in combination with fibrin glue was effective in healing and/or reducing the ulcer size and should be considered as an additional ulcer treatment option in patients with leprosy sequelae.Na hanseníase as úlceras podem surgir, principalmente, pelo fato de existirem áreas anestésicas, que com facilidade podem ser traumatizadas, queimadas e secundariamente infectadas. Este estudo teve por objetivo tratar as úlceras de membro inferior de pacientes com seqüelas de hanseníase por meio do implante de queratinócitos autólogos. Participaram 14 pacientes, sendo seis com uma única úlcera, quatro com mais de uma úlcera no mesmo membro inferior e quatro com úlceras nos dois membros, totalizando 31 úlceras. Um fragmento de pele sadia foi coletado e submetido à digestão enzimática para obtenção dos queratinócitos, que foram cultivados em meio específico, por quatro semanas. Os queratinócitos foram implantados nas úlceras em associação com cola de fibrina, as quais foram acompanhadas semanalmente, por dois meses. As úlceras cujas medidas eram ≤ a 9,0 cm de altura x 5,0 cm de largura (total de 23 úlceras) tiveram redução de tamanho em 68,8 ± 27,1%, sendo que nove delas apresentaram cicatrização total; àquelas com tamanho superior a esta medida diminuíram 50,0 ± 31,9%, sendo que duas cicatrizaram totalmente. Assim, o implante de queratinócitos autólogos em associação com cola de fibrina se mostrou eficaz na cicatrização e/ou redução do tamanho das úlceras e constitui mais uma opção de tratamento para úlceras de pacientes com seqüelas de hanseníase.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq