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Abstract(s)
Introdução: A prevalência crescente de feridas crónicas levou a OMS (2008) a designá-la por
epidemia escondida. Um fenómeno com elevado impacto mas cuja prevalência e caraterização
se encontra nacional e internacionalmente pouco estudado. Com o objetivo de caraterizar as
feridas crónicas em Portugal analisamos a prevalência, características do portador e da ferida,
intervenções e custos associados. Material e métodos: Estudo exploratório-descritivo das
variáveis obtidas na colheita de dados, que decorreu de janeiro de 2012 a dezembro de 2013,
numa amostra representativa da população portuguesa, e que incluiu indivíduos internados nos
CSD e indivíduos que recorreram aos CSP. Foram consideradas feridas crónicas, de acordo com
Fletcher, úlceras por pressão, úlceras de perna, lesões no pé diabético e feridas malignas.
Resultados: Dos 108840 indivíduos observados, 2182 tinham ferida crónica, correspondendo a
uma prevalência de 2% nos indivíduos observados e uma prevalência estimada de 1,4/1000
habitantes, 2 em cada 100 indivíduos que recorre aos CSP tem uma ferida cronica e 9 em cada
100 internados. As úlceras por pressão e as úlceras de perna são as lesões crónicas mais
prevalentes (0,5/1000 habitantes). Nos CSD a mais prevalente é a úlcera por pressão e nos CSP
a úlcera de perna. O portador de ferida crónica na sua maioria tem entre 65 e 79 anos, são não
ativos, têm como fatores de risco hipertensão (44,5%), diabetes (25,1%) e insuficiência venosa
periférica (24,7%), 61,8% tem dor relacionado com a ferida. O tempo médio de existência da
ferida é de 1 ano e 1 mês, têm uma média de score PUSH de 11,45 e 1/5 tem associado infeção.
O material de penso mais utilizado no tratamento das feridas complexas é o hidrogel (26,3%) e
a hidrofibra (21,4%) e é efetuado na sua maioria 2 vezes/semana. O custo direto de tratamento
de cada ferida crónica varia entre o mínimo de 1,52€ e o máximo de 166,32€ e a média é de
11,01€. A média do custo de cada tratamento é superior nos CSP do que nos CSD e a etiologia
de ferida com custos superiores é a úlcera de perna mista, seguida da ferida maligna e da úlcera
por pressão categoria IV. Nas úlceras por pressão a categoria III é a mais representada (30,3%) e
em apenas 40,24% dos indivíduos foi aplicada a escala de Braden. Nas úlceras de perna 62,68%
são exclusivamente venosas e em 20,33% não foi efetuado o diagnóstico diferencial, o IPTB
apenas foi efetuado a 9,8% dos indivíduos com úlcera de perna. Conclusão: Os resultados deste
estudo contribuem para um saber global e mais aprofundado do fenómeno das feridas crónicas
em Portugal, fornecendo um conjunto de dados que serão a base de outras investigações e
constituem matéria fundamental para o desenvolvimento de medidas promotoras de cuidados
eficientes, seguros e de qualidade.
Introduction: The growing prevalence of chronic wounds lead World Health Organization (2008) to designate it by hidden epidemic. A high impact phenomena that besides its prevalence and characterization is still less explored. With the objective of chronic wounds characterization in Portugal it prevalence, human carrier and wound characteristics were analysed as the interventions and associated costs. Material and Methods: Exploratory-Descriptive study of obtained variables in data collection occurred from January 2012 to December 2013, with a representative sample of Portuguese population that included internal patients in hospital and individuals that rely on community. Chronic wounds were considered according with Fletcher, pressure ulcer, leg ulcers, diabetic foot lesions and malign wounds. Results: Of the 108840 observed individuals, 2182 had chronic wounds, corresponding to a prevalence of 2% in the observed individuals and an estimated prevalence of 1,6/1000 residents, 2 in 100 individuals that go to community have a chronic wound and 9 in 100 of interned residents. The pressure ulcers and leg ulcers are the more prevalent (0,5/1000 residents). In hospital the more prevalent wound is ulcer pressure and in the community is the leg ulcer. The carriers of chronic wounds have ages between 65 and 79 years, are non-actives, they have risk of hypertension (44,5%), diabetes (25,1%) and peripheral venous insufficiency (24,7%), 61,8% have pain related to the wound. The average time of wound existence is 1 year and 1 month, they have an average score PUSH of 11,45 and 1/5 have associated infection. The patch material more used in the complex wound treatment is hydrogel (26,3%) and hydrofibre (21,4%) and it is performed in the most of times twice per week. The direct cost of each chronic wound varies between the minimum of 1,52€ and the maximum of 166,32€, the average is 11,01€. The medium cost per treatment is higher in community comparing to hospital, the wound etiology with higher costs is the mixed leg ulcer by pressure of category IV. In pressure ulcers the category III is the most representative (30,3%) and in just 40,24% of individuals was applied the Braden scale. In leg ulcers 62,68% were exclusively venous and in 20,33% the differential diagnosis was not performed, ankle pressure arm index was just performed in 9,8% of individuals with leg ulcer. Conclusion: The results of this study contribute to a global knowledge and more explored in the chronic wounds phenomena in Portugal, providing a data set that will serve as base for other researches and constitute fundamental matters to the development of promoting measures of efficient, secure and quality care.
Introduction: The growing prevalence of chronic wounds lead World Health Organization (2008) to designate it by hidden epidemic. A high impact phenomena that besides its prevalence and characterization is still less explored. With the objective of chronic wounds characterization in Portugal it prevalence, human carrier and wound characteristics were analysed as the interventions and associated costs. Material and Methods: Exploratory-Descriptive study of obtained variables in data collection occurred from January 2012 to December 2013, with a representative sample of Portuguese population that included internal patients in hospital and individuals that rely on community. Chronic wounds were considered according with Fletcher, pressure ulcer, leg ulcers, diabetic foot lesions and malign wounds. Results: Of the 108840 observed individuals, 2182 had chronic wounds, corresponding to a prevalence of 2% in the observed individuals and an estimated prevalence of 1,6/1000 residents, 2 in 100 individuals that go to community have a chronic wound and 9 in 100 of interned residents. The pressure ulcers and leg ulcers are the more prevalent (0,5/1000 residents). In hospital the more prevalent wound is ulcer pressure and in the community is the leg ulcer. The carriers of chronic wounds have ages between 65 and 79 years, are non-actives, they have risk of hypertension (44,5%), diabetes (25,1%) and peripheral venous insufficiency (24,7%), 61,8% have pain related to the wound. The average time of wound existence is 1 year and 1 month, they have an average score PUSH of 11,45 and 1/5 have associated infection. The patch material more used in the complex wound treatment is hydrogel (26,3%) and hydrofibre (21,4%) and it is performed in the most of times twice per week. The direct cost of each chronic wound varies between the minimum of 1,52€ and the maximum of 166,32€, the average is 11,01€. The medium cost per treatment is higher in community comparing to hospital, the wound etiology with higher costs is the mixed leg ulcer by pressure of category IV. In pressure ulcers the category III is the most representative (30,3%) and in just 40,24% of individuals was applied the Braden scale. In leg ulcers 62,68% were exclusively venous and in 20,33% the differential diagnosis was not performed, ankle pressure arm index was just performed in 9,8% of individuals with leg ulcer. Conclusion: The results of this study contribute to a global knowledge and more explored in the chronic wounds phenomena in Portugal, providing a data set that will serve as base for other researches and constitute fundamental matters to the development of promoting measures of efficient, secure and quality care.
Description
Keywords
Prevalência feridas crónicas Caraterísticas do indivíduo Características da ferida Tratamento Custos Chronic wounds prevalence Individual characteristics Wound characteristics Treatment Costs