Uso de ácido hialurônico no tratamento de lesões por pressão: relato de casos

Abstract

Pressure injuries (PIs) arise from the intense and/or prolonged pressure associated with local shear. Although the occurrence of PIs is considered an adverse event that can generally be preventable, there are occasions when the conditions of the patient make them unavoidable. This study reports experiences connected with the treatment of PIs from different etiologies. The patients were attended by the multidisciplinary team of the Programa Melhor em Casa de Jaguariúna- -SP. Case 1 - male, 19 years old, beating victim, resulting in severe cranioencephalic trauma, remaining in coma for a few days. He was quadriplegic, under rehabilitation and used orthesis in the lower limbs (LLs), which compressed the right malleolus, resulting in PI. Necrotic tissue was removed by means of instrumental debridement and daily cleansing with 0.9% saline solution (SS) and daily application of a thin layer of 0.2% HA cream. Case 2 - woman, 79 years old, smoker, obese, with systemic arterial hypertension, type 2 diabetes, COPD, osteoporosis, anemia, femoral fracture and PI in the sacral region of stage 2 and in the right ischium. It was used, without success, dressings involving daily cleaning with 0.9% SS and application of essential fatty acids (EFA) in the treatment of PI. A protocol was started with daily cleaning with 0.9% SS and daily application of a thin layer of cream based on 0.2% HA. After 15 to 34 days of treatment with topical HA, the complete cutaneous repair of the PIs was verified, revealing the effectiveness of the protocol used. Descriptors: pressure ulcer, hyaluronic acid, wound healing.