Knowledge on therapies for pressure ulcer: an integrative review

Objective: to analyze the evidences on therapies for the treatment of pressure ulcers. Methods: integrative review with articles published between 2014 and 2019 in SciELO, MEDLINE, LILACS, BDENF, IBECS and CINAHL databases. The descriptors used were: pressure ulcer, therapeutics and nursing care. Results: twelve articles were found that met the study ́s objectives. Data from the eligible studies were extracted using the data collection instrument. After this step, they were categorized and synthesized, in a descriptive way, and listed in four categories: professionals’ knowledge about therapies; adequate management of therapies; therapies with biophysical agents; and non-conventional therapies. Conclusion: the analyzed articles reflect on the use of some therapies and strategies to treat pressure ulcers. The various therapies addressed in the research on the treatment of these ulcers proved to be effective, however, they are insufficient to ensure their wide and safe use. Descriptors: Pressure Ulcer; Nursing Care; Therapeutics; Review. RESUMO Objetivo: analisar as evidências acerca das terapias para tratamento das lesões por pressão. Métodos: revisão integrativa com artigos publicados entre 2014 e 2019 nas bases de dados SciELO, MEDLINE, LILACS, BDENF, IBECS e CINAHL. Os descritores utilizados foram: lesões por pressão, terapêutica e cuidados de enfermagem. Resultados: encontrados 12 artigos que atenderam ao objetivo do estudo. Os dados dos estudos elegíveis foram extraídos por meio do instrumento de coleta de dados. Após essa etapa, os mesmos foram categorizados e sintetizados, de forma descritiva, e elencados em quatro categorias: conhecimento dos profissionais sobre as terapias; adequado gerenciamento de terapias; terapias com agentes biofísicos; terapias não convencionais. Conclusão: os artigos analisados refletem sobre a utilização de algumas terapêuticas e estratégias para tratar as lesões por pressão. As diversas terapias abordadas nas pesquisas sobre o tratamento dessas lesões se mostraram efetivas, no entanto, são insuficientes para garantir a sua ampla e segura utilização. Descritores: Lesão por Pressão; Cuidados de Enfermagem; Terapêutica; Revisão. 1Universidade do Estado da Bahia. Salvador, BA, Brazil. 2Escola Bahiana de Medicina e Saúde Pública. Salvador, BA, Brazil. Corresponding author: Rosana Freitas Azevedo Universidade do Estado da Bahia Campus IDepartamento de Ciências da Vida Rua Silveira Martins, 2555, Cabula. CEP:41.150-000. Salvador, BA, Brazil. E-mail: rosanafazevedo@hotmail.com EDITOR IN CHIEF: Viviane Martins da Silva ASSOCIATE EDITOR: Renan Alves Silva Rosana Freitas Azevedo1 Rosana Maria Pereira Garcia2 Maria Thais Calasans2 How to cite this article: Azevedo RF, Garcia RMP, Calasans MT. Knowledge on therapies for pressure ulcer: an integrative review. Rev Rene. 2021;22:e60265. DOI: https://doi.org/10.15253/2175-6783.20212260265 Azevedo RF, Garcia RMP, Calasans MT Rev Rene. 2021;22:e60265. 2 Introduction Pressure ulcers are an important public health problem due to their high rates in bedridden and hospitalized individuals, which hinders their recovery, increasing the risk for the development of different complications. Furthermore, they reflect on the health care system as they generate high costs for the state, as well as for families, institutions and society, generating also physical and emotional suffering for the individual, since it reduces their independence, the execution of their daily activities, impacting on their quality of life(1). They are called lesions on the skin and/or underlying tissues due to pressure alone or associated with friction and/or shear, often located on bony prominences in people with impaired physical mobility(2). In order to adequately prevent and treat pressure ulcers, the National Pressure Ulcer Advisory Panel (NPUAP), the European Pressure Ulcer Advisory Panel (EPUAP) and the Pan Pacific Pressure Injury Alliance (PPPIA) have recently published new international guidelines with recommendations for the development of public policies, education and research on treatment and prevention of Pressure injuries(2). Even with the existence of protocols with recommendations regarding the prevention of this type of injury, when its development is inevitable, adherence to good therapeutic practices is necessary in order to reduce the negative outcomes and prevent the progression of its severity. The pressure ulcer is a problem that must be considered in all professional areas, highlighting Nursing for its effective care, as it follows the patient’s evolution in full time, becoming responsible for the preservation of the risks that the lesions may entail. The range of factors related to the onset of pressure ulcers is evidenced in numerous studies and, to treat these causes, it is essential to include nursing care combined with the involvement of high level of information and knowledge(3). In this context, it is justified to analyze the available evidence in the literature about the treatments used in pressure ulcers, since the choice of appropriate treatment favors proper healing, reduces the hospitalization process and patient damage, and contributes to the quality of care. Under this aspect, the search for scientific evidence through integrative literature review about the treatments for Pressure injuries allows a broad analysis of the available therapies for adequate treatment by nurses, when these lesions are present. This study aimed to analyze the evidence on therapies for pressure ulcers treatment.