Efeitos do ultra-som e da drenagem linfática manual na absorção das sufusões hemorrágicas após safenectomia radical: experimento clínico randomizado

Abstract

Currently, good aesthetic results combined with functional recovery of the limbs in radical saphenectomy postoperative are eagerly sought not only by patients but also by vascular surgeons. The objective of this study was to determine whether ultrasound (U.S.) and manual lymphatic drainage (MLD) influence the absorption of the hemorrhagic suffusions after radical saphenectomy, and if there is superiority of one in relation to the other. The study included 36 white female patients living with chronic venous insufficiency that have undergone radical saphenectomy; 63 limbs (analysis units) were randomized in three groups of 21 each: DLM (Leduc method), U.S. (continuous mode, 3 Mhz and 1 W/cm²) and Control. The proceedings were started on the 5th postoperative day and completed on the 30th postoperative day, three times a week on alternate days. The limbs were photographed at 5th, 20th and 30th days after surgery, and then three vascular surgeons, assessed the photos blindly, through score given from 0 (best condition) to 10 (worst condition) for three variables: colors intensity and areas of the hemorrhagic suffusions and aesthetics of the limbs. To assess the degree of improvement in each group were obtained variations (differences) in notes between 5th and 20th and between 5th and 30th postoperative days, by subtracting the notes given on the 5th postoperative day from those obtained on the 20th and on the 30th days after surgery, respectively. We used Tukey´s Test to verific significant differences in average scores between groups DLM, U.S. and Control (p <0.05). On the 5th postoperative day, DLM, U.S. and Control groups had similar grade point average but only for colors intensity (p> 0.05); on the 20th and 30 th postoperative days, there was no significant difference between U.S. and MLD groups; grade point averages were lower for DLM and U.S. groups in relation to Control group, for all variables (p <0.05). Variations in notes between 5th and 20th and between 5th and 30th postoperative days of MLD and U.S. groups, showed to be higher than in the Control group (p <0.05), and on the MLD group greater than in the U.S. group (p <0.05), indicating so that although both, DLM and U.S. are effective therapy resources to absorb the hemorragics suffusions after radical saphenectomy, the DLM is more effective than US.