Tipos de tecidos em percentual no leito de feridas crônicas do tipo úlceras venosas e do pé diabético por planimetria digital

Abstract

Chronic lower limb ulcers are a global health issue, reflecting the billion-dollar costs to the health services. Expenses rise even higher when there are complications such as hospitalizations, infections, and amputations. Wound management can be guided by image documentation of the wound bed and the use of digital planimetry to characterize the type and percentage of tissue. These data, when interpreted by qualified professionals, are extremely important for the control and prevention of complications. The objective of this study was to characterize and compare the profile of diabetic foot and venous ulcers, addressing the type of tissue in the wound bed in percentage terms, by means of digital planimetry software. A cross-sectional study that contemplated a sample of 22 patients with chronic wounds divided into 11 diabetic foot ulcer patients and 11 venous ulcer patients, enrolled in this research according to the inclusion criteria. Data collection was carried out at the Municipal Center for Diabetic Care - Uberlândia, in the period from September 2021 to December 2021. Digital planimetry of wound photographs was analyzed using Image J 1.53e software and a smartphone with WoundDoc Plus®,2.8.2. Statistical analyses were performed using binomial, Mann-Withney and Kruskal-Wallis tests. This research characterized the wound bed of 22 patients with venous ulcers and diabetic foot ulcers, according to the percentage of granulation, coagulative necrosis, by liquefaction and other tissues via digital planimetry. We had as a result the association between low levels of exudate with the group of venous ulcer patients (p=0.0102), this characteristic predominating in 81.1% (9/11) of the individuals. Wound edges characterized as hydrated were also associated with venous ulcer patients (p=0.0102), prevailing in 72.7% (8/11) of the individuals in this group. However, maceration was associated with the diabetic foot ulcer group (p=0.0221), since 54.4% (6/11) of the patients in that group had that characteristic. The comparison between tissue types, in percentage terms, showed significant differences between granulation and coagulative (p<0.0001) and liquefaction necrosis (p=0.0305) in patients with diabetic foot ulcer. We also noticed a significant difference between the percentage of granulation tissue and coagulative necrosis (p=0.0003), in patients with venous ulcer. It is concluded that the measurement of the percentage and description of tissue types present in the wound bed, by digital planimetry, are accurate data to clinically characterize the wound and help health professionals, especially nurses specializing in the wound area, in decision making involving specific dressings according to the type of predominant tissue.