Keywords
Leprosy
chronic ulcer
healing
out-patient units
Public Health Service
chronic ulcer
healing
out-patient units
Public Health Service
How to Cite
1.
Gonçalves G, Gonçalves A, Padovani CR, Parizotto NA. Laser therapy applied to leprous and non-leprous ulcers healing: : a clinical trial in out-patient units of Public Health Service. Hansen. Int. [Internet]. 2000 Nov. 30 [cited 2024 Nov. 23];25(2):133-42. Available from: https://periodicos.saude.sp.gov.br/hansenologia/article/view/36435
Abstract
Plantar ulcer is a very frequent physical disability caused by leprosy. This fact improses, to endemic countries, the necessity of appling newer technologies to improve the quality of life of such impatients, by developing more resolutive Public Health Services. Aiming to contribute to these objectives, a clinical trial on chronic ulcer healing by laser therapy was conducted, compairing leprous and non leprous lesions, in local health units. Once reference population was defined, inclusion and exclusion criteria were established, and ethical norms observed. Measuring, evaluation and application standardized procedures were adopted, as well as clinical and documental follow up. A set of indicators based on quantitative and qualitativescales has been used, measuring on time width, lenght, depth and volume; in the same manner, clinical lesion signs were also rigorously considered, as erythema, oedema and limits aspects. For statistical analysis, Anova, Wilcoxon and Goodman test (for variations intra and among multinomial populations) were employed. Lesion disappearance prevailed significantly on reduction and worsening among leprosers (66, 7; 16,7% and 16,7%, respectively) and non-leprosers (55,3; 20,0% and 26,7%). This points out not only to expansion of therapeutic possibilities to the studied conditions in local public health services, but also to the sucess of laser therapy in such conditions.
References
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19. FEEDAR, J.A., KLOTH, L.C., GENTZKOW, G.D. Chronic dermal ulcer healing enhaced with monophasic pulssed eletrical stimulation. Physical Therapy, v.71, n.9, p.639-648, 1991.
20. FERNANDEZ, S. Physiotherapy: prevention and treatment of pressure sores. Physioterapy, v.73, n.9, p.450-454, 1987.
21. FUIRINI, N.J. Utilização do laser HeNe em cicatrização de úlceras rebeldes. Fisioterapia em Movimento, v.6, n.1, p.9-15, 1993.
22. GARBINO, J.A. Gênese das incapacidades em hanseníase. Bauru, Instituto "Lauro de Souza Lima", Centro de Estudos "Dr. Reynaldo Quagliato", 1991.
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25. GONÇALVES, A. Os testes de hipóteses como instrumental de validação e interpretação (Estatísticas Inferencial). In: MARCONDES, M.A., LAKATOS, E.M. Técnicas em pesquisas. São Paulo: Atlas, 1982.
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28. HENDRIX, R.W. CALENOFF, L. LEDERMAN, R.B. NEIMAN, H.L. Radiology of pressure sores. Radiology, v.138,
p.351-356, 1981.
29. HUNT, T.K. Basic principles of wound healing. J. Trauma, v.30, n.12, p.123-128, 1990. (Suplemento).
30. IUPATOV, S.I., SMOTRIN, S.M., GAVCRILIK, B.L., STENKO, V.G. Treatment of trophic ulcers of the lower extremities ind elderly patients. Khirurgiia (Mosk), n.5, p.105-108, 1990.
31. KITCHEN, S.S., PARTRIDGE, C.J. A review of low laser therapy. Physioterapy, v.77, n.3, p.161-168, 1991.
32. KOVACS, L., VARGA, L., PALYI,I. et al. Experimental investigation of photostimulation effect of low energy HeNe laser radiation. Laser Basic Biomedical Research, v.22, p.14-16, 1982.
33. KUMAR, K., KANT, M., BELSARE, R.K. Neuropathic plantar ulceration. Indian J. Leprosy, v.57, n.1, p.172-177, janmar, 1985.
34. MAMEDE, M.C., CARVALHO, E.C., CUNHA, A.M.P. Técnicas em enfermagem. São Paulo: Sarvier, 1984. p.44-45
35. McDIARMID,T., BURNS, P.N., LENITH, G.T., MACHIN, D. Ul trasound and the treatment oí pressure sores. Physiotherapy, v.71, n.2, p.66-70, 1985.
36. MESTER, E., LUDANY, G., SELLYEI, M., SZENDE, B., TOTA, J. The stimulating effects of low power laser rays on biological systems. Laser Rev. (Lond), v.1, p.3, 1968.
37. MESTER, E., SPIRY, T., SZENDE, B. et al. Effect of laser rays on wound healing. Amer. J. Surg., v.122, p.532-535, 1971.
38. OPROMOLLA, D.V.A. Capacitação pessoal (Editorial). Hansen. Int., v.16, n.1/2, p.1-3, 1991.
39. OPROMOLLA, D.V.A. Organizações não governamentais e o MORHAN (Editorial). Hansen. Int., v.20, n.2, p.1-2, 1995.
40. PADOVANI, C.R. Estatística na metodologia da investigação científica. Botucatu: Instituto de Biociências, 1995.
41. PEDROSO, M., OLIVEIRA, S., BACCARELLI, R., VIEIRA, P., GONÇALVES, A. Incapacidades físicas na hanseníase: estudo multicêntrico da realidade brasileira. An. bras. Derm., v.64, n.6, p.301-306, 1989.
43. PFALTZGRAFF, R.E.- Management of ulceration in anesthesic extremities. Star, may-June, 1985.
44. PROFFITT, N. Working with leprosy patients in North-East Thailand. Physiotherapy, v.75, n.11, p.681-682, 1989.
45. ROCHE, C., WEST, J. A controlled trial investigating the effect of ultrasound on venous ulcers referred from general practitioners. Physiotherapy, v.70, n.12, p.475-477, 1984.
47. ROIG, J.L.G., TRASOBARES, E.M.L., SANCHEZ, H.M., ALVAREZ, A.V.J. Tratamiento de las úlceras por presión em el lesionado medular com laser de baja potencia y cirurgia. Presentacion de um caso. Revista Cuba - Ortopedia traumatologia, v.4, n.2, p.41-45, 1990.
49. SHEA, D.J. Pressure ulcers classification and management. Clinical Orthopedics, v.112, p.89-100, 1975.
50. THE CHARTERED SOCIETY OF PHYSIOTHERAPY. Safety of electroterapy equipament working group. Guide lines of the safe use oí lasers in physiotherapy. Physiotherapy, v.77, n.3, p.169-170, 1991.
48. THOMAZ, J.G., HERDY, C.D.C., OLIVEIRA, J.C.P., SOUZA, S.R., ROBARDEY, R.A. Fundamentos da cicatrização das feridas Arq. bras. Med., v.7, n.2, p.65-72, 1996.
49. VIRMOND, M., DUERKSEN F., GONÇALVES, A. Report and evalluation of Brazilian experience in the rehabilitation of patientes with leprosy. Leprosy Rev., v.60, p.214-220, 1989.
50. VUKSIC, M., MONASCEVIC, M. The use of the helium-neon laser for treating bad sores in elderly patients with psychiatric disorders. Medical laser reporp, v.3, p.29-35, 1985.
51. WORLD HEALTH ORGANIZATION. Leprosy. Geneve: WHO, 1994 a.
52. WORLD HEALTH ORGANIZATION. Report of the International Conference on the Elimination of Leprosy. Geneve: WHOICTD/LEP/94.5, 1994 b.
53. YARKONY, G.M. Pressure ulcers:a review. Arch. phys. med. Rehabil., v.75, p.908-917, 1994.
2. BASFORD, J.R. Laser therapy: scientific basic and clinical role. Orthopedics, v.16, p.541-547,1993.
3. BAXTER, G.D. Therapeutic Lasers: theory and practice. UK: Churchill Livingstone, 1994.
4. BAXTER, G D., BELL, A.J., ALLEN, J.M., RAVEY, J. Low level laser therapy: current clinical practice in Northen bland. Physiotherapy, v.77, n.3, p. 171-178, 1991.
5. BECHELLI , L.M. Assessment of the importance of reconstructive surgery in the control oí leprosy from the public health point oí view. Acta Ieprol, v.45, p. 5-29, 1971.
6. BECHELLI, L.M., CURBAN, G.V. Compêndio de dermatologia. 6.ed. São Paulo: Atheneu, 1988.
7. BIRKE, J.A., KOZIATEK, E., GRAHAM, S.L., NOVICK, A. Physical therapy at the Gillis W. Long Hansen's Disease Center. Star, v.48, n.5, p.7-10, 1989.
8. BIRKE, J.A., NOVICK, A., GRAHAM, S.L., COLEMAN, W.C., BRASSEAUX, D.M. Methods of treating plantar ulcers. Physical therapy, v.71, n.2, p.41-46, 1991.
9. BRAND, P. Deformities of the hands and feet in Hansen's Disease. Star, sept-oct, 1983.
10. BRAND, P. Leprosy today. insensitive feet: a pratical handbook on foot problems in leprosy. London: The Leprosy Mission, 1966. p.88
11. BRAND, P. Neuropathic ulceration. Star, may-june, 1983.
12.BRASIL. Ministério da Saúde. Fundação Nacional de Saúde. Centro Nacional de Epidemiologia. Resolução n° 196/96 sobre pesquisa envolvendo seres humanos. Informe Epidemiológico do SUS, v.5, n.2, p13-41, 1996.
13. BRYCENTON, A., PFALTZGRAFF R.E. Leprosy. UK: Churchill Livingstone, 1990.
14. CENTRO NACIONAL DE EPIDEMIOLOGIA. Prevalência, detecção e tendência da hanseníase, segundo macrorregião e unidade federada, Brasil, 1992. Informe Epidemiológico SUS, v.2, n.3, p 83, 1993.
15. CONFERÊNCIA NACIONAL DE SAÚDE, 10. Boletim da Associação Brasileira de Pós-Graduação em Saúde Coletiva, v.14. n.62, p. 1-12, 1996.
16. CONFERÊNCIA NACIONAL DE SAÚDE, 8. Relatório final. Brasília: Ministério da Saúde, 1986.
17. DOYLE, J. Hansen's Disease in South India: A student elective. Physiotherapy, v.76, n.7, p.419-422, 1990.
18. ENGLAND, S. Introduction to mid laser therapy. Physiotherapy, v.74, n.3, p.100-102, 1988.
19. FEEDAR, J.A., KLOTH, L.C., GENTZKOW, G.D. Chronic dermal ulcer healing enhaced with monophasic pulssed eletrical stimulation. Physical Therapy, v.71, n.9, p.639-648, 1991.
20. FERNANDEZ, S. Physiotherapy: prevention and treatment of pressure sores. Physioterapy, v.73, n.9, p.450-454, 1987.
21. FUIRINI, N.J. Utilização do laser HeNe em cicatrização de úlceras rebeldes. Fisioterapia em Movimento, v.6, n.1, p.9-15, 1993.
22. GARBINO, J.A. Gênese das incapacidades em hanseníase. Bauru, Instituto "Lauro de Souza Lima", Centro de Estudos "Dr. Reynaldo Quagliato", 1991.
23. GEORGADZE, A.K. KARPOV, V.I. KUZNETSOV, E.V. SODATOV, A.V. RUKOSUEV, V.P. Treatment oí nonhealing wounds and trophic ulcers by low-intensity laser irradiation in an outpatient clinic. Khirurgiia (Mask), n.12, p.93-96, 1990.
24. GOGIA, P.P. Low-energy laser in wound management. Clinical wound management. USA, v.102, n.3, p.246256, 1995.
25. GONÇALVES, A. Os testes de hipóteses como instrumental de validação e interpretação (Estatísticas Inferencial). In: MARCONDES, M.A., LAKATOS, E.M. Técnicas em pesquisas. São Paulo: Atlas, 1982.
26. GONÇALVES, A. Epidemiologia e controle da hanseníase no Brasil. Bol. Ofic. Sanita Panamer., v.102, n.3, p.246-256, 1987.
27. GONÇALVES, G., PARIZOTTO, N.A., GONÇALVES, A. A hanseníase no contexto da transição epidemiológica: perspectivas da aplicação de laserterapia de baixa intensidade em úlceras específicas. In: CONGRESSO DO COLÉGIO DE HANSENOLOGIA DOS PAÍSES ENDÊ-MICOS, 6. Foz do Iguaçu, 1997.
28. HENDRIX, R.W. CALENOFF, L. LEDERMAN, R.B. NEIMAN, H.L. Radiology of pressure sores. Radiology, v.138,
p.351-356, 1981.
29. HUNT, T.K. Basic principles of wound healing. J. Trauma, v.30, n.12, p.123-128, 1990. (Suplemento).
30. IUPATOV, S.I., SMOTRIN, S.M., GAVCRILIK, B.L., STENKO, V.G. Treatment of trophic ulcers of the lower extremities ind elderly patients. Khirurgiia (Mosk), n.5, p.105-108, 1990.
31. KITCHEN, S.S., PARTRIDGE, C.J. A review of low laser therapy. Physioterapy, v.77, n.3, p.161-168, 1991.
32. KOVACS, L., VARGA, L., PALYI,I. et al. Experimental investigation of photostimulation effect of low energy HeNe laser radiation. Laser Basic Biomedical Research, v.22, p.14-16, 1982.
33. KUMAR, K., KANT, M., BELSARE, R.K. Neuropathic plantar ulceration. Indian J. Leprosy, v.57, n.1, p.172-177, janmar, 1985.
34. MAMEDE, M.C., CARVALHO, E.C., CUNHA, A.M.P. Técnicas em enfermagem. São Paulo: Sarvier, 1984. p.44-45
35. McDIARMID,T., BURNS, P.N., LENITH, G.T., MACHIN, D. Ul trasound and the treatment oí pressure sores. Physiotherapy, v.71, n.2, p.66-70, 1985.
36. MESTER, E., LUDANY, G., SELLYEI, M., SZENDE, B., TOTA, J. The stimulating effects of low power laser rays on biological systems. Laser Rev. (Lond), v.1, p.3, 1968.
37. MESTER, E., SPIRY, T., SZENDE, B. et al. Effect of laser rays on wound healing. Amer. J. Surg., v.122, p.532-535, 1971.
38. OPROMOLLA, D.V.A. Capacitação pessoal (Editorial). Hansen. Int., v.16, n.1/2, p.1-3, 1991.
39. OPROMOLLA, D.V.A. Organizações não governamentais e o MORHAN (Editorial). Hansen. Int., v.20, n.2, p.1-2, 1995.
40. PADOVANI, C.R. Estatística na metodologia da investigação científica. Botucatu: Instituto de Biociências, 1995.
41. PEDROSO, M., OLIVEIRA, S., BACCARELLI, R., VIEIRA, P., GONÇALVES, A. Incapacidades físicas na hanseníase: estudo multicêntrico da realidade brasileira. An. bras. Derm., v.64, n.6, p.301-306, 1989.
43. PFALTZGRAFF, R.E.- Management of ulceration in anesthesic extremities. Star, may-June, 1985.
44. PROFFITT, N. Working with leprosy patients in North-East Thailand. Physiotherapy, v.75, n.11, p.681-682, 1989.
45. ROCHE, C., WEST, J. A controlled trial investigating the effect of ultrasound on venous ulcers referred from general practitioners. Physiotherapy, v.70, n.12, p.475-477, 1984.
47. ROIG, J.L.G., TRASOBARES, E.M.L., SANCHEZ, H.M., ALVAREZ, A.V.J. Tratamiento de las úlceras por presión em el lesionado medular com laser de baja potencia y cirurgia. Presentacion de um caso. Revista Cuba - Ortopedia traumatologia, v.4, n.2, p.41-45, 1990.
49. SHEA, D.J. Pressure ulcers classification and management. Clinical Orthopedics, v.112, p.89-100, 1975.
50. THE CHARTERED SOCIETY OF PHYSIOTHERAPY. Safety of electroterapy equipament working group. Guide lines of the safe use oí lasers in physiotherapy. Physiotherapy, v.77, n.3, p.169-170, 1991.
48. THOMAZ, J.G., HERDY, C.D.C., OLIVEIRA, J.C.P., SOUZA, S.R., ROBARDEY, R.A. Fundamentos da cicatrização das feridas Arq. bras. Med., v.7, n.2, p.65-72, 1996.
49. VIRMOND, M., DUERKSEN F., GONÇALVES, A. Report and evalluation of Brazilian experience in the rehabilitation of patientes with leprosy. Leprosy Rev., v.60, p.214-220, 1989.
50. VUKSIC, M., MONASCEVIC, M. The use of the helium-neon laser for treating bad sores in elderly patients with psychiatric disorders. Medical laser reporp, v.3, p.29-35, 1985.
51. WORLD HEALTH ORGANIZATION. Leprosy. Geneve: WHO, 1994 a.
52. WORLD HEALTH ORGANIZATION. Report of the International Conference on the Elimination of Leprosy. Geneve: WHOICTD/LEP/94.5, 1994 b.
53. YARKONY, G.M. Pressure ulcers:a review. Arch. phys. med. Rehabil., v.75, p.908-917, 1994.
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