Manejo da osteomielite em ferida de adultos: Aspectos terapêuticos
DOI:
https://doi.org/10.33448/rsd-v13i4.45504Palavras-chave:
Tratamento; Osteomielite; Ferimentos e lesões; Adulto; Enfermagem; Equipe de assistência ao paciente.Resumo
Objetivos: identificar na literatura científica métodos terapêuticos utilizados para osteomielite em feridas crônicas de adultos e elaborar um guia clínico para um Hospital Universitário federal do Rio de Janeiro. Metodologia: revisão integrativa da literatura, cujos critérios de inclusão foram artigos completos sobre aspectos terapêuticos da osteomielite em feridas de adultos desde 2018, em português, espanhol ou inglês. A busca eletrônica sistemática ocorreu mediante descritores em ciências da saúde (DeCS) e Medical Subject Heading (MeSH). Resultados: 508 artigos identificados (500 eletrônicos e 08 físicos), após leitura de resumo por dois pesquisadores e excluídas duplicatas, restaram 76 artigos selecionados e incluídos para análise. A maioria dos estudos eram americanos (42,10%) e publicados por médicos (92,1%). 98% apontou a cultura microbiológica e exames de sangue enquanto guias para parâmetros terapêuticos, além de exames de imagens enquanto complementares (20%). O debridamento cirúrgico foi o procedimento mais utilizado (82,3%) para remoção da infecção óssea. Não houve consenso terapêutico, mas recomendações de boas práticas, que constam no guia clínico de tratamento de ferida com osteomielite elaborado com base nesta revisão. Conclusão: a falta de consenso e a escassez literária, especialmente nacional podem estar comprometendo a segurança e qualidade assistencial, diante disso, enfermeiros, especialmente especialistas em enfermagem dermatológica/estomaterapia, devem exercer liderança na avaliação clínica precoce com vistas aos encaminhamentos para confirmação diagnóstica médica. E com isso, acelerar o início do tratamento mais adequado guiado por exames, o que poderá prevenir complicações e a cronicidade de um problema de saúde pública.
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