Efeito da terapia fotônica no tratamento de lesões traumáticas de tecidos moles: ensaio clínico controlado randomizado duplo-cego

Detalhes bibliográficos
Autor(a) principal: Jaña Neto, Frederico Carlos
Data de Publicação: 2022
Tipo de documento: Tese
Idioma: por
Título da fonte: Biblioteca Digital de Teses e Dissertações da Uninove
Texto Completo: http://bibliotecatede.uninove.br/handle/tede/3006
Resumo: Soft tissue injuries are directly related to the energy of trauma and their repair is the main factor for bone healing and recovery of the affected limb function. Photonic therapies (TF) are indicated as adjuvant treatments in decontamination and acceleration of wound heal-ing, however, there is still a lack of evidence regarding their effect on soft tissue injuries of traumatic origin. The main objective of this study was to evaluate the efficacy and safety of ST using LEDs in the healing process of soft tissue injuries associated with tibial fractures. We included 27 adult individuals, aged between 18 and 72 years, hospitalized with a tibial frac-ture who were awaiting resolution of the soft tissue injuries to undergo definitive surgery. Participants were randomized into two groups: TF (device with 144 LED emitting diodes at wavelengths of 420, 660 and 850nm, 3J per point for 10 minutes) and simulated TF (sham) (device with identical external characteristics but no of light). The primary outcome measure was the assessment of the wound healing process as measured by the variation of the BATES-JENSEN (BJ) scale. Secondary outcomes were: time to release for definitive surgery, pain intensity, consumption of analgesic drugs, area of injury and presence of adverse events. An economic analysis of the treatments was also performed. Assessments were performed before the start of the intervention and daily until the participant was considered to have resolved the wound. Data were statistically analyzed considering a significance level of 5%. The daily mean in the BJ classification showed a significant difference in the direct comparison between the groups (Control 34.26 ±0.90 versus TF 32.10 ±1.23 (p=0.03)). There was a significant dif-ference in the change in the pain score from the 5th to the last day (2.1 ±1.2 versus 0.8 ±1.7 (p = 0.02)) and in the mean rate of daily change in the pain scale to favor of the TF group (0.58 ±0.38 versus 0.28 ±0.37). The average time for wound resolution of the participants was 13.1 days (±11.5) in the intervention group (TF) and 23.1 days (±21.3) in the control group, but this difference cannot be considered statistically. significant between groups (p = 0.76). There was a statistically significant difference (p=0.02) in the occurrence of infection in the path of the external fixator pins, four times more frequent in the Control group (n=8/14) than in the TF group (n=2/13). By subdividing the population into subgroups considering the severity of the injury, among the patients with less severity, it was possible to observe statistically signifi-cant differences between the groups in the daily mean of the BJ scale (Control 34.78 versus TF 27.46 (p=0.0081)). The time in which less severe patients undergoing TF reached the pa-rameters of release for surgery was significantly shorter than the control group, with a differ-ence of approximately 7 days (mean intervention 7.0 versus control 14.6 days; p = 0, 03). In patients who had more severe injuries, there was no difference between the groups in the time of evolution (mean TF 26.25 versus control 44.25 days p=0.28). In the economic analysis of the data from all patients, in the daily average item on the BJ scale, the TF treatment was dominant because it presented greater effectiveness and lower cost, therefore, it can be con-sidered an alternative for insertion in health services. As implications for practice, the use of TF is safe and seems to have better efficacy in less severe and more superficial injuries, reduc-ing wound resolution time, and consequently, the time for definitive surgery, the hospitaliza-tion period and the treatment costs.
id NOVE_fd2510c305c1d88afd1e29589d0c12bd
oai_identifier_str oai:localhost:tede/3006
network_acronym_str NOVE
network_name_str Biblioteca Digital de Teses e Dissertações da Uninove
repository_id_str
spelling Fernandes, Kristianne Porta Santoshttp://lattes.cnpq.br/6532810307204867Fernandes, Kristianne Santos Portahttp://lattes.cnpq.br/6532810307204867Cecatto, Rebeca Bolteshttp://lattes.cnpq.br/0228531403374909Ambra, Luiz Felipe Morlinhttp://lattes.cnpq.br/6443152827335599Ferrari, Raquel Agnelli Mesquitahttp://lattes.cnpq.br/7048141683554943Martimbianco, Ana Luiza Cabrerahttp://lattes.cnpq.br/5154258820540281http://lattes.cnpq.br/0777570041524216Jaña Neto, Frederico Carlos2022-07-26T21:52:45Z2022-05-02Jaña Neto, Frederico Carlos. Efeito da terapia fotônica no tratamento de lesões traumáticas de tecidos moles: ensaio clínico controlado randomizado duplo-cego. 2022. 125 f. Tese( Programa de Pós-Graduação em Biofotônica Aplicada às Ciências da Saúde) - Universidade Nove de Julho, São Paulo.http://bibliotecatede.uninove.br/handle/tede/3006Soft tissue injuries are directly related to the energy of trauma and their repair is the main factor for bone healing and recovery of the affected limb function. Photonic therapies (TF) are indicated as adjuvant treatments in decontamination and acceleration of wound heal-ing, however, there is still a lack of evidence regarding their effect on soft tissue injuries of traumatic origin. The main objective of this study was to evaluate the efficacy and safety of ST using LEDs in the healing process of soft tissue injuries associated with tibial fractures. We included 27 adult individuals, aged between 18 and 72 years, hospitalized with a tibial frac-ture who were awaiting resolution of the soft tissue injuries to undergo definitive surgery. Participants were randomized into two groups: TF (device with 144 LED emitting diodes at wavelengths of 420, 660 and 850nm, 3J per point for 10 minutes) and simulated TF (sham) (device with identical external characteristics but no of light). The primary outcome measure was the assessment of the wound healing process as measured by the variation of the BATES-JENSEN (BJ) scale. Secondary outcomes were: time to release for definitive surgery, pain intensity, consumption of analgesic drugs, area of injury and presence of adverse events. An economic analysis of the treatments was also performed. Assessments were performed before the start of the intervention and daily until the participant was considered to have resolved the wound. Data were statistically analyzed considering a significance level of 5%. The daily mean in the BJ classification showed a significant difference in the direct comparison between the groups (Control 34.26 ±0.90 versus TF 32.10 ±1.23 (p=0.03)). There was a significant dif-ference in the change in the pain score from the 5th to the last day (2.1 ±1.2 versus 0.8 ±1.7 (p = 0.02)) and in the mean rate of daily change in the pain scale to favor of the TF group (0.58 ±0.38 versus 0.28 ±0.37). The average time for wound resolution of the participants was 13.1 days (±11.5) in the intervention group (TF) and 23.1 days (±21.3) in the control group, but this difference cannot be considered statistically. significant between groups (p = 0.76). There was a statistically significant difference (p=0.02) in the occurrence of infection in the path of the external fixator pins, four times more frequent in the Control group (n=8/14) than in the TF group (n=2/13). By subdividing the population into subgroups considering the severity of the injury, among the patients with less severity, it was possible to observe statistically signifi-cant differences between the groups in the daily mean of the BJ scale (Control 34.78 versus TF 27.46 (p=0.0081)). The time in which less severe patients undergoing TF reached the pa-rameters of release for surgery was significantly shorter than the control group, with a differ-ence of approximately 7 days (mean intervention 7.0 versus control 14.6 days; p = 0, 03). In patients who had more severe injuries, there was no difference between the groups in the time of evolution (mean TF 26.25 versus control 44.25 days p=0.28). In the economic analysis of the data from all patients, in the daily average item on the BJ scale, the TF treatment was dominant because it presented greater effectiveness and lower cost, therefore, it can be con-sidered an alternative for insertion in health services. As implications for practice, the use of TF is safe and seems to have better efficacy in less severe and more superficial injuries, reduc-ing wound resolution time, and consequently, the time for definitive surgery, the hospitaliza-tion period and the treatment costs.Lesões de tecidos moles estão diretamente relacionadas à energia do trauma e seu repa-ro é o principal fator para a cicatrização óssea e recuperação da função do membro afetado. As terapias fotônicas (TF) são indicadas como tratamentos adjuvantes na descontaminação e ace-leração da cicatrização de feridas; porém, ainda existe escassez de evidências a respeito de seu efeito em lesões de partes moles de origem traumática. O objetivo principal deste estudo foi avaliar a eficácia e segurança das TF com uso de LEDs no processo de cicatrização de lesões de partes moles associadas a fratura de tíbia. Foram incluídos 27 indivíduos adultos, com ida-de entre 18 e 72 anos, internados com fratura de tíbia que aguardavam resolução das lesões de partes moles para serem submetidos à cirurgia definitiva. Os participantes foram randomizados em dois grupos: TF (dispositivo de 144 diodos emissores de LED nos comprimentos de onda de 420nm, 660nm e 850nm, 3J por ponto, por 10 minutos) e TF simulada (sham) (aparelho com características externas idênticas, mas sem passagem de luz). O desfecho primário foi a avaliação do processo de cicatrização das feridas medido pela variação da escala BATES-JENSEN (BJ). Os desfechos secundários foram: tempo para liberação para a cirurgia definiti-va, intensidade da dor, consumo de medicamentos analgésicos, área da lesão e presença de eventos adversos. Também foi realizada análise econômica dos tratamentos. As avaliações foram realizadas antes do início da intervenção e diariamente até que o participante fosse con-siderado com a ferida resolvida. Os dados foram analisados estatisticamente considerando significância de 5%. A média diária na classificação de BJ mostrou diferença significativa na comparação direta entre os grupos (controle 34,26 ±0,90 vesus TF 32,10 ±1,23 (p=0,03)). Houve diferença significativa na mudança do escore de dor do quinto ao último dia (2,1 ±1,2 versus 0,8 ±1,7 (p = 0,02)) e na taxa média de alteração diária da escala de dor a favor do gru-po TF (0,58 ±0,38 versus 0,28 ±0,37). O tempo médio de resolução das feridas dos participan-tes foi de 13,1 dias (±11,5) no grupo intervenção (TF) e 23,1 dias (±21,3) no grupo controle, porém, essa diferença não pode ser considerada estatisticamente significativa entre os grupos (p = 0,76). Houve diferença estatisticamente significativa (p=0,02) na ocorrência de infecção no trajeto dos pinos do fixador externo quatro vezes mais frequentes no grupo controle (n=8/14) que no grupo TF (n = 2/13). Ao subdividir a população em subgrupos considerando a gravidade da lesão, dentre os pacientes com menor gravidade, foi possível observar diferenças estatisticamente significativas entre os grupos na média diária da escala BJ (Controle 34,78 verus TF 27,46 (p=0,0081)). O tempo em que os pacientes de menor gravidade submetidos à TF atingiram os parâmetros de liberação para cirurgia foi significativamente menor que o grupo controle, com diferença de aproximadamente 7 dias (média intervenção 7,0 versus controle 14,6 dias; p = 0,03). Já nos pacientes que apresentavam lesões de maior gravidade, não houve diferença entre os grupos no tempo de evolução (média TF 26,25 versus controle 44,25 dias p=0,28). Na análise econômica dos dados da totalidade dos pacientes, no quesito média diária na escala BJ, o tratamento TF foi dominante, por apresentar maior efetividade e menor custo; portanto, pode ser considerada uma alternativa para inserção nos serviços de saúde. Como implicações para a prática, o uso da TF é seguro e parece ter melhor eficácia em lesões de me-nor gravidade e mais superficiais, reduzindo o tempo de resolução da ferida e, consequente-mente, o tempo para a cirurgia definitiva, o período de internação e os custos do tratamento.Submitted by Nadir Basilio (nadirsb@uninove.br) on 2022-07-26T21:52:45Z No. of bitstreams: 1 Frederico Carlos Jaña Neto.pdf: 2709700 bytes, checksum: 65bbc6eaff697ee16e51ececd6f50f82 (MD5)Made available in DSpace on 2022-07-26T21:52:45Z (GMT). No. of bitstreams: 1 Frederico Carlos Jaña Neto.pdf: 2709700 bytes, checksum: 65bbc6eaff697ee16e51ececd6f50f82 (MD5) Previous issue date: 2022-05-02application/pdfporUniversidade Nove de JulhoPrograma de Pós-Graduação em Biofotônica Aplicada às Ciências da SaúdeUNINOVEBrasilSaúdeterapia fotônicafototerapiafotobiomodulaçãoterapia fotodinâmicalesão traumática de tecido moleferidacicatrizaçãophotobiomodulationphototherapyphotodynamic therapysoft tissue injurieshealingCIENCIAS DA SAUDEEfeito da terapia fotônica no tratamento de lesões traumáticas de tecidos moles: ensaio clínico controlado randomizado duplo-cegoEffect of photonic therapy in the treatment of traumatic soft tissue injuries: randomized double-blind controlled clinical trialinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesis8765449414823306929600info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da Uninoveinstname:Universidade Nove de Julho (UNINOVE)instacron:UNINOVEORIGINALFrederico Carlos Jaña Neto.pdfFrederico Carlos Jaña Neto.pdfapplication/pdf2709700http://localhost:8080/tede/bitstream/tede/3006/2/Frederico+Carlos+Ja%C3%B1a+Neto.pdf65bbc6eaff697ee16e51ececd6f50f82MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82165http://localhost:8080/tede/bitstream/tede/3006/1/license.txtbd3efa91386c1718a7f26a329fdcb468MD51tede/30062022-07-26 18:52:45.549oai:localhost: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Biblioteca Digital de Teses e Dissertaçõeshttp://bibliotecatede.uninove.br/PRIhttp://bibliotecatede.uninove.br/oai/requestbibliotecatede@uninove.br||bibliotecatede@uninove.bropendoar:2022-07-26T21:52:45Biblioteca Digital de Teses e Dissertações da Uninove - Universidade Nove de Julho (UNINOVE)false
dc.title.por.fl_str_mv Efeito da terapia fotônica no tratamento de lesões traumáticas de tecidos moles: ensaio clínico controlado randomizado duplo-cego
dc.title.alternative.eng.fl_str_mv Effect of photonic therapy in the treatment of traumatic soft tissue injuries: randomized double-blind controlled clinical trial
title Efeito da terapia fotônica no tratamento de lesões traumáticas de tecidos moles: ensaio clínico controlado randomizado duplo-cego
spellingShingle Efeito da terapia fotônica no tratamento de lesões traumáticas de tecidos moles: ensaio clínico controlado randomizado duplo-cego
Jaña Neto, Frederico Carlos
terapia fotônica
fototerapia
fotobiomodulação
terapia fotodinâmica
lesão traumática de tecido mole
ferida
cicatrização
photobiomodulation
phototherapy
photodynamic therapy
soft tissue injuries
healing
CIENCIAS DA SAUDE
title_short Efeito da terapia fotônica no tratamento de lesões traumáticas de tecidos moles: ensaio clínico controlado randomizado duplo-cego
title_full Efeito da terapia fotônica no tratamento de lesões traumáticas de tecidos moles: ensaio clínico controlado randomizado duplo-cego
title_fullStr Efeito da terapia fotônica no tratamento de lesões traumáticas de tecidos moles: ensaio clínico controlado randomizado duplo-cego
title_full_unstemmed Efeito da terapia fotônica no tratamento de lesões traumáticas de tecidos moles: ensaio clínico controlado randomizado duplo-cego
title_sort Efeito da terapia fotônica no tratamento de lesões traumáticas de tecidos moles: ensaio clínico controlado randomizado duplo-cego
author Jaña Neto, Frederico Carlos
author_facet Jaña Neto, Frederico Carlos
author_role author
dc.contributor.advisor1.fl_str_mv Fernandes, Kristianne Porta Santos
dc.contributor.advisor1Lattes.fl_str_mv http://lattes.cnpq.br/6532810307204867
dc.contributor.referee1.fl_str_mv Fernandes, Kristianne Santos Porta
dc.contributor.referee1Lattes.fl_str_mv http://lattes.cnpq.br/6532810307204867
dc.contributor.referee2.fl_str_mv Cecatto, Rebeca Boltes
dc.contributor.referee2Lattes.fl_str_mv http://lattes.cnpq.br/0228531403374909
dc.contributor.referee3.fl_str_mv Ambra, Luiz Felipe Morlin
dc.contributor.referee3Lattes.fl_str_mv http://lattes.cnpq.br/6443152827335599
dc.contributor.referee4.fl_str_mv Ferrari, Raquel Agnelli Mesquita
dc.contributor.referee4Lattes.fl_str_mv http://lattes.cnpq.br/7048141683554943
dc.contributor.referee5.fl_str_mv Martimbianco, Ana Luiza Cabrera
dc.contributor.referee5Lattes.fl_str_mv http://lattes.cnpq.br/5154258820540281
dc.contributor.authorLattes.fl_str_mv http://lattes.cnpq.br/0777570041524216
dc.contributor.author.fl_str_mv Jaña Neto, Frederico Carlos
contributor_str_mv Fernandes, Kristianne Porta Santos
Fernandes, Kristianne Santos Porta
Cecatto, Rebeca Boltes
Ambra, Luiz Felipe Morlin
Ferrari, Raquel Agnelli Mesquita
Martimbianco, Ana Luiza Cabrera
dc.subject.por.fl_str_mv terapia fotônica
fototerapia
fotobiomodulação
terapia fotodinâmica
lesão traumática de tecido mole
ferida
cicatrização
topic terapia fotônica
fototerapia
fotobiomodulação
terapia fotodinâmica
lesão traumática de tecido mole
ferida
cicatrização
photobiomodulation
phototherapy
photodynamic therapy
soft tissue injuries
healing
CIENCIAS DA SAUDE
dc.subject.eng.fl_str_mv photobiomodulation
phototherapy
photodynamic therapy
soft tissue injuries
healing
dc.subject.cnpq.fl_str_mv CIENCIAS DA SAUDE
description Soft tissue injuries are directly related to the energy of trauma and their repair is the main factor for bone healing and recovery of the affected limb function. Photonic therapies (TF) are indicated as adjuvant treatments in decontamination and acceleration of wound heal-ing, however, there is still a lack of evidence regarding their effect on soft tissue injuries of traumatic origin. The main objective of this study was to evaluate the efficacy and safety of ST using LEDs in the healing process of soft tissue injuries associated with tibial fractures. We included 27 adult individuals, aged between 18 and 72 years, hospitalized with a tibial frac-ture who were awaiting resolution of the soft tissue injuries to undergo definitive surgery. Participants were randomized into two groups: TF (device with 144 LED emitting diodes at wavelengths of 420, 660 and 850nm, 3J per point for 10 minutes) and simulated TF (sham) (device with identical external characteristics but no of light). The primary outcome measure was the assessment of the wound healing process as measured by the variation of the BATES-JENSEN (BJ) scale. Secondary outcomes were: time to release for definitive surgery, pain intensity, consumption of analgesic drugs, area of injury and presence of adverse events. An economic analysis of the treatments was also performed. Assessments were performed before the start of the intervention and daily until the participant was considered to have resolved the wound. Data were statistically analyzed considering a significance level of 5%. The daily mean in the BJ classification showed a significant difference in the direct comparison between the groups (Control 34.26 ±0.90 versus TF 32.10 ±1.23 (p=0.03)). There was a significant dif-ference in the change in the pain score from the 5th to the last day (2.1 ±1.2 versus 0.8 ±1.7 (p = 0.02)) and in the mean rate of daily change in the pain scale to favor of the TF group (0.58 ±0.38 versus 0.28 ±0.37). The average time for wound resolution of the participants was 13.1 days (±11.5) in the intervention group (TF) and 23.1 days (±21.3) in the control group, but this difference cannot be considered statistically. significant between groups (p = 0.76). There was a statistically significant difference (p=0.02) in the occurrence of infection in the path of the external fixator pins, four times more frequent in the Control group (n=8/14) than in the TF group (n=2/13). By subdividing the population into subgroups considering the severity of the injury, among the patients with less severity, it was possible to observe statistically signifi-cant differences between the groups in the daily mean of the BJ scale (Control 34.78 versus TF 27.46 (p=0.0081)). The time in which less severe patients undergoing TF reached the pa-rameters of release for surgery was significantly shorter than the control group, with a differ-ence of approximately 7 days (mean intervention 7.0 versus control 14.6 days; p = 0, 03). In patients who had more severe injuries, there was no difference between the groups in the time of evolution (mean TF 26.25 versus control 44.25 days p=0.28). In the economic analysis of the data from all patients, in the daily average item on the BJ scale, the TF treatment was dominant because it presented greater effectiveness and lower cost, therefore, it can be con-sidered an alternative for insertion in health services. As implications for practice, the use of TF is safe and seems to have better efficacy in less severe and more superficial injuries, reduc-ing wound resolution time, and consequently, the time for definitive surgery, the hospitaliza-tion period and the treatment costs.
publishDate 2022
dc.date.accessioned.fl_str_mv 2022-07-26T21:52:45Z
dc.date.issued.fl_str_mv 2022-05-02
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/doctoralThesis
format doctoralThesis
status_str publishedVersion
dc.identifier.citation.fl_str_mv Jaña Neto, Frederico Carlos. Efeito da terapia fotônica no tratamento de lesões traumáticas de tecidos moles: ensaio clínico controlado randomizado duplo-cego. 2022. 125 f. Tese( Programa de Pós-Graduação em Biofotônica Aplicada às Ciências da Saúde) - Universidade Nove de Julho, São Paulo.
dc.identifier.uri.fl_str_mv http://bibliotecatede.uninove.br/handle/tede/3006
identifier_str_mv Jaña Neto, Frederico Carlos. Efeito da terapia fotônica no tratamento de lesões traumáticas de tecidos moles: ensaio clínico controlado randomizado duplo-cego. 2022. 125 f. Tese( Programa de Pós-Graduação em Biofotônica Aplicada às Ciências da Saúde) - Universidade Nove de Julho, São Paulo.
url http://bibliotecatede.uninove.br/handle/tede/3006
dc.language.iso.fl_str_mv por
language por
dc.relation.cnpq.fl_str_mv 8765449414823306929
dc.relation.confidence.fl_str_mv 600
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidade Nove de Julho
dc.publisher.program.fl_str_mv Programa de Pós-Graduação em Biofotônica Aplicada às Ciências da Saúde
dc.publisher.initials.fl_str_mv UNINOVE
dc.publisher.country.fl_str_mv Brasil
dc.publisher.department.fl_str_mv Saúde
publisher.none.fl_str_mv Universidade Nove de Julho
dc.source.none.fl_str_mv reponame:Biblioteca Digital de Teses e Dissertações da Uninove
instname:Universidade Nove de Julho (UNINOVE)
instacron:UNINOVE
instname_str Universidade Nove de Julho (UNINOVE)
instacron_str UNINOVE
institution UNINOVE
reponame_str Biblioteca Digital de Teses e Dissertações da Uninove
collection Biblioteca Digital de Teses e Dissertações da Uninove
bitstream.url.fl_str_mv http://localhost:8080/tede/bitstream/tede/3006/2/Frederico+Carlos+Ja%C3%B1a+Neto.pdf
http://localhost:8080/tede/bitstream/tede/3006/1/license.txt
bitstream.checksum.fl_str_mv 65bbc6eaff697ee16e51ececd6f50f82
bd3efa91386c1718a7f26a329fdcb468
bitstream.checksumAlgorithm.fl_str_mv MD5
MD5
repository.name.fl_str_mv Biblioteca Digital de Teses e Dissertações da Uninove - Universidade Nove de Julho (UNINOVE)
repository.mail.fl_str_mv bibliotecatede@uninove.br||bibliotecatede@uninove.br
_version_ 1811016887996252160