Epidemiological clinical profile and closure of chronic plantar ulcers in patients with leprosy sequelae undergoing orthopedic surgery in a municipality in western Amazon.

Autor: João FM; University of the State of Amazonas, Manaus, Amazonas, Brazil.; Postgraduate Program in Tropical Medicine, Manaus, Amazonas, Brazil.; Adventist Hospital, Manaus, Amazonas, Brazil., Peninni SN; Alfredo da Mata Foundation Hospital, Manaus, Amazonas, Brazil., Vasconcelos ZS; Postgraduate Program in Tropical Medicine, Manaus, Amazonas, Brazil.; Jungle Warfare Instruction Center, Manaus, Amazonas, Brazil., da Silva AS; University of the State of Amazonas, Manaus, Amazonas, Brazil.; Postgraduate Program in Tropical Medicine, Manaus, Amazonas, Brazil., Couceiro KDN; University of the State of Amazonas, Manaus, Amazonas, Brazil., Jorge Brandão AR; University of the State of Amazonas, Manaus, Amazonas, Brazil.; Postgraduate Program in Tropical Medicine, Manaus, Amazonas, Brazil., Silva MRHDSE; University of the State of Amazonas, Manaus, Amazonas, Brazil.; Postgraduate Program in Tropical Medicine, Manaus, Amazonas, Brazil., do Vale Filho MF; Metropolitan Faculty of Manaus, Manaus, Amazonas, Brazil., de Oliveira GMS; Federal University of Amazonas, Manaus, Amazonas, Brazil., Ferreira LS; University of the State of Amazonas, Manaus, Amazonas, Brazil.; Postgraduate Program in Tropical Medicine, Manaus, Amazonas, Brazil., Mwangi VI; University of the State of Amazonas, Manaus, Amazonas, Brazil.; Postgraduate Program in Tropical Medicine, Manaus, Amazonas, Brazil., da Silva BM; Carlos Borborema Clinical Research Institute, Manaus, Amazonas, Brazil., Barbosa Guerra MDGV; University of the State of Amazonas, Manaus, Amazonas, Brazil.; Alfredo da Mata Foundation Hospital, Manaus, Amazonas, Brazil.; Doutor Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, Amazonas, Brazil., Guerra JAO; University of the State of Amazonas, Manaus, Amazonas, Brazil.; Metropolitan Faculty of Manaus, Manaus, Amazonas, Brazil.; Doutor Heitor Vieira Dourado Tropical Medicine Foundation, Manaus, Amazonas, Brazil.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2023 Jul 28; Vol. 18 (7), pp. e0284706. Date of Electronic Publication: 2023 Jul 28 (Print Publication: 2023).
DOI: 10.1371/journal.pone.0284706
Abstrakt: Introduction: Chronic plantar ulcers in leprosy are lesions resulting from motor and sensory alterations caused by Mycobacterium leprae. They are lesions refractory to conventional dressings and present high recurrence rates.
Objective: To evaluate the epidemiological clinical profile of patients with chronic plantar ulcers associated with bony prominences in the lesion bed and to evaluate the efficacy of orthopedic surgical treatment of these lesions.
Methods: This is a descriptive and analytical retrospective study with the evaluation of medical records of patients undergoing surgical treatment of chronic plantar ulcers from 2008 to 2018. The surgical technique applied consisted of corrective resection of bone prominences and the primary closure of the lesion with bipediculated local flap.
Results: 234 patients were submitted to surgery, 55.1% male with an average age of 69.5 years old. Of these, 82.9% were illiterate; and 88.5% with open lesions over 10 years. After surgical treatment, total wound healing occurred in an average time of 12 weeks. The variables that contributed to shorter healing time were: Patients' lower age group; regular use of orthopedic shoes and insoles and dressings performed by nurse aides in health units before surgery. Obesity was the factor that correlated with the delay of healing time.
Conclusion: A higher incidence was observed in males and male and female illiterate patients. The regular use of shoes and insoles and dressings performed by nurse aides in health units contributed to shorter postoperative healing time. Orthopedic surgical treatment with corrective resection of bony prominences proved to be an efficient therapeutic method for the closure of chronic plantar ulcers. It is a reproducible method, justifying the importance of the orthopedic surgeon in the context of the multidisciplinary team to cope with these complex lesions.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2023 João et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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