Vitamina D e cicatrização de pele: estudo prospectivo, duplo-cego, placebo controlado na cicatrização de úlceras de perna / Vitamin D and skin repair: a prospective, double-blind and placebo controlled study in the healing of leg ulcers

OBJETIVO: Estudar a relação entre deficiência de vitamina D e cicatrização de pele em pacientes com úlceras de perna, relacionar esta deficiência com características da úlcera e avaliar se a reposição de vitamina D nos indivíduos deficientes acelera a cicatrização da úlcera. MÉTODOS: Foram escolhidos aleatoriamente 26 pacientes com úlceras venosas de perna e 26 sem úlcera pareados para sexo, idade, HAS e tabagismo. Os grupos foram comparados com relação à dosagem sérica de vitamina D. O grupo úlcera foi dividido em dois subgrupos: um que tomou placebo e outro que recebeu vitamina D 50.000UI por semana durante dois meses. Foi realizada a dosagem da 25-OH-vitamina D e avaliados o tamanho da úlcera e a gravidade da dor, antes e após o tratamento. RESULTADOS: A maioria dos pacientes apresentava níveis insuficientes de vitamina D. Não foi encontrada correlação entre o tamanho da úlcera sem tratamento e os níveis de vitamina D. Nos pacientes que receberam vitamina D, após o tratamento, o tamanho mediano da área da úlcera, diminui de 25cm², para 18cm² e no grupo placebo, de 27cm² para 24,5cm² (p=0,7051 e p=0,7877, respectivamente). Considerando-se a variabilidade da área da úlcera do grupo vitamina D versus placebo, a mediana foi igual a -0,75cm² no primeiro grupo e 4cm² no segundo grupo (p=0,0676). CONCLUSÃO: Pacientes com úlcera de perna têm mais deficiência de vitamina D que os sem. A deficiência de vitamina D não influiu nas características das lesões. A cicatrização nos pacientes com hipovitaminose D mostrou tendência para ser maior naqueles que receberam reposição vitamínica.

OBJECTIVE: To analyze the relation between vitamin D insufficiency and wound healing in patients with venous ulcers; to correlate vitamin D insufficiency with characteristics of the ulcer (size and pain) and to evaluate if reposition of vitamin D in these subjects expedites ulcer healing. METHODS: We selected 26 patients with leg ulcers, and 26 control patients without ulcers, matched for gender, age, systemic arterial hypertension and tobacco use. The venous ulcer group was divided in two subgroups: one that received placebo (nine patients) and other receiving vitamin D, 50.000 IU per week over two months (13 patients). Blood was collected for 25 OH vitamin D dosage before and after the medication. In the ulcer group, we obtained data concerning demographics, leg ulcer size, as well as pain severity, measured by an analogical visual scale. Data was grouped in contingency and frequency tables, the tests of Fisher and chi-squared being used for nominal variables and Mann-Whitney for numerical variables. The adopted significance was of 5%. RESULTS: We found vitamin D insufficiency in the great majority of the patients. The median level in the ulcer group was 17.05 ng/dl and 22.75 ng/dl in the group without ulcer (p=0,0182) No relation was found between the ulcer size without treatment and the level of vitamin D. After treatment, the average size of the ulcer changed from 25 cm² to 18 cm² in the patients that took vitamin D and from 27 cm² to 24,5 cm² in the placebo group (p=0,7051 and p=0,7877, respectively). Considering the variability of the size of the ulcer in the treatment group versus placebo group, the average size was equal to -0,75 cm² in the first group and +4cm² in the second (p=0,0676) CONCLUSION: Patients with leg ulcers have more vitamin D deficiency. No difference in the ulcer characteristics was noted between those with and without vitamin D deficiency. There was a trend toward a better healing in those with vitamin D reposition.

Dressing spray enhances the adhesive strength of surgical dressing tapes.

BACKGROUND: The use of surgical adhesive tapes after minor surgical and dermatologic operations is widespread. Their use reduces the wound tension and separation and they ultimately improve the postoperative scar. The most commonly used wound adhesives to enhance the adhesiveness of the surgical tapes, are tincture of benzoin and mastisol. AIM: The purpose of the present study is to demonstrate the role of adhesive power of dressing spray with the adhesive tape application on the skin, which is widely used in clinics after the skin closure. METHODS: Fifteen volunteers who were chosen among the medical personnel of the hospital comprised the study group. The skin of the flexor aspect of the 1/3 middle forearm of the subjects was used as the procedure region. The data is collected in the first, second and eighth days of the study. At the first stage of the study, an adhesive wound closure tape was applied to the skin without any compound of adhesives (group A). In the second and third stages, a thin coat of transparent film dressing spray (group B) and an adhesive compound of tincture of benzoin (group C) were applied to the skin before the adhesive tape placement, respectively. Different values of weights ranging between 50-900 gm were hanged by hooking into the center of the adhesive tape. The weights that caused complete separations of the tape from the skin after exactly 20 seconds were recorded in all groups. The data was analyzed by using Friedman test in order to calculate statistical significance between groups A, B and C. RESULTS: The difference in adhesive power between control and groups B and C was found to be highly significant ( p CONCLUSION: The results indicated that dressing spray tested has an additional adhesive power besides its well known features and that it can be used as an efficient alternative material among other adhesive compounds.