Formulação de protocolo para uso de terapia por pressão negativa ma prevenção de complicações em ferida cirúrgica de artroplastia total e joelho

Abstract

Introduction: Total knee arthroplasty (TKA) is a surgery recommended for advanced osteoarthritis, replacing damaged components with a prosthesis, resulting in functional improvement in about 90% of cases. Due to increased life expectancy and obesity, the demand for TKAs continues to grow. Complications such as infections and dehiscence are common, but negative pressure therapy (NPT) has shown promise in reducing these issues through better healing and infection prevention. Objectives: Develop a protocol for the use of negative pressure dressings in preventing postoperative complications in TKA incisions; create an infographic with basic concepts and benefits of Negative Pressure Wound Therapy (NPWT) up to the practical application of dressings, including inspection and continuous monitoring; develop a protocol to guide healthcare professionals in using negative pressure dressings, specifically the PICO 7 system, to prevent postoperative complications and promote efficient healing. Methods: This study adopted a quantitative approach, using a randomized clinical trial (RCT) design to evaluate the effectiveness of negative pressure dressings (NPT) compared to "standard" dressings in patients undergoing TKA. The sample consisted of 47 participants aged between 60 and 80 years, of both sexes, from September 2023 to January 2024, after approval by the Research Ethics Committee. Demographic and clinical variables such as comorbidities, nutritional status, laterality, and medication use were analyzed, observing both the Control and Experimental Groups. The protocol produced provides a valuable tool for healthcare professionals in managing surgical wounds in primary total knee arthroplasty. Results: Negative pressure therapy can accelerate healing and significantly reduce complications such as signs and symptoms of infection, pain, and edema compared to standard treatment. The outcomes include an integrative review article titled "Effects of Negative Pressure Therapy in Preventing Complications in Surgical Wounds of Total Knee Arthroplasty: Na Evidence-Based Study," published in the journal "Observatorio de La Economia Latinoamericana (OLEL)," classified as Qualis A4 by the Unified CAPES Program; na original article titled "Effects of Negative Pressure Therapy (NPT) in Elderly Patients Undergoing Primary Total Knee Arthroplasty in a Public Reference Hospital in the Federal District: A Randomized Controlled Clinical Trial," submitted to the jornal Rebenf, classified as Qualis A2 by the Unified CAPES Program. Clinical protocol titled "Protocol for Managing the Wound in Primary TKA," published as an e-book by Publisher Coleta Científica in the year 2025, link:https://portalcoleta.com.br/index.php/editora/article/view/177. Conclusion: The integrative review article supports the efficiency of NPT in treating surgical wounds in arthroplasty; the original article shows that NPT is highly promising in preventing complications and promoting healthier healing in patients undergoing total knee arthroplasty; the infographic enables standardization and improvement in postoperative care for TKA patients; and the protocol is an important contribution to clinical practice by providing a valuable tool for healthcare professionals in managing surgical wounds in TKA.