Efetividade do metronidazol no tratamento de odores em feridas tumorais
DOI:
https://doi.org/10.15253/2175-6783.2018193245Palavras-chave:
Ferimentos e Lesões; Odorantes; Metronidazol; Neoplasias.Resumo
Objetivo: analisar as evidências da efetividade do Metronidazol no tratamento de odores em feridas tumorais. Métodos: revisão integrativa realizada nas bases de saúde e no portal PubMed. Os estudos foram avaliados pela Escala de Jadad (ensaios clínicos randomizados), Downs e Black (quase experimentais) e o Strengthening the Reporting of Observational studies in Epidemiology (observacionais). Amostra de dez estudos e considerou-se como ponto de corte artigos que atingiram 50,0% dos critérios. Resultados: o Metronidazol se mostrou efetivo em 95,6% dos casos e a preparação em gel a 0,75% foi a mais utilizada nos estudos. Conclusão:as evidências apontam o metronidazol como seguro e eficaz no controle de odores em feridas tumorais, porém não há consenso sobre as formas de apresentação e vias de administração mais efetivas. A maioria dos estudos associa o surgimento de mau odor com o crescimento de bactérias anaeróbias no tecido tumoral.
Referências
Tilley C, Lipson J, Ramos M. palliative wound care for malignant fungating wounds: holistic considerations at end-of-life. Nurs Clin North Am. 2016; 51(3):513-31. doi: http://dx.doi.org/10.1016/j.cnur.2016.05.006
Tamai N, Mugita Y, Ikeda M, Sanada H. The relationship between malignant wound status and pain in breast cancer patients. Eur J Oncol Nurs. 2016; 24:8-12. doi: http://dx.doi.org/10.1016/j.ejon.2016.05.004
Probst S, Arber A, Faithfull S. Malignant fungating wounds – the meaning of living in an unbounded body. Eur J Oncol Nurs. 2013; 17(1):38-45. doi: http://dx.doi.org/10.1016/j.ejon.2012.02.001
Watanabe K, Shimo A, Tsugawa K, Tokuda Y, Yamauchi H, Miyai E, et al. Safe and effective deodorization of malodorous fungating tumors using topical metronidazole 0.75% gel (GK567): a multicenter, open-label, phase III study. Support Care Cancer. 2016; 24(6):2583-90. doi: http://dx.doi.org/10.1007/s00520-015-3067-0
Castro DLV, Santos VLCG. Controlling wound odor with metronidazole: a systematic review. Rev Esc Enferm USP. 2015; 49(5):858-63.doi:http://dx.doi.org/10.1590/S0080-623420150000500021
Romero-Collado A. Cuidados domiciliarios de enfermería a una mujer con una herida neoplásica en el ámbito de la atención primaria de la salud. Enferm Clín. 2012; 22(2):100-4. doi: http://dx.doi.org/10.1016/j.enfcli.2011.05.007
Galvão TF, Preira MG. Revisões sistemáticas da literatura: passos para sua elaboração. Epidemiol Serv Saúde. 2014; 23(1):183-4. doi: http://dx.doi.org/10.5123/S1679-49742014000100018
Galvão TF, Pansini TSA, Harrad D. Principais itens para relatar revisões sistemáticas e meta-análises: a recomendação PRISMA. Epidemiol Serv Saúde. 2015; 24(2):335-42. doi: http://dx.doi.org/10.5123/S1679-49742015000200017
Jadad AR, Moore RA, Carrol D, Jenkinson C, Reynolds DJM, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: Is blinding necessary? Control Clin Trials. 1996; 17(1):1-12. doi: https://doi.org/10.1016/0197-2456(95)00134-4
Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health. 1998; 52:377-84. doi: http://dx.dg/oi.or10.1136/jech.52.6.377
Malta M, Cardoso LO, Bastos FI, Magnanini MMF, Silva CMFP. STROBE initiative: guidelines on reporting observational studies. Rev Saúde Pública. 2010; 44(3):559-65. doi: http://dx.doi.org/10.1590/S0034-89102010000300021
Agra G, Gouveia BLA, Sousa ATO, Costa MML, Oli-veira SHS, Soares MJG. Nursing palliative care in pa-tient with terebrating basal cell carcinoma: a case study. Rev Enferm UFPE on line [Internet]. 2015 [cited 2017 July 14]; 9(11):9873-81. Avaliable from: https://periodicos.ufpe.br/revistas/revis-taenfermagem/article/download/10781/11929
Agra G, Xavier VMA, Gouveia BLA, Andrade LL, Oliveira SHS, Costa ML. Nursing care to patient with breast fungating malignant wound: case study. Rev Enferm UFPE on line [Internet]. 2015 [cited 2017 July 14]; 9(6):8295-303. Avaliable from: http://www.revista.ufpe.br/revistaenfermagem/index.php/revista/article/view/7752/pdf_8028
Aiken K. Managing tissue necrosis associated with oral carcinoma. Clin J Oncol Nurs. 2004; 8(4):408-9. doi: https://doi.org/10.1188/04.CJON.408-409
Bauer C, Gerlach MA, Doughty D. Options in practice: care of metastatic skin lesions [editorial]. J Wound Ostomy Continence Nurs. 2000; 27(4):247-51. doi: https://doi.org/10.1067/mjw.2000.107985
Von Gruenigen VE, Coleman RL, Li AJ, Heard MC, Miller DS, Hemsell DL. Bacteriology and treatment of malodorous lower reproductive tract in gynecologic cancer patients. Obstet Gynecol [Internet]. 2000 [cited 2017 Oct 31]; 96(1):23-7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/10862836
Kuge S, Tokuda Y, Ohta M, Okumura A, Kubota M, Ninomiya S, et al. Use of metronidazole gel to control malodor in advanced and recurrent breast cancer. Jpn J Clin Oncol [Internet]. 1996 [cited 2017 Oct 31]; 26(4):207-10. Available from: https://www.ncbi.nlm.nih.gov/pubmed/8765176
O’Brien C. Malignant wounds: managing odour. Can Fam Physician [Internet]. 2012 [cited 2017 Oct 31]; 58(3):272-4. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3303648/
West D. A palliative approach to the management of malodour from malignant fungating tumors. Int J Palliat Nurs. 2007; 13(3):137-42. doi: http://dx.doi.org/10.12968/ijpn.2007.13.3.23276
Finlay IG, Bowszyc J, Ramlau C, Gwiezdzinski Z. The effect of topical 0.75% metronidazole gel on malodorous cutaneous ulcers. J Pain Symptom Manage. 1996; 11(3):158-62. doi: https://doi.org/10.1016/0885-3924(95)00164-6