Possui Graduação em Medicina pela Universidade Federal do Pará - UFPA (1996); Mestrado em Medicina - Ortopedia e Traumatologia pela Universidade Federal do Rio de Janeiro - UFRJ (2003). Doutor em Medicina Tropical pelo Programa de pós -graduação em Medicina Tropical da Universidade Estadual do Amazonas em parceria com a Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (UEA/FMTHVD), em 2023. Pós-doutorado na Santa Casa de São Paulo - 2024 em andamento ; Pós Graduação em Administração Hospitalar (Faculdade de Tecnologia de Curitiba), 2018; Pós Graduação de Gestão de Qualidade e Acreditação Hospitalar (Faculdade de Tecnologia de Curitiba), 2018; MBA Executivo de Gestão em Saúde ( Hospital Albert Einstein - São Paulo) - 2024 em andamento; Professor concursado de Ortopedia e Traumatologia da Universidade Estadual do Amazonas UEA; Professor do curso de Medicina da Universidade Nilton Lins: Professor de Ortopedia e Traumatologia na Faculdade de Medicina da Universidade Federal do Amazo
Epidemiological clinical profile and closure of chronic plantar ulcers in patients with leprosy sequelae undergoing orthopedic surgery in a municipality in western Amazon Francisco Mateus João, Silmara Navarro Peninni, Zanair Soares Vasconcelos, Arineia Soares da Silva, Katia do Nascimento Couceiro, et al. Plos One, 2023 IntroductionChronic 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.ObjectiveTo 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.MethodsThis 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.Results234 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.ConclusionA 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.
