Primary bandages for people with pemphigus vulgaris lesions: an integrative literature review

Soares, Hayana Pereira Leal; Brandão, Euzeli da Silva; Tonole, Renato

doi:10.1590/1983-1447.2020.20190259

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Integrative Review • Rev. Gaúcha Enferm. 41 • 2020 • https://doi.org/10.1590/1983-1447.2020.20190259 copy

Primary bandages for people with pemphigus vulgaris lesions: an integrative literature review

Coberturas primarias en personas con lesiones por pénfigo vulgar: revisión integradora de literatura

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To identify the primary bandages recommended in the literature to dress the wounds of people with pemphigus vulgaris and to describe the positive or negative repercussions related to these bandages.

Method:

Integrative literature review, using the descriptors "dressing", "nursing care", "nursing", "skin diseases / vesiculobollous" and "pemphigus"; inclusion criteria: articles that address primary bandages for pemphigus vulgaris skin lesion dressing; published between 2010 and 2017; in Portuguese, English or Spanish; indexed in BDENF, LILACS, PubMed, and/or Scopus.

Results:

eight articles were selected, seven had evidence levels 4 and 5 and one had evidence level 3. The primary bandages covered were: silver gel, hydrocolloid, hydrogel, silver-containing hydrofiber, antibiotics, sterilized vaseline, corticoid, and vitamin E ointment

Conclusion:

Sterile gauze with vaseline, prepared according to protocol, was the bandage presented in the study with the most significant level of evidence.

Keywords:
Nursing; Nursing care; Dermatology; Pemphigus; Bandages

N	Database	Title	Author	Year Category	Country	Type of study/ Level of evidence
1	BDENF	Aplicación de un plano de cuidados enfermeros utilizando el modelo de Virginia Henderson (catorce necesidades) a una persona que presenta lesiones causadas por pénfigo vulgar	Cortés LN, Santiago SG88. Cortés LN, Santiago SG. Aplicación de un plan de cuidados enfermeros utilizando el modelo de Virginia Henderson (catorce necesidades) a una persona que presenta lesiones causadas por pénfigo vulgear. Rev Enferm Neurol [on line] 2014 [cited 2018 Apr 10];13(1):37-42. Available from: http://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=48956 http://www.medigraphic.com/cgi-bin/new/r... .	2014 Nurses	Mexico	Case study Level 5
2	LILACS	Curativo de hidrofibra com prata: opção de tratamento para pênfigo vulgar	Andrade SMF; Pontes MC; Sano D T; Martins ACGP; Gonzaga Júnior JL99. Andrade SMF, Pontes MC, Sano DT, Martins ACGP, Gonzaga Júnior JL. Curativo de hidrofibra com prata: opção de tratamento para pênfigo vulgar. Surg Cosmet Dermatol. 2012;(3):274-6..	2012 Physicians Nurse	Brazil	Case study Level 5
3	LILACS	Presentación de un caso de pénfigo vulgar	Zárate ZB, Hernández JCM, Naranjo AS1010. Zárate ZB, Hernández JCM, Naranjo AS. Presentación de un caso de Pénfigo Vulgar. Rev Univ Ind Santander, Salud. 2012;44(3):49-55..	2012 Physicians	Colombia	Case study Level 5
4	LILACS BDENF Scopus	Evolução do cuidado de enfermagem ao cliente com pênfigo: revisão integrativa de literatura	Brandão ES; Santos I dos; Carvalho MR; Pereira SK1111. Brandão ES, Santos I, Carvalho MR, Pereira SK. Evolução do cuidado de enfermagem ao cliente com pênfigo: revisão integrativa de literatura. Rev Rnferm UERJ. 2011;19(3):479-84..	2011 Nurses	Brazil	Literature Review Nível 4
5	LILACS BDENF Scopus	Evidências do cuidar de pessoas com pênfigo vulgar: desafio à enfermagem	Brandão ES; Santos I dos1212. Brandão ES, Santos I. Evidências do cuidar de pessoas com pênfigo vulgar: desafio à enfermagem. Online Braz J Nurs. 2013 [cited 2018 Mar 15];12(1):162-77. Available from: http://www.objnursing.uff.br/index.php/nursing/article/view/3674 http://www.objnursing.uff.br/index.php/n... .	2013 Nurses	Brazil	Literature Review Nível 4
6	Scopus	Redução da dor em clientes com dermatoses imunobolhosas: avaliação pela lógica fuzzy.	Brandão ES; Santos I dos; Lanzillotti, RS1313. Brandão ES, Santos I, Lanzillotti RS. Redução da dor em clientes com dermatoses imunobolhosas: avaliação pela lógica fuzzi. Online Braz J Nurs. 2016 [cited 2018 May 10];15(4):675-82. Available from: http://www.objnursing.uff.br/index.php/nursing/article/viewFile/5467/pdf_2n http://www.objnursing.uff.br/index.php/n... .	2016 Nurses	Brazil	Quasi-experimental study Level 3
7	Scopus	Radiation induced pemphigus vulgaris of the breast.	Vigna-Taglianti R; Russi EG; Denaro N; Numico G, Brizio R1414. Vigna-Taglianti R, Russi EG, Denaro N, Numico G, Brizio R. Radiation-induced pemphigus vulgaris of the breast. Cancer Radiother. 2011;15(4):334-7. doi: https://doi.org/10.1016/j.canrad.2011.01.006 https://doi.org/10.1016/j.canrad.2011.01... .	2011 Non-specified	Italy	Case study Level 5
8	Scopus	Nursing diagnoses in pemphigus vulgaris: a case study	Pena SB; Guimarães HC; Bassoli SR, Casarin SN; Herdman TH; de Barros AL1515. Pena SB, Guimarães HC, Bassoli SR, Casarin SN, Herdman TH, Barros AL. Nursing diagnoses in Pemphigus Vulgaris: a case study. Int J Nurs Knowl. 2013;24(3):176-9. doi: https://doi.org/10.1111/j.2047-3095.2013.01250 https://doi.org/10.1111/j.2047-3095.2013... .	2013 Nurses	Brazil	Case study 186. Level 5

N	Primary bandages	Aspects that influence the evolution of the skin lesions
1	Antimicrobial gel (silver gel) Hydrogel Hydrocolloid	The gel mentioned is associated to prevent infection. In case of infection in lesions, its use is recommended for 14 days. Later, the hydrogel and the hydrocolloid are recommended every 3 days, with positive results in the evolution of the lesions. Pain control should be conducted with systemic analgesics before the wound is bandaged.
2	Silver-containing hydrofiber	Two bandages were used and remained for five days each, totaling 10 days of treatment with significant improvements in the lesions. The need for systemic topical treatment association was highlighted.
3	Corticoids	Concludes that systemic and occasionally topical treatments enable lesion scarring.
4	Antibiotics Ointment-moisturized paper Sterilized vaseline Corticoid-based ointment	Recommends the use of systemic antibiotics to treat infections in lesions regardless of topical antibiotics use - risk of bacterial resistance (indiscriminate use). 226. Opposes the counter-recommendation of occlusive bandages due to the risk of lesion adherence in the contact surface, in addition to the possibility of generating infections, infestations, and to difficulties resting and changing positions that can lead to pressure lesions.
5	Corticoids Antibiotics Hydrophilic ointment	Concludes that the content of the articles analyzed is superficial and has a low level of evidence (4-5) Highlights the need for clinical studies capable of establishing the real effects of the bandages recommended. Highlights the use of topical corticoids to control mild to moderate levels of the disease. The articles selected consider topical care as complementary to the medication treatment.
6	Gauze with vaseline	Considered relevant in reducing the intensity of pain that happened after the bandages mentioned were applied, which promotes the maintenance of a humid environment, avoiding dryness in the site of lesions and preventing against adherence. This bandaging promoted pain reduction, increased mobility and improved sleeping patterns, offering more comfort to the client and more willingness and energy for self-care and for confronting the disease.
7	Vitamin-E ointments Hydrofiber Hydrocolloid	Describes the features of carboxymethyl cellulose bandages (hydrocolloid and hydrofiber): it adsorbs exudates and transforms into a gel that reduces friction and pain during movements. Concludes that appropriate hydrocolloid and hydrofiber use optimized healing and improved the comfort of the patient, reducing friction, trauma, pain, and pruritus. Associated to steroids, vitamin-E ointments and hydrofiber (in the more exudative stage) and hydrocolloid (in the less exudative stage), it resulted in reports of less discomfort.
8	Plastic sheet soaked with unsaturated fatty acid	Describes features of unsaturated fatty acids: good absorption by the body; potent antioxidant action; protects the skin DNA; inhibits free-radicals that prevent tissue reparation processes. After 21 days of systemic treatment and associated topical treatment, most lesions in the surface of the body were granulated. There were also significant epithelialization and diminution in the edema around the wound.

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[1] Corresponding author:
Euzeli da Silva Brandão E-mail: euzelibrandão@gmail.com