Eficacia del láser y terapias kinesicas convencionales en el tratamiento de cicatrices por quemaduras : revisión sistemáticas
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Fecha
2022
Profesor/a Guía
Facultad/escuela
Idioma
es
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Universidad Andrés Bello
Nombre de Curso
Licencia CC
Licencia CC
Resumen
Las quemaduras constituyen un problema de salud pública en Chile y en el mundo.
Las secuelas de lesiones por quemaduras pueden cicatrizar en forma patológica, generando
alteraciones funcionales, estéticas y de calidad de vida en los pacientes. Tanto terapias kinésicas
convencionales como terapias con láser han sido utilizadas para mejorar las características de las
cicatrices por quemaduras, aunque se estima que la calidad de la evidencia que sustenta tales
intervenciones es moderada. No existen estudios que comparen la eficacia y seguridad de ambos
tratamientos. El objetivo del estudio es comparar la eficacia y seguridad de las terapias kinésicas
convencionales versus terapias con láser en el tratamiento de cicatrices post quemaduras.
Métodos: Se diseñó un protocolo para ejecutar una revisión sistemática de literatura siguiendo la
guía PRISMA-P. Se incluyeron artículos pertinentes para evaluar eficacia terapéutica de
intervenciones cuyos participantes sean adultos o niños mayores de 5 años con cicatrices de
quemaduras, y que describan el efecto de terapia con láser o de terapias kinésicas convencionales
como presoterapia, silicona, masaje e hidroterapia. Los artículos incluidos reportaron
características de la cicatriz tales como grosor, prurito, flexibilidad y pigmentación o la presencia
de efectos adversos o complicaciones. La búsqueda se realizó utilizando tres bases de datos y los
autores realizaron sucesivamente la valoración de títulos y resumen, textos completos y calidad de
la evidencia en forma independiente.
Resultados: La terapia con láser mostró ser efectiva para reducir el grosor de la cicatriz, aliviar el
prurito y mejorar la pigmentación, pero no tuvo efectos positivos en la vascularización. Por su parte
las técnicas kinésicas convencionales como la presoterapia mostraron ser efectivas para el grosor,
la flexibilidad y enrojecimiento de la misma forma que la silicona gel, la terapia de masaje mostró
resultados positivos en la flexibilidad y el prurito.
Conclusión: Tanto la terapia con láser como las técnicas kinésicas convencionales muestran cierto
grado de efectividad en la mejoría de los resultados analizados. Los resultados deben ser
interpretados con cautela, debido a la calidad de los estudios incluidos y a la heterogeneidad de los
mismos, que impidió una síntesis estadística de los resultados obtenidos.
Introduction: Burns are a public health problem in Chile and in the world. The sequelae of burn injuries can lead to scarring, which generates functional, aesthetic and quality of life alterations in patients. Both conventional physiotherapy and laser therapies have been used to improve burn scars. However, the quality of the evidence supporting such interventions is moderate and there are no studies comparing the efficacy and safety of both treatments. The objective of this study is to compare the efficacy and safety of conventional physiotherapy treatment versus laser therapies in the treatment of burn scars. Methods: A protocol was designed to carry out a systematic review following the PRISMA-P guideline. Articles designed to evaluate interventions were included according to the following criteria: inclusion of participants both adults or children over 5 years of age with burn scars; studies that describe the effect of laser therapy or conventional physiotherapy such as pressotherapy, silicone, massage and hydrotherapy; articles that report scar characteristics such as thickness, pruritus, flexibility and pigmentation or the presence of adverse effects or complications. The search was carried out using three databases and the authors assessed titles and abstracts, full texts and quality of evidence independently. Results: Laser therapy was shown to be effective on reducing scar thickness, relieving pruritus, and improving pigmentation, but had no positive effects on vascularity. Conventional physiotherapy techniques such as pressotherapy and silicone gel therapy have shown to be effective on decreasing scar thickness, improving flexibility and redness. Massage therapy showed positive results in flexibility and itching. Conclusion: Both laser therapy and conventional physiotherapy techniques showed effectiveness on improving the outcomes analyzed. The results must be interpreted with caution, due to the quality of the studies included and their heterogeneity, which prevented a statistical synthesis of the results obtained.
Introduction: Burns are a public health problem in Chile and in the world. The sequelae of burn injuries can lead to scarring, which generates functional, aesthetic and quality of life alterations in patients. Both conventional physiotherapy and laser therapies have been used to improve burn scars. However, the quality of the evidence supporting such interventions is moderate and there are no studies comparing the efficacy and safety of both treatments. The objective of this study is to compare the efficacy and safety of conventional physiotherapy treatment versus laser therapies in the treatment of burn scars. Methods: A protocol was designed to carry out a systematic review following the PRISMA-P guideline. Articles designed to evaluate interventions were included according to the following criteria: inclusion of participants both adults or children over 5 years of age with burn scars; studies that describe the effect of laser therapy or conventional physiotherapy such as pressotherapy, silicone, massage and hydrotherapy; articles that report scar characteristics such as thickness, pruritus, flexibility and pigmentation or the presence of adverse effects or complications. The search was carried out using three databases and the authors assessed titles and abstracts, full texts and quality of evidence independently. Results: Laser therapy was shown to be effective on reducing scar thickness, relieving pruritus, and improving pigmentation, but had no positive effects on vascularity. Conventional physiotherapy techniques such as pressotherapy and silicone gel therapy have shown to be effective on decreasing scar thickness, improving flexibility and redness. Massage therapy showed positive results in flexibility and itching. Conclusion: Both laser therapy and conventional physiotherapy techniques showed effectiveness on improving the outcomes analyzed. The results must be interpreted with caution, due to the quality of the studies included and their heterogeneity, which prevented a statistical synthesis of the results obtained.
Notas
Tesis (Licenciado en Kinesiología)
Palabras clave
Lasers, Uso Terapéutico, Quemaduras, Rehabilitación, Kinesiología