<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1646-706X</journal-id>
<journal-title><![CDATA[Angiologia e Cirurgia Vascular]]></journal-title>
<abbrev-journal-title><![CDATA[Angiol Cir Vasc]]></abbrev-journal-title>
<issn>1646-706X</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Angiologia e Cirurgia Vascular]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1646-706X2021000200125</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[Novos paradigmas no tratamento das feridas complexas]]></article-title>
<article-title xml:lang="en"><![CDATA[New paradigms in the management of complex wounds]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Jorge]]></surname>
<given-names><![CDATA[Helena]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[Cláudia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pinto]]></surname>
<given-names><![CDATA[Cíntia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Almeida]]></surname>
<given-names><![CDATA[Ana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pedro]]></surname>
<given-names><![CDATA[Luís Mendes]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Hospitalar Universitário Lisboa Norte Serviço de Angiologia e Cirurgia Vascular ]]></institution>
<addr-line><![CDATA[Lisboa ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>06</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>06</month>
<year>2021</year>
</pub-date>
<volume>17</volume>
<numero>2</numero>
<fpage>125</fpage>
<lpage>134</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S1646-706X2021000200125&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S1646-706X2021000200125&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S1646-706X2021000200125&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  O tratamento de feridas tem sido uma temática com crescente interesse pelas envolventes que comporta, tanto ao nível físico como psicossocial, pelos custos associados ao tratamento e pelo stress causado na pessoa, na família e no sistema de saúde. A Organização Mundial da Saúde (OMS) considera esta temática como uma epidemia pela elevada prevalência. Em Portugal, os dados epidemiológicos são limitados mas estima-se que haja 3,3 portadores de ferida por mil habitantes. A presente revisão narrativa tem como objetivo contribuir para clarificar a abordagem ao tratamento da ferida complexa à luz das novas guidelines emitidas pela European Wound Management Association (EWMA).  Material e Métodos:  Foi efectuada uma revisão narrativa sobre os aspectos actuais da abordagem à ferida complexa ou de difícil cicatrização, (ferida que não regride em 40-50% da sua dimensão em 4 semanas). Efectuou-se uma pesquisa bibliográfica na Pubmed e nos últimos documentos de consenso elaborados pela EWMA (European Wound Management Association) a qual foi integrada na experiência dos autores no tratamento deste tipo de doentes. Resultados: A abordagem da ferida complexa deve ser sistemática e sistematizada, em equipa multidisciplinar, mediada por um gestor de ferida, e em centros dedicados ao tratamento da mesma. O portador de ferida deve estar no centro dos cuidados como parceiro o que requer por parte dos profissionais de saúde formação na capacitação da pessoa/família/cuidador. O controlo de infeção associado ao tratamento de feridas deve envolver intervenções simples e pouco onerosas, mas muito importantes, como a higienização das mãos, a utilização de equipamentos de proteção individual dos profissionais e dos utentes e uma boa gestão das salas de tratamento. As terapias mais avançadas baseiam-se em novos princípios e tecnologias ou em novas aplicações de princípios e tecnologias já consolidados e a sua utilização deve ser baseada na evidência. Os algoritmos em saúde são instrumentos de apoio à decisão clínica na presença de situações complexas e apresenta-se uma proposta de algoritmo para o tratamento de ferida complexa.  Conclusão:  A abordagem da ferida complexa deve englobar aspectos multifatoriais e a escolha de terapias avançadas deve ser criteriosa tendo em conta o custo.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  The treatment of wounds is a topic with growing interest due to the physical and psychosocial implications, to the costs associated with the treatments and also due to the stress caused to the patients, families and the health system. The World Health Organization (WHO) considers chronic wounds as an epidemic due to its high prevalence. In Portugal the available epidemiological data is limited but it is estimated that there are 3.3 wound carriers per thousand inhabitants. The aim of the present narrative review is to clarify the approach to the treatment of complex wounds in light guidelines issued by the European Wound Management Association (EWMA).  Material and Methods:  A narrative review was carried out on the current aspects of the approach to the complex or difficult-to-heal wound (wound that does not heal by 40-50% of its size in 4 weeks). A literature search was carried out in Pubmed and in the latest consensus documents prepared by the EWMA (European Wound Management Association) which was integrated in the authors&amp;apos; experience. Results: The approach to the complex wound must be systematic in dedicated centers and conducted by multidisciplinary teams. It should be mediated by a wound manager and the wounded person must always act as a partner. Proper training of the person/family/caregiver is also crucial. Infection control should start with simple and inexpensive interventions such as hand hygiene and the use of personal protective equipment for patients and professionals in the treatment rooms. The most advanced therapies are based on new principles and technologies and its application should be evidence-based. Algorithms in health are useful tools to support the clinical decision and an algorithm for the treatment of complex wounds is presented.  Conclusion:  The approach of complex wounds must encompass multifactorial aspects and the choice of advanced therapies must be judicious.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Ferida Complexa]]></kwd>
<kwd lng="en"><![CDATA[Complex Wound Management]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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