Effectiveness Of 2% And 4% Papain Gels In The Healing Of Venous
                  Ulcers

Ribeiro, Andréa Pinto Leite; Oliveira, Beatriz Guitton Renaud Baptista de; Soares, Marja Ferreira; Barreto, Bruna Maiara Ferreira; Futuro, Débora Omena; Castilho, Selma Rodrigues de

doi:10.1590/S0080-623420150000300006

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Artigo Original • Rev. esc. enferm. USP 49 (3) • June 2015 • https://doi.org/10.1590/S0080-623420150000300006 copy

Effectiveness Of 2% And 4% Papain Gels In The Healing Of Venous Ulcers^* * Extracted from the dissertation "A efetividade de um protocolo de uso do gel de papaína a 2% e 4% na cicatrização de úlceras venosas", Aurora de Afonso Costa School of Nursing, Universidade Federal Fluminense, 2012.

Efectividad De Los Geles De Papaína Al 2% Y Al 4% En La Cicatrización De Úlceras Venosas

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE

To analyze the effectiveness of 2% and 4% papain gels in tissue repair of venous ulcers.

METHOD

Quasi-experimental study with consecutive sample of 16 patients with 30 venous ulcers treated at the outpatient clinic of a teaching hospital, from April to November in 2011, using a form for clinical assessment of the patient and its lesion. Variables were analyzed by Wilcoxon and McNemar test (p < 0.05).

RESULTS

Most participants were female; aged between 51 and 59 years; obese; with hypertension. Regarding ulcers, there was an average decrease of 7.9 cm²(50% of its original size) in 90 days; 20% of the ulcers completely healed within 56.67 days. There was an increase in epithelialization, significant reduction in the slough and edema, improved depth, in the type and amount of exudate (p < 0.0001).

CONCLUSION

2% and 4% papain gels were effective in healing venous ulcers.

Varicose Ulcer; Leg Ulcer; Papain; Treatment Outcome; Nursing

Type of tissue	Intensity	Baseline (0 day)		End (90 days)		p value ^a a McNemar test.
Type of tissue	Intensity	N	%	n	%	p value ^a a McNemar test.
Slough	0%	0	0	10	33.3	< 0.001
	1-25%	12	40.0	17	56.7
	26-50%	9	30.0	3	10.0
	51-75%	2	6.7	0	0
	76-99%	7	23.3	0	0
	100%	0	0	0	0
Granulation	0%	2	6.7	7	23.3	0.25
	1-25%	7	23.3	2	6.7
	26-50%	8	26.7	4	13.3
	51-75%	5	16.7	9	30.0
	76-99%	8	26.7	8	26.7
	100%	0	0	0	0
Epithelialization	0%	4	13.3	0	0	< 0.001
	1-25%	26	86.7	14	46.7
	26-50%	0	0	7	23.3
	51-75%	0	0	2	6.7
	76-99%	0	0	1	3.3
	100%	0	0	6	20.0

Characteristics	Category	Baseline (0 day)		End (90 days)		p value ^a a McNemar test.
Characteristics	Category	N	%	n	%	p value ^a a McNemar test.
Depth	Healed	-	-	6	20.0	0.001
	Superficial	8	26.7	14	46.7
	Partial	22	73.3	10	33.3
Exudate type	None	-	-	6	20.0	0.0001
	Serous	3	10.0	13	43.3
	Serosanguineous	25	83.3	11	36.7
	Purulent	2	6.7	0	0.0
Exudate amounts	None	-	-	6	20.0	< 0.0001
	Small	9	30.0	13	43.3
	Medium	15	50.0	11	36.7
	Large	6	20.0	0	0.0
Foul odor	Yes	1	3.3	0	0.0	0.99
Foul odor	No	29	96.7	30	100.0	0.99
Pain in the bed of venous ulcers	Yes	13	43.3	8	26.7	0.30
Pain in the bed of venous ulcers	No	17	56.7	22	73.3	0.30
Pain after using the product	Yes	2	6.7	6	20.0	0.28
Pain after using the product	No	28	93.3	24	80.0	0.28
Perilesional edema	Yes	25	83.3	6	20.0	< 0.0001
Perilesional edema	No	5	16.7	24	80.0	< 0.0001
Ulcer edges	Epithelized	27	90.0	28	93.3	0.99
Ulcer edges	Macerated	3	10.0	2	6.7	0.99
Adjacent skin	Hydrated	19	63.3	26	86.7	0.096
Adjacent skin	Dried	11	36.7	4	13.3

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Andréa Pinto Leite Ribeiro. Rua São João, 25 - Apto. 515, Centro. CEP 24020-040 - Niterói, RJ, Brazil. andreapintoleite@yahoo.com.br

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Effectiveness Of 2% And 4% Papain Gels In The Healing Of Venous Ulcers* * Extracted from the dissertation "A efetividade de um protocolo de uso do gel de papaína a 2% e 4% na cicatrização de úlceras venosas", Aurora de Afonso Costa School of Nursing, Universidade Federal Fluminense, 2012.

Efectividad De Los Geles De Papaína Al 2% Y Al 4% En La Cicatrización De Úlceras Venosas

OBJECTIVE

METHOD

RESULTS

CONCLUSION

Effectiveness Of 2% And 4% Papain Gels In The Healing Of Venous Ulcers^* * Extracted from the dissertation "A efetividade de um protocolo de uso do gel de papaína a 2% e 4% na cicatrização de úlceras venosas", Aurora de Afonso Costa School of Nursing, Universidade Federal Fluminense, 2012.