A estomaterapia é uma especialidade exclusiva da Enfermagem que exerce papel fundamental na promoção, prevenção, tratamento e reabilitação de pacientes com feridas e incontinência anal e urinária, além de outros cuidados com drenos, cateteres, tubos e fístulas. Na Casa de Cuidados do Ceará (CCC), unidade da Secretaria da Saúde do Estado (Sesa) responsável pela desospitalização de pacientes, uma equipe multiprofissional é especializada no assunto.
Os perfis dos pacientes atendidos na unidade são geralmente de pessoas acamadas ou com mobilidade reduzida, com desnutrição, idosas, em tratamento paliativo ou com histórico de possuir lesão por pressão prévia. Daí a necessidade trabalhar, principalmente, com a prevenção.
“Em sua maioria, também, são pacientes com cuidadores, por isso sempre buscamos inserir e envolvê-los no cuidado com o paciente e nas ações de prevenção de lesão por pressão. Além disso, são feitos treinamentos direcionados tanto para a equipe assistencial como para cuidadores, conforme a necessidade”, explica a enfermeira estomaterapeuta da CCC, Beatriz Avelino .
Os treinamentos englobam prevenção, identificação, avaliação e tratamento de feridas, boas práticas de cuidados com a pele e com estomias (aberturas cirúrgicas) tanto de alimentação como de eliminação, a fim de evitar problemas de saúde relacionados a essa área.
“Conseguimos prevenir lesões por pressão em quase 80% dos pacientes, o que é um ótimo resultado. Além disso, começamos a acompanhar o desfecho das lesões que são incidência da Casa de Cuidados, ou seja, das lesões que não conseguimos prevenir na unidade”, acrescenta a profissional.
O paciente Francisco Gerson de Oliveira, 55, está há dois meses na CCC se recuperando de sequelas de infarto e trombose. Antes de ser transferido para a Casa, esteve muito tempo acamado em um hospital e, por isso, teve feridas na pele. Segundo a filha e cuidadora do paciente, Gisele Maria, o pai tem progressos no tratamento com a estomaterapia.
“Antes ele não conseguia nem colocar o pé no chão, e agora já coloca, já está andando sozinho com o uso do andador. Atualmente ele já faz fisioterapia na sala de reabilitação. A relação e parceria com a equipe é muito boa, ele vem melhorando cada vez mais, somos muito gratos por esse avanço”, comenta a cuidadora.
Na rotina de trabalho, são promovidas visitas aos pacientes para avaliar a necessidade de intervenção em medidas de promoção da saúde, preventivas e/ou tratativas, em parceria com toda a equipe multiprofissional.
A busca por estratégias e soluções para lesões de pele é um dos maiores desafios dos profissionais de saúde, visto que este tipo de dano é um dos mais importantes eventos adversos que podem ocorrer durante a internação hospitalar.
“A estomaterapia é imprescindível no processo de cuidado e reabilitação do paciente. Esse tipo de ocorrência acontece principalmente em pacientes acamados ou com dificuldade de mobilidade em virtude do quadro clínico. Temos como principal objetivo manter a pele íntegra do paciente, promover reparo tecidual adequado, de forma para que o paciente possa se recuperar e evitar reinternação, sendo inserido de volta à sociedade, junto com sua família”, conclui a enfermeira estomoterapeuta.
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