Utilização da papaína no tratamento de feridas realizado por enfermeiros : revisão de escopo

Abstract

The care of people with wounds is an attribution of the nursing professional, regardless of specific training and presents itself as a challenge in the field of assistance, since there are several types of primary dressings. Among the most commonly found is papain, which is characterized by a complex mixture of proteolytic enzymes and peroxidases, present in the latex of the unripe plant Carica papaya (papaya), with wide therapeutic application and different commercial presentations. In this sense, the general objective of this study was to map the scientific literature related to the use of papain by nurses in wound treatment. This is a scoping review conducted in October 2022, guided by the Joanna Briggs Institute guidelines and guided by the study question: how have Nurses used papain in wound care? The information sources used were MEDLINE (PubMed), CINAHL (EBSCOhost), Embase, LILACS (VHL), BDENF (VHL), Scopus, Web of Science, SciELO, Cochrane Library and Google academic. We included primary or secondary research articles, theses and dissertations, including gray literature, published in full, in any language, with no time cut, regardless of approach, that answered the research question. The results, presented through the PRISMA-ScR flowchart, showed that of the 169 publications identified, nine articles comprised the final sample. The studies dated from 1987 to 2019 and showed that papain is used in all stages of healing, in different concentrations (0.5 to 30%), formulations (especially in gel, but also in natura, powder, solution and cream associated with urea) and purposes (debridement action, healing, anti-inflammatory and/or antimicrobial), according to the wound tissue. Its use has been recorded in various ages and contexts, with emphasis on surgical wounds, pressure sores, burns, infected wounds, lower limb injuries, and dehiscence in newborns. Despite demonstrating satisfactory effects, clinical and field studies on the management and effectiveness of papain as a wound dressing indicate that there is difficulty on the part of Nurses in selecting the product and handling it. Thus, this scoping review revealed the need for studies that systematically evaluate both Nurses' knowledge about papain and its effectiveness.