ABSTRACT
OBJECTIVE: Wound assessment is an essential part of wound management and has traditionally focused on the wound bed. The Triangle of Wound Assessment (Triangle) is a new assessment tool that includes a holistic evaluation of the patient with a wound. The aim of this pilot study was to describe the use of the Triangle in our clinical practice in Spain. METHODS: Prospective, consecutive patients, male and female, over 18 years old, with wounds of any aetiology and duration, who attended the centres involved in the study, were recruited between May and June 2017. The TWA was used during the first presentation, to assess the wound bed, edge and periwound skin. The study's expert panel met to discuss the results collected by the assessment, as well as the advantages and disadvantages of the system. RESULTS: We recruited 90 patients. Non-viable tissue (necrotic/sloughy) was recorded in 57.8% of the patients, elevated exudate (medium/high) in 52.2%. Approximately 25% of the patients had signs or symptoms of local infection. Maceration was the most prevalent issue recorded on the wound edge and periwound skin assessment, affecting 31.1% and 30.0% of the patients, respectively. The presence of hyperkeratosis was high for the study population as the main aeitologies of the wounds identified here were DFU. CONCLUSIONS: The implementation of Triangle Wound Assessment could help in the holistic approach to patient care by focusing on more than local wound care, identifying barriers to achieving wound healing and evaluating wound response and patient compliance.
Subject(s)
Chronic Disease/classification , Diagnostic Techniques and Procedures/standards , Practice Guidelines as Topic , Wounds and Injuries/classification , Wounds and Injuries/diagnosis , Aged , Female , Humans , Male , Middle Aged , Pilot Projects , Prospective StudiesABSTRACT
The treatment of chronic wounds requires the use of highly specific products for different phases of the healing process. This article raises a number of clinical cases with chronic wounds of vascular origin and pressure ulcers. Such cases required a initial debridement because of the large content of fibrin covering the wound bed at this stage was used dressing hidrodetersive polyacrylate fibers with TLC. Once the debridement is continued treatment with a polyurethane foam dressing with TLC-NOSF.
Subject(s)
Debridement/methods , Leg Ulcer/therapy , Occlusive Dressings , Pressure Ulcer/therapy , Wound Healing , Acrylates/administration & dosage , Aged, 80 and over , Chronic Disease , Colloids/administration & dosage , Female , Humans , Lipids/administration & dosage , Male , Middle Aged , Polyurethanes/administration & dosageABSTRACT
Las heridas crónicas representan una carga para el sistema sanitario español; hoy en día es necesaria una optimización de los recursos empleados y por esto debe justificarse el uso de unos productos, en detrimento de otros, a través de estudios de coste-efectividad que demuestren beneficio económico para los profesionales y calidad de vida para el paciente. El presente artículo compara el uso de una nueva tecnología aplicada en formato de espuma de poliuretano, la TLC-NOSF, con los productos de uso más habitual en el tratamiento de heridas. Dicha comparativa se realiza mediante un modelo de coste- efectividad (Modelo Markov). Los resultados demuestran que los tratamientos con apósito de espuma de poliuretano con TLC-NOSF son coste-efectivos versus los realizados con espumas de poliuretano de uso más habitual en España(AU)
Development in the implementation of the programme of the anticoagulated patient self-management concludes with the follow-up. Your objective is to guide, support, advise and provide the patient with the necessary support material and training and improve their autonomy and quality of life. Contacts are established through both scheduled and unscheduled visits and phone calls. The article describes this phase interspersed, so serve as a practical example, with the experience which has resulted in our unit. Relates the workloads of different professionals and the most the recurrent causes of consultation. Also lists the contents that must be observed in the contacts: practical problems in the puncture or tables of dosing, assessment of the implementation of the programme, dump the data registered in the coagulometer to the computer system, revision of the autoanalyzer, material supply and treatment settings. Reviews of records that help us detect and assess problems that are resolved by a continuous and permanent health education almost in its entirety should periodically conduct. Finally, we present a study on the incidence of adverse effects occurring in self-controlled patients that we are witnessing in our unit(AU)
Subject(s)
Humans , Male , Female , Cost-Benefit Analysis/methods , Cost-Benefit Analysis/organization & administration , Cost-Benefit Analysis/standards , Evaluation of the Efficacy-Effectiveness of Interventions , Wound Healing , Wounds and Injuries/nursing , Quality of Life/legislation & jurisprudence , Varicose Ulcer/nursing , Varicose Ulcer/therapy , Varicose Ulcer/rehabilitationABSTRACT
El tratamiento de heridas crónicas requiere la utilización de productos altamente específicos para las diferentes fases del proceso de cicatrización. En el presente artículo se plantea una serie de casos clínicos con heridas crónicas de origen vascular y úlceras por presión. Dichos casos requerían un desbridamiento previo debido al gran contenido de fibrina que cubría el lecho de la herida; en esta fase se utilizó el apósito de fibras hidrodetersivas de poliacrilato con TLC. Una vez realizado el desbridamiento se prosiguió el tratamiento con un apósito tipo espuma de poliuretano con TLC-NOSF(AU)
The treatment of chronic wounds requires the use of highly specific products for differente phases of the healing process. This article raises a number of clinical cases with chronic wounds of vascular origin and pressure ulcers. Such cases required a initial debridement because of the large content of fibrin covering the wound bed at this stage was used dressing hidrodetersive polyacrylate fibers with TLC. Once the debridement is continued treatment with a polyurethane foam dressing with TLC-NOSF(AU)
Subject(s)
Humans , Male , Female , Wound Healing , Wound Infection/nursing , Wounds and Injuries/nursing , Wound Closure Techniques/nursing , Bandages/trends , Bandages , Pressure Ulcer/nursing , Pressure Ulcer/rehabilitation , Pressure Ulcer/therapy , Fibrin Foam/therapeutic useABSTRACT
Chronic wounds represent a drain on the Spanish health system, nowdays is necessary an optimization of the resources used and that is for this that is necessary justify the use of the products over others through cost-effective studies for to show the economic benefit to professionals and the life quality of patient. This article compares the use of a new technology for format polyurethane foam, TLC-NOSF, with the most commonly used products for treating wounds. This comparison is made using a cost-effectiveness model (Markov Model). The results demonstrate that treatment with polyurethane foam dressing with TLC-NOSF are cost-effective versus treatments with polyurethane foams most commonly used in Spain.
Subject(s)
Bandages/economics , Leg Ulcer/therapy , Polyurethanes/economics , Cost-Benefit Analysis , HumansABSTRACT
An overall summary of this article was submitted at the VII National Symposium on Bed Sores and Chronic Wounds and at the First Latin American Congress on Ulcers and Wounds. This article consists of an introductory first part followed by a series of numbered questions and answers in which the authors more extensively develop the hottest topics which may affect nurses' daily practice.
Subject(s)
Liability, Legal , Malpractice/legislation & jurisprudence , Pressure Ulcer , Humans , SpainABSTRACT
Este artículo fue expuesto en sus líneas generales en el VII Simposio Nacional de Úlceras por Presión y Heridas Crónicas y Primer Congreso Latinoamericano sobre Úlceras y Heridas. Consta de una primera parte introductoria y una enumeración de preguntas y respuestas en las que las autoras desarrollan más extensamente los temas más candentes que pueden afectar a la actuación enfermera(AU)
An overall summary of this article was submitted at the VII National Symposium on Bed Sores and Chronic Wounds and at the First Latin American Congress on Ulcers and Wounds. This article consists of an introductory first part followed by a series of numbered questions and answers in which the authors more extensively develop the hottest topics which may affect nurses daily practice(AU)
Subject(s)
Humans , Male , Female , Pressure Ulcer/epidemiology , Home Nursing/legislation & jurisprudence , Nurses/legislation & jurisprudence , Legislation as Topic/standards , Legislation, Hospital , Ethics, Nursing , Legislation, Nursing/organization & administration , Legislation, Nursing/standards , Legislation, Nursing/trendsABSTRACT
Las úlceras por presión (UPP) constituyen un importante problema de saludque afecta a todos los sistemas sanitarios desarrollados. Existe un amplio gradode consenso en considerar que la prevención constituye el método máseficiente de abordar el problema. La valoración del riesgo es un aspecto claveen la prevención. El objetivo de la valoración del riesgo es la identificación delos individuos que necesitan medidas de prevención y la identificación de losfactores específicos que los ponen en situación de riesgo. Para ello se utilizanlas escalas de valoración del riesgo. El presente documento técnico repasa elestado actual del conocimiento, deteniéndose en la definición y los objetivosde las escalas, en su desarrollo conceptual, que dota de las herramientas al investigadorpara validar cualquier escala, y repasa las cinco escalas validadashasta la fecha: Braden, Norton, EMINA, Waterlow y Cubbin-Jackson. Seguidamenteel documento hace un repaso de las evidencias disponibles en la literaturacientífica actual y las engloba en el apartado de recomendaciones parala práctica. El documento finaliza con el capítulo de recomendaciones a losinvestigadores donde se sugieren líneas de investigación para los próximosaños en lo relacionado con las mismas(AU)
Pressure ulcers are an important health problem worldwide. There is a wide consensusto consider prevention as the most efficient method to avoid this problem.Risk assessment is a key component in prevention. The aim of risk assessment isthe identification of patients who need preventive measures and their specific riskfactors. Risk assessment scales are tools to make the risk assessment. This technicalreport updates the knowledge about risk assessment scales, its definition and objectives. Also deal with its conceptual framework and tools and methods useful tovalidate a scale. Currently there are 5 risk assessment scales than been properlyvalidated: Braden, Norton, EMINA, Waterlow and Cubbin-Jackson. Literaturebasedevidences and recommendations for practice are presented. The text endswith some implications for research, with a suggestion of some research issues thatmust be clarified in the next years(AU)
Subject(s)
Humans , Pressure Ulcer/prevention & control , Risk Adjustment/methods , Pressure Ulcer/epidemiology , Risk Factors , Predictive Value of TestsABSTRACT
Se presentan los resultados de un estudio realizado con el objetivo de revisar la literatura científica publicada en los últimos siete años, sobre los aspectos epidemiológicos, los factores de riesgo y las medidas de prevención y de tratamiento de las lesiones por presión en personas de 65 años o más. La estrategia de búsqueda definida se utilizó en las bases de datos CINAHL, CUIDEN, COCHRANE y MEDLINE, durante los meses de mayo y junio de 2003. Los criterios de inclusión de los artículos fueron: publicados entre 1997 y 2003; ámbito geográfico del estudio: EE.UU., Canadá y Europa; idioma: inglés, francés y castellano; y sujetos de estudio de 65 años o más. De las 102 referencias identificadas, se eliminaron 85 por estar duplicadas en alguna de las bases de datos o no cumplir los criterios de la búsqueda, quedando 17 artículos para realizar la síntesis que se presenta. Los escasos estudios que se han encontrado sobre lesiones por presión en población mayor de 65 años, de los que una parte importante ha sido desarrollada en España, presentan una gran variabilidad y algunos tienen problemas metodológicos importantes
Findings of a survey performed to review scientific literature published in the last seven years on epidemiological aspects, risk factors and measures for the prevention and treatment of pressure ulcers in people aged 65 or over. The defined search strategy was used in the following databases: CINAHL, CUIDEN, COCHRANE and MEDLINE in May and June 2003. Inclusion criteria for articles were: articles published between 1997 and 2003; geographical area of the survey: USA, Canada and Europe; language of publication: English, French and Spanish; subjects of the survey aged 65 or over. Eighty five out of the 102 identified references were removed as they were present in more than one database or did not comply with the search criteria, so 17 articles were used to performed this review. The small amount of surveys on pressure ulcers in people aged 65 or over which have been found, a vast number of which have been performed in Spain, show a high degree of variability and some of them have significant methodological problems
Subject(s)
Humans , Male , Female , Aged , Pressure Ulcer/epidemiology , Risk Factors , Pressure Ulcer/prevention & control , Length of StayABSTRACT
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