Mayores, enfermeras y COVID-19 / No disponible

No disponible

Visión gerontológica de la campaña Nursing Now / Gerontological vision of the Nursing Now campaign

No disponible

Preliminary experience of an expert panel using Triangle Wound Assessment for the evaluation of chronic wounds.

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.

Una mirada a la especialidad de enfermería geriátrica / No disponible

No disponible

[Dressings impregnated in antibacterial agent: multicenter study on acute and chronic wounds, with Atrauman Ag]. / Apósitos impregnados en agente antibacteriano: estudio multicéntrico, en heridas agudas y crónicas, con Atrauman Ag.

UNLABELLED: Ulcers and chronic wounds are an ideal medium for bacterial growth. This growth occurs in both number and variety of species, resulting in lesions with polymicrobial flora. The use of antimicrobial treatments to control and/or prevention of infection is discussed. Silver dressings as an alternative safe and effective for treating infected wounds and/or in situations of critical colonization. There are already evidence of what kind of silver-containing dressings are more cost-effective. The aim of this study is to evaluate the efficacy and effectiveness of Atrauman Ag dressing in the treatment of skin lesions in acute and chronic, as to the resolution of signs of infection and progression of healing during a period of four weeks. MATERIAL AND METHODS: we performed an observational, prospective, multicenter open study where the patient inclusion period was from April to August 2007. The sample consisted of patients seen giving their informed consent in primary care centers, health centers and hospitals throughout the country and met the inclusion criteria and had none of the exclusion criteria. The study variables were collected sociodemographic, injury-related variables to study with the dressing and the ratings of professionals and patients. The values of each variable were collected weekly in a CRD. The recorded data are processed in a database originally composed of 116 variables, which were analyzed with SPSS software. RESULTS: we evaluated 219 patients finally included 147 who met the inclusion criteria and no exclusion. At the end of the study had chronic injuries granulation tissue in 84.8% and 100% acute wounds with statistically significant differences with respect to the initial assessment. Exudate levels in wounds evaluated at 4 weeks of treatment show a significant reduction, from exudate abundant or very abundant in 81.8% to a level of low or moderate exudate in 80.5% of the cases end of the study The evolution of clinical signs of infection by 87% (n=91) of the lesions disappeared after 4 weeks. 11.7% of lesions were healed in the study period. In the case of chronic wounds, we go from a median of 17.5 cm2 to 9.9 cm2, this means a relative reduction of 39.05% and a speed of 1. 12 cm2/week healing. In the case of acute wounds, a move from a median of 8.25 cm2 to 3.0 cm2 and a relative reduction of 65.03% with a healing rate of 2.28 cm2/week, with statistically significant differences both cases. The permeability of the dressing exudate was evaluated as good or very good in 88% of cases and the perilesional skin care by 79.9% as good or very good. The pain in the wounds was evaluated as nothing or very little, in 72% of cases.

Tratamiento de úlceras de diversa etiología Estudio prospectivo sobre Permafoam® / Care for ulcers having diverse etiology. Prospective study on PermaFoam®

El apósito a estudiar es una espuma de poliuretano con gradiente de poro, lo que permite: absorber rápidamente grandes cantidades de exudado, restos celulares y exudados viscosos gracias a la capa de poros de gran tamaño que se encuentra en contacto con la herida; distribuir y retener el exudado en la capa intermedia del apósito que presenta un diámetro de poro menor; y, a través de la última capa, que se caracteriza por un diámetro de poro más pequeño, conseguir una gran semipermeabilidad y adaptabilidad a las distintas localizaciones donde deba ser aplicado. Se llevó a cabo el presente trabajo para evaluar su utilidad en la cicatrización de heridas de diversa etiología. Como objetivos secundarios se tuvieron en cuenta: la reducción de superficie de la herida, el respeto de la piel perilesional, estimar su comodidad de manejo y aplicación, e identificar sus cualidades más destacables(AU)

PermaFoam®, the dressing under study, is characterized as a polyurethane foam having gradient pores which, besides all the aforementioned characteristics, makes it possible to: rapidly absorb large quantity of seepage or exudation, cell remains and viscous seepage thanks to a layer of large size pores that are in contact with the wound; distribute and retain seepage in an intermediate layer of this dressing which is composed of pores having a smaller diameter; and, through a final layer characterized by an even smaller pore which permits a high degree of semi-permeability and adaptability to the distinct locales where this dressing needs be applied.

Prevalencia de úlceras por presión en una zona básica de salud / Prevalence of the pressure ulcers in a Basic Zone of Health

Introducción: Las úlceras por presión (UPP) representan un importante problemade salud en todos los niveles asistenciales, pero un volumen importantede las mismas precisan de cuidados continuados desde la comunidad. Elobjetivo de nuestro estudio es conocer la prevalencia de período de las UPP ysu distribución entre otras características que se encuentran en nuestra zonabásica de salud. Material y métodos: Se ha realizado un corte de prevalenciade período retrospectivo en la ZBS de Piloña (Asturias) para el intervalo detiempo comprendido entre el 1 de septiembre de 2004 y el 31 de agosto de2005, ambos inclusive. La población estudiada es de 8.475 habitantes (datosdel Padrón Municipal actualizado en 2005) de los cuales 4.339 fueron mujeres.Mayores de 65 años eran 2.644 personas, de las cuales 853 son mayoresde 80 años. Se trata de una población dispersa, envejecida y en regresión conun índice de dependencia de 0,69. Se consideró caso de UPP todo aquel queconstaba como tal en el registro de la historia clínica de Atención Primaria,formato electrónico OMI-AP 6.0, de nuestro Equipo de Atención Primariapara el período estudiado. Resultados: Se estudiaron 33 UPP (32 pacientes)de las cuales 20 (60,6%) las padecía mujeres. La edad media fue de 88,21 ±8,98 años. La prevalencia cruda (PC) del período de UPP para el total de lapoblación fue del 0,39% y la razón de prevalencia mujer/varón fue de 1,48.Por grupos de edad en < 65 años la frecuencia absoluta (FA) de lesiones fuede una úlcera (3%) y la PC fue de 0,02%. En > 65 años la FA fue de 32 úlceras(97%) y la PC del 1,22%. En el colectivo de 80 y más años la FA fue de29 úlceras (88%) y la PC del 3,4%. El 69% de las personas con UPP estabaincluido en el servicio Atención Domiciliara y la PC del período de UPP para (..) (AU)

Introduction: The pressure ulcers (PU) represent an important problem of healthin all the welfare levels, but a volume of them need continued care from the community.The aim of our study is to know the period of prevalence of the pressureulcers and its distribution among other characteristics that we find in our BasicZone of Health. Material and methods: A cut was realized for retrospective periodof prevalencia in Piloña's BZH (Asturias) for the interval of time from01/09/2004 to 31/08/2005 both included. The population to study belongs to8475 inhabitants, (information of the Municipal poll updated in 2005) ofwhich 4339 were women. There were 2644 persons over 65 years old of which853 are over 80 years old. It is a dispersed, aged population and in regressionwith an index of dependence of 0,69. Was considered to be PU's case anyone thatshould consist in the record of the Clinical History of Primary care, an electronicformat OMI - AP 6.0, of our Team of Primary care for the studied period.Results: There were studied 33 PU (32 patients) of which 20 (60,60 %) womenwere suffering them. The middle ages were of 88,21 + - 9,98 years. The raw periodof prevalencia (RP) of PU for the whole of the population was 0,39 % and thereason of prevalencia woman / male was of 1,48. For groups of age in <65 yearsold the absolute frequency (AF of the wounds was of 1 (3 %) ulcers and the RPwas 0,02 %. In> 65 years old the FA was 32 (97 %) ulcers and the RP of 1,22%. In the group of 80 and more years old the AF was 29 (88 %) ulcers and theRP of 3,40 %. 69 % of the persons with PU was included in the service ofDomiciliary Attention and the RP of period of PU for the population included in (..) (AU)

Valoración del riesgo de desarrollar úlceras por presión: uso clínico en España y metaanálisis de la efectividad de las escalas / Pressure ulcers risk assessment: Clinical practice in Spain and a meta-analysis of scales effectiveness

Objetivos: 1) Actualizar el conocimiento sobre las escalas de valoración delriesgo de úlceras por presión (EVRUPP): validación, eficacia y predicción delriesgo. 2) Identificar los métodos usados para valorar el riesgo de desarrollar úlceras por presión en la práctica clínica real en España. Métodos: Para el primer objetivo, se ha realizado una revisión sistemática de la literatura con metaanálisis de los estudios de validación. La búsqueda se hizo sobre 14 bases de datos bibliográficas con los descriptores “úlceras por presión”, “úlceras por decúbito “, “valoración del riesgo” y sus combinaciones. Se realizó una valoracióncrítica de los estudios encontrados mediante la guía CASP. Se extrajeronlos datos de validación de cada escala y se realizó un metaanálisis para las escalas con 2 ó más estudios publicados. Para el segundo objetivo, se realizóuna encuesta entre enfermeras de comisiones de úlceras por presión. Resultados: Se han seleccionado 44 estudios con datos de validación de 17 escalas de valoración de riesgo de UPP. Sólo 5 escalas tienen 2 ó más estudios de validación: Braden, Cubbin-Jackson, EMINA, Norton y Waterlow. Las escalas con mayor capacidad predictiva son las de Braden (OR = 5,1) y EMINA (OR =7,14). El juicio clínico de las enfermeras, por sí sólo, no tiene suficiente capacidad de predicción de riesgo de UPP. En pacientes de cuidados intensivos, las escalas con mejor capacidad predictiva son: Cubbin-Jackson (OR = 6,63) y Braden (OR = 3,02). Una gran mayoría (67,3%) de las enfermeras encuestadas afirmaron valorar siempre el riesgo de UPP; el procedimiento más frecuente fue el uso de una EVRUPP (46,2%). Las EVRUPP usadas con mayor frecuencia en España son, en este orden: Braden, Norton, Norton modificado, Cubbin-Jackson y EMINA. El número y tipo de medidas preventivas utilizadas se asocia con el nivel de riesgo de UPP de los pacientes(AU)

Conclusiones: Las EVRUPP que tienen mejores indicadores de validación y capacidad predictiva son Braden, EMINA y Norton (original). El uso de una de estas escalas es superior al juicio clínico sólo en la predicción de riesgo de UPP. En cuidados intensivos, las escalas con mejor comportamiento son Braden yCubbin-Jackson. Entre las enfermeras españolas encuestadas, la valoracióndel riesgo de UPP es una práctica habitual y la mayoría utilizan las escalas de Braden o Norton(AU)

Aims: 1) To update knowledge about pressure ulcers risk assessment scales (RAS):validation, efficacy and risk prediction. 2) To identify the methods for pressure ulcersrisk assessment in actual clinical practice in Spain. Methods: For the first objective, asystematic review of validation studies with meta-analysis was carried out. The searchwas made on 14 bibliographic databases using “pressure ulcers”, “decubitus ulcers”,“risk assessment” and its combinations as descriptors. The CASP instrument was usedfor critical assessment of retrieved studies. Validation data was extracted for each scaleand a meta-analysis was performed for RAS with 2 or more published studies. For thesecond objective, a survey was carried out among nurses belonging to PU committees.Results: 44 studies with validation data on 17 RAS were selected. Only 5 RAS havetwo or more validation studies: Braden, Cubbin-Jackson, EMINA, Norton and Waterlow.The best predictive RAS were Braden (OR = 5.10) and EMINA (OR =7.14). Nurses’ clinical judgement alone is not a good PU risk predictor. For criticalcare patients the best predictive RAS were: Cubbin-Jackson (OR = 6.663) andBraden (OR = 3.02). Most of surveyed nurses (67.3%) stated that they assessed alwaysPU risk; usually (46.2%) using a RAS. Braden, Norton, Norton-modified,Cubbin-Jackson and EMINA, in this order, were the most used RAS in Spain. Numberand types of preventive measures were related with patients’ PU risk. Conclusions:Braden, EMINA and Norton were the RAS with best validation and predictionindicators. Anyone of theses scales perform better that clinical judgment alone inPU risk prediction. Braden and Cubbin-Jackson were the best RAS for critical care.Among the Spanish nurses surveyed PU risk assessment is a usual practice and most ofthem used Braden or Norton scales(AU)

Cuidados de la piel y prevención de úlceras por presión en el paciente encamado / Skin care and prevention of bed sores in bebridden patients

El proceso de envejecimiento y las agresiones medioambientales dejarán su impronta sobre el estado de la piel pudiendo comprometer alguna de sus funciones. La edad es un factor de riesgo para el desarrollo de úlceras por presión (upp), pero no el único ni el más importante; de ahí que debamos desarrollar programas de prevención dirigidos a todos los pacientes que pasen largos periodos de tiempo en sedestación o en cama. Los programas de prevención de upp deben basarse en la mejor evidencia disponible y abordar la valoración del riesgo de: padecer lesiones por presión; los cuidados específicos de la piel, el control de la incontinencia y el exceso de humedad; el manejo de la presión mediante el aumento de la movilidad y actividad del paciente, los cambios posturales y la utilización de superficies especiales para el manejo de la presión y dispositivos locales reductores de la misma; así como la atención a determinadas situaciones especiales. Todas estas intervenciones tienen que desarrollarse en un entorno de continuidad de cuidados entre instituciones y niveles asistenciales(AU)

The aging process and environmental aggressions will leave their imprints on the state of a person’s skin, possibly compromising some of its functions. Age is a risk factor for the development of bed sores, but not the only factor nor the most important one; therefore, we need to develop prevention programs directed to all patients who spend long periods of time sedentary or bedridden. Prevention programs for bed sores must be based on the best evidence available and include a risk evaluation on these factors: suffering a lesion due to pressure, specific skin treatment, incontinence control, excessive humidity, posture changes and the use of special surfaces to manage pressure during an increase in mobility or activity by the patient, local pressure reducing devices as well as paying attention to special situations. All of these care measures have to be developed based on a continuity of treatment among the institutions and caretakers involved with treating each patient(AU)

Infección y heridas crónicas. Estado actual del conocimiento / Infections and chronic wounds: current state of knowledge

La infección en la herida, tanto sea aguda como crónica es uno de los principales problemas y complicaciones que pueden acaecer, por lo que ha preocupado desde siempre. Si bien la evidencia publicada al respecto es muy escasa, en los últimos años se ha avanzado mucho en la determinación de algunos conceptos como TIME o preparación del lecho de la herida, o en la plata como elemento muy apropiado en algunos casos. Sobre todos estos temas profundiza el artículo que sigue, y que forma parte de los contenidos expuestos por los autores en el VI Simposio Nacional de Úlceras por Presión y Heridas Crónicas

An infection in a wound, whether serious or chronic, is one of the main problems and complications which can occur, a reason why infections have always caused worry. Although the published evidence regarding infections in wounds is very scarce, in recent years many advances have taken place in the determination of some concepts such as "TIME" or the preparation of the bed of a wound or in the use of silver as a very apt element in some situations. The following article goes into detail about these topics and forms part of the concept the authors presented in the VI National Symposium on Bed Sores and Chronic Wounds

[Skin care and prevention of bed sores in bedridden patients]. / Cuidados de la piel y prevención de úlceras por presión en el paciente encamado.

The aging process and environmental aggressions will leave their imprints on the state of a person's skin, possibly compromising some of its functions. Age is a risk factor for the development of bed sores, but not the only factor nor the most important one; therefore, we need to develop prevention programs directed to all patients who spend long periods of time sedentary or bedridden. Prevention programs for bed sores must be based on the best evidence available and include a risk evaluation on these factors: suffering a lesion due to pressure, specific skin treatment, incontinence control, excessive humidity posture changes and the use of special surfaces to manage pressure during an increase in mobility or activity by the patient, local pressure reducing devices as well as paying attention to special situations. All of these care measures have to be developed based on a continuity of treatment among the institutions and caretakers involved with treating each patient.

Desbridamiento de úlceras por presión y otras heridas crónicas / Debridement of pressure ulcers and other chronic wounds

No disponible

[Evaluation of the clinical effectiveness of the dressing PermaFoam for the treatment of chronic ulcers]. / Evaluación de la eficacia clínica del apósito PermaFoam en el tratamiento de úlceras crónicas.

INTRODUCTION: The presence on the market of new dressings to cure injuries makes it necessary for professionals to know their peculiarities for use in order to optimize their applications. The main objective of this study is to know the clinical behavior of a polymer sponge dressing having a porous grade called PermaFoam in the treatment of chronic ulcers caused by various etiologies. MATERIAL AND METHODS: The authors carried out an open observational, prospective and multi-centric study during the first semester in 2004 on patients who suffered from chronic lesions sent by the Primary Health Care Centers and Social-Sanitary Centers. The injuries under study showed states II, III or IV with moderate to high oozing and whose follow-up took place during a maximum of 8 weeks of treatment. RESULTS: 53 patients, 31 women and 22 men, formed part of this study; their average age was 76.1 (+/- 13.18). 56 lesions were treated; 26 bedsores, 11 venous sores, 10 mixed lesions and 9 other types, they had an average presence on the patient of 270 (+/- 684) days, the medium was 85 days and the mode 365 days. Complete cicatrisation occurred in 21 lesions (37.5%), the absolute average surface reduction was 13.42 cm2 squared (IC 95%: 7.39-19.45) and the relative mean reduction was 61.31% (IC 95%: 50.66-71.97) CONCLUSIONS: The use of the PermaFoam dressing permitted complete cicatrisation of an improvement in the final surface area in all lesions treated regardless of their etiology state, or length of presence. The use of this dressing has controlled the levels of oozing, diminished the number of changes of the dressing, respected the skin surrounding the lesion, and favored a reduction in the number of alterations in the surrounding area.

Evaluación de la eficacia clínica del apósito PermafoamTM en el tratamiento de úlceras crónicas / Evaluation of the clinical effectiveness of the dressing permafoam for the treatment of chronic ulcers

La presencia en el mercado de nuevos apósitos para la curación de heridas supone conocer sus peculiaridades de uso para optimizar su aplicación. El objetivo principal ha sido conocer el comportamiento clínico de un apósito de espuma polimérica con gradiente de poro (PermaFoamTM) en el tratamiento de úlceras crónicas de diferente etiología de estadios II, III, y IV y exudado moderado o alto mediante un estudio observacional abierto, prospectivo y multicéntrico realizado en el primer semestre del año 2004 con pacientes procedentes de Atención Primaria de Salud y centros socio-sanitarios. El seguimiento se ha realizado durante un máximo de ocho semanas de tratamiento. Se han incorporado al estudio 53 pacientes con una edad media de 76,1±13,18 años y 56 lesiones (26 UPP, 11 venosas, 10 mixtas y 9 de otras) con una antigüedad media de 270± 684 días, siendo la mediana de 85 días y la moda de 365 días. Han cicatrizado completamente 21 lesiones (37,5%), la reducción media absoluta de la superficie ha sido de 13,42 cm2 (IC95%: 7,39-19,45) y la reducción media relativa del 61,31% (IC95%: 50,66-71,97). Se ha conseguido la cicatrización completa o la mejora de la superficie final de todas las lesiones tratadas independientemente de la etiología, estadio o antigüedad. Se han controlado los niveles de exudado, disminuido los cambios de apósito, respetado la piel perilesional y favorecido la disminución del número de alteraciones de la perilesión

Introduction: The presence on the market of new dressings to cure injuries makes it necessary for professionals to know their peculiarities for use in order to optimize their applications. The main objective of this study is to know the clinical behavior of a polymer sponge dressing having a porous grade called PermaFoamTM in the treatment of chronic ulcers caused by various etiologies. Material and Methods: The authors carried out an open observational, prospective and multi-centric study during the first semester in 2004 on patients who suffered from chronic lesions sent by the Primary Health Care Centers and Social-Sanitary Centers. The injuries under study showed states II, III or IV with moderate to high oozing and whose follow-up took place during a maximum of 8 weeks of treatment. Results: 53 patients, 31 women and 22 men, formed part of this study; their average age was 76.1 (+- 13.18). 56 lesions were treated; 26 bedsores, 11 venous sores, 10 mixed lesions and 9 other types; they had an average presence on the patient of 270 (+-684) days, the medium was 85 days and the mode 365 days. Complete cicatrisation occurred in 21 lesions (37.5%); the absolute average surface reduction was 13.42 cm2 squared (IC 95%: 7.39-19.45) and the relative mean reduction was 61.31 % (IC95%: 50.66-71.97) Conclusions: The use of the PermaFoamTM dressing permitted complete cicatrisation of an improvement in the final surface area in all lesions treated regardless of their etiology, state, or length of presence. The use of this dressing has controlled the levels of oozing, diminished the number of changes of the dressing, respected the skin surrounding the lesion, and favored a reduction in the number of alterations in the surrounding area

[Society and chronic wounds. Thoughts to stop invisibility]. / Sociedad y heridas crónicas. Reflexiones para salir de la invisibilidad.

The authors presented a conference at the 5th National Symposium on Bedsores, or Decubitus Ulcers, and Chronic Injuries which dealt with all the dimensions related to this problem: epidemiological data, economic costs, social repercussions and possible alternative treatments; their goal was to raise the consciousness of nursing professionals so that they realize decubitus ulcers are a public health problem for which a solution exists if nursing professionals so desire.

Primer Estudio Nacional de Prevalencia de úlceras de Pierna en España. Estudio GNEAUPP-UIFC-Smith & Nephew 2002-2003. Epidemiología de las úlceras venosas, arteriales, mixtas y de pie diabético / First National Survey of Leg Ulcer Prevalence in Spain. GNEAUPP-UIFCSmith & Nephew 2002-2003. Epidemiology of venous, arterial, mixed and diabetic foot ulcers

Introducción: Las úlceras de pierna constituyen un importante problema de salud del que se desconoce el impacto epidemiológico en España. Por ello, desde el Grupo Nacional para el Estudio y Asesoramiento en úlceras por Presión y Heridas Crónicas (GNEAUPP) se planteó la realización del primer estudio nacional de prevalencia de úlceras de pierna. Pacientes, material y método: Para ello se elaboró un cuestionario postal que fue enviado a todos los miembros del GNEAUPP. También se administraron cuestionarios a través de la red de ventas de Smith & Nephew España. Cada profesional participante en el estudio informaba acerca de la realidad correspondiente a su lista de usuarios, en el caso de la Atención Primaria, o a su unidad de enfermería, en el caso de los centros hospitalarios y los centros socio-sanitarios. El estudio se realizó entre octubre y diciembre de 2002. Resultados: Dentro del plazo establecido se recibió un total de 353 cuestionarios, lo que significa una tasa de respuesta del 8,82 por ciento. Doscientos veintidós (un 62,8 por ciento de los cuestionarios) procedían de profesionales de Atención Primaria, 66 (un 18,7 por ciento) de profesionales de hospitales y los 65 restantes (18,4 por ciento) de centros socio-sanitarios. Los cuestionarios recibidos representaban a usuarios de centros de Atención Primaria con una prevalencia total de úlceras de pierna en mayores de 14 años del 0,165 por ciento. Un 0,09 por ciento en úlceras venosas, un 0,06 por ciento en mixtas, un 0,013 por ciento en arteriales. En el caso de las úlceras de pie diabético se determinó una prevalencia del 0,53 por ciento en los diabéticos. Discusión: Las úlceras de pierna en España constituyen un importante problema de salud cuyas dimensiones se agravan a medida que aumenta la edad de los pacientes. En el caso de las úlceras venosas destaca la muy escasa utilización de sistemas que permitan conseguir elevadas cifras de presión. Esta última circunstancia concuerda con la severidad de las lesiones así como con variables relacionadas con su atención (tiempo asistencial, consumo de recursos, etc.). Un abordaje integral del problema de las úlceras de pierna en España pasa por la definición de marcos de referencia interdisciplinares en los que los profesionales de la atención especializada (servicios de cirugía vascular) trabajen de manera conjunta e interrelacionada con la Atención Primaria y la atención socio-sanitaria (AU)

[Hydro-cellular dressing and silver sulfadiazine. Evaluation of its combination in the treatment of infected skin ulcers]. / Apósito hidro celular sulfadiacina argéntica. Evaluación de su combinación en el tratamiento de úlceras cutáneas infectadas.

The authors carried out an observational, descriptive, prospective and multi-centric study on 49 infected lesions which had clinical signs of local infection as well as infection from a positive sprinkler method culture. These lesions were treated over a three week period with argentic sulfadiazine and a semi-permeable dressing; afterward, treatment continued for seven weeks more based on cures in a humid environment by means of a semi-permeable dressing. After three weeks of treatment, two-thirds of these lesions showed a negative exudative culture, the number of strains present in the rest of the cultures diminished to at least half of those present at the start of this study. 15 of these lesions completely closed over during the period of study (mean = 46.73 +/- 22.74 days) and the absolute cicatrisation surface area varied, on average, from 23.46 square cm at the start to 12.39 square cm at the end of this study. In relation to the relative cicatrisation an average reduction of 76.5% (IC 95= (66.85% - 86.2%)) occurred. Variance analysis (ANOVA) over repeated measurements established significant differences (p = 0.001) having a tendency toward a lineal decrease. The authors also found statistically significant differences regarding the mean relative cicatrisation in the subgroup having lesions which stopped being infected during the third week of treatment when compared to those lesions which continued being infected. In conclusion, the authors state the topical treatment using argentic sulfadiazine in combination with a semi-permeable dressing has been favorable in treating two of every three lesions which stopped being infected in the third week of treatment, furthermore, this treatment produced a reduction in the size of these lesions, both in terms of the absolute mean cicatrisation area as in the relative mean cicatrisation area cicatrisation area for the lesion group in this study.