RESUMO
BACKGROUND: Chronic venous insufficiency, in its final stage can cause venous ulcers. Venous ulcers have a prevalence of 0.5 % to 0.8 % in the general population, and increases starting at 60 years of age. This condition often causes increased dependency in affected individuals, as well as a perceived reduced quality of life and family overload. Local Treating chronic venous ulcers has 2 components: topically healing the ulcer and controlling the venous insufficiency. There is evidence that compressive therapy favours the healing process of venous ulcers. The studies we have found suggest that the use of multilayer bandage systems is more effective than the use of bandages with a single component, these are mostly using in Spain. Multilayer compression bandages with 2 layers are equally effective in the healing process of chronic venous ulcers as 4-layer bandages and are better tolerated and preferenced by patients. More studies are needed to specifically compare the 2-layer bandages systems in the settings where these patients are usually treated. METHOD/DESIGN: Randomised, controlled, parallel, multicentre clinical trial, with 12 weeks of follow-up and blind evaluation of the response variable. The objective is to assess the efficacy of multilayer compression bandages (2 layers) compared with crepe bandages, based on the incidence of healed venous ulcers in individuals treated in primary care nursing consultations, at 12 weeks of follow-up. The study will include 216 individuals (108 per branch) with venous ulcers treated in primary care nursing consultations. The primary endpoint is complete healing at 12 weeks of follow-up. The secondary endpoints are the degree of healing (Resvech.2), quality of life (CCVUQ-e), adverse reactions related to the healing process. Prognosis and demographic variables are also recorder. Effectiveness analysis using Kaplan-Meier curves, a log-rank test and a Cox regression analysis. The analysis was performed by intention to treat. DISCUSSION: The study results can contribute to improving the care and quality of life of patients with venous ulcers, decreasing healing times and healthcare expenditure and contributing to the consistent treatment of these lesions. TRIAL REGISTRATION: This study has been recorded in the Clinical Trials.gov site with the code NCT02364921. 17 February 2015.
RESUMO
Estudio observacional, descriptivo, prospectivo y multicéntrico, sobre 49 lesiones infectadas, con signos clínicos de infección local y cultivo por hisopo positivo, tratadas durante tres semanas con sulfadiacina argéntica y un apósito semipermeable, continuando posteriormente durante siete semanas más con curas en ambiente húmedo a través del apósito semipermeable. A las tres semanas de tratamiento, dos terceras partes de las lesiones presentaban cultivo de exudado negativo, disminuyendo el número de cepas presentes en el resto de cultivos a menos de la mitad de las que partíamos al inicio. Quince de las lesiones cicatrizaron completamente durante el periodo de estudio (media = 46,73 ñ 22,74 días) y la superficie de cicatrización absoluta varía, en términos medios, de 23,46 cm2 al inicio hasta 12,39 cm2 al final del estudio. Con relación a la cicatrización relativa se produce una reducción media del 76,5 por ciento (IC95 = [66,85 por ciento-86,2 por ciento]). El análisis de la varianza (ANOVA) de medidas repetidas estableció diferencias significativas (p = 0,001) con una tendencia lineal decreciente. También hemos encontrado diferencias estadísticamente significativas respecto a la cicatrización relativa media del subgrupo de lesiones que dejaron de estar infectadas en la tercera semana frente a las que continuaron con la infección. Como conclusión decir que el tratamiento tópico con sulfadiacina argéntica más un apósito semipermeable ha favorecido que dos de cada tres lesiones dejen de estar infectadas a las tres semanas y que se produzca una reducción en el tamaño de las lesiones, tanto en lo referente a la cicatrización absoluta media como a la cicatrización relativa media del grupo de lesiones en estudio (AU)
