[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.

Preventing pressure ulcers on the heel: a Canadian cost study.

An adaptation of a clinical study of 130 patients at risk of developing a pressure ulcer on the heels was performed using Canadian costs. The aim of the study was to compare the cost effectiveness of a specially shaped hydrocellular dressing (Allevyn Heel) versus that of a protective heel bandage (Soffban and gauze) in pressure ulcer prevention over an 8-week period.

[The usefulness of protective creams on fragile and aged skin]. / Utilidad de las cremas protectoras pieles frágiles y envejecidas.

The ADDERMIS protective cream has these properties: it prevents skin maceration, exercises a regenerative effect, has bacteriostatic and bactericide activity, possesses a noted anti-inflammatory effect and reduces the risk of mycotic infections. Its application is indicated for use in cases of: skin lesions, such as bed sores or leg ulcers, which require the use of a barrier product; dermatitis lesions in zones of skin folds or due to diaper use; to prevent friction zones; fragile skin; peeling, zones where cracks in the skin appear...and to use for cases of incontinence when diapers are required.

[A device for feminine urinary incontinence]. / Dispositivo para la incontinencia urinaria femenina.

Urinary incontinence is grave health problem which causes severe repercussions in the quality of life of those patients which suffer it and it is a serious risk factor in the development of pressure sores or ulcers. Urinary collecting sacks provide an option to deal with this problem even though up to present time these collecting sacks were only available for male patients. In this instrument usage article, the authors introduce a new device, VILUC, commercialized by Lauclar Laboratories in Spain, for feminine urinary incontinence as a possible alternate treatment for women affected by this problem who are incapable of maintaining a progressive and complete vesicle reeducation. The authors inform about how to install this device, its different components, how to care for it and the indications for its use in females who suffer from incontinence.

[Combined polyurethane foam and hydrogel dressing. Outcome in lesions of diverse etiology]. / Apósito combinado de espuma de poliuretano e hidrogel (Indafoam). Comportamiento ante lesiones de diferente etiología.

The authors present an observational evaluation on the effectiveness of a dressing included in the Indafoam brand for treatment of skin lesions due to different etiology which have an acute or chronic diagnosis; the authors include some very valuable information for professionals who use combined polyurethane foam and hydrogel dressings in their daily practice. Due to their composition, these dressings may be considered combined dressings having only one structure which maintains a stable temperature at the lesion site; these dressings have a high absorption capacity which prevents maceration of the skin surrounding lesions and protects lesions from contamination by exogenous germs.

[Venous ulcers. Multilayer compression system or crepe bandage? Comparative study on effectiveness, cost, and impact on quality of life]. / Ulceras venosas. Sistema de compresión multicapa o venda de crepé? Estudio comparativo sobre la efectividad, coste e impacto en la calidad de vida.

Treatment for varicose ulcers is based on treating an ulcer as a chronic injury and its primary cause, hypertension in the veins, by means of a system of decreasing and sustained high compression. In Spain patients suffering from varicose ulcers are treated mainly with systems based on the use of crepe bandages which have a low compression effectiveness. In order to bring to light information on this important facet of health care and to generate evidence on this topic, the authors present a comparative study of a standard therapy method utilizing compression on patients suffering from varicose ulcers in Spain, a crepe bandage, against the use of a Profore multi-layer system. The authors studied 30 varicose ulcers on 24 patients who met the criteria to be included in this study; 17 of these, 70.8%, in women and 7, 29.2%, in men. The average treatment period of these lesions with crepe bandages on these lesions was 1045 +/- 2370 (DS) days (mean of 120). At the start of treatment with the multi-layer system, the average lesion surface area reached 10.64 +/- 9.45 (DS) cm2 (mean 7.28). After treatment with this multi-layer system, all these lesions cicatrized entirely. In order for this to happen, an average of 43.73 +/- 27.38 (DS), (mean 34) was required. Based on our results, we can state that the use of the multi-layer system in this study compared to a crepe bandage allowed for the reduction in cicatrisation time, in the number of bandage changes, in the number of visits, in the professional time needed, and reduced by a factor of 20 the cost of the material involved.

[Topical administration of an hyperoxygenated fatty acid compound. Preventive and curative effects on pressure ulcer]. / Aplicación tópica de un compuesto de ácidos grasos hiperoxigenados. Efectos preventivos y curativos en úlceras por presión.

INTRODUCTION: Hyper-oxygenized acidic fats are a very useful topical use product for preventing pressure ulcers and to treat stage I pressure ulcers. Mepentol is a hyper-oxygenized acidic fats product (linoleic acid, gamma linolenic acid, oleic acid, palmitic acid, stearic acid, palmitoleic acid, arachidonic acid and eicosenoic acid) with extracts of Equisetum Avrense and Hypericum Perforatum. It works in three main facets: improve as is possible the epidermis's resistance, repair the damage to the epidermis produced by a prolonged pressure, and restore capillary circulation and counter arrest the effect of oxygen radicals produced during reactive hyperemia which are caused by periods of prolonged pressure. The exclusive formula, based on hyperoxygenized acidic fats and the above referred plant extracts, gives to Mepentol a demonstrated effectiveness, and also special features, like speed of action, great speed of topical absorption and a peculiar fragrance. PATIENTS, MATERIAL AND METHOD: In order to evaluate the tissue level effect of Mepentol, we carried out an experimental research project based on two different objectives: determine the effect at capillary circulation level in heels of healthy volunteers and in patients under risk of developing pressure ulcers, a well as in the treatment of stage I pressure ulcers in patients under high risk of developing pressure ulcers. To do so, the authors determined the capillary blood flow by means of a Doppler laser flow meter. RESULTS: After the application of a hyper-oxygenized acidic fats product, the authors noted an increase of 122.29 +/- 68.74% in flow units related to base values. The authors also observed an increase in microcirculation in heels of patients under high risk of developing pressure ulcers, as well as those who suffer from stage I lesions. These increases remain constant over long periods of time. COMMENTARY: Based on the tests carried out, Mepentol shows an undoubtable effect which improves local circulation in zones under risk of developing pressure ulcers as well as for stage I lesions; this supports the use of this product as a preventive measure against pressure ulcers and as treatment for stage I lesions.

[Collagen powder dressing in the treatment of pressure ulcer. Multicenter comparative study assessing effectiveness and cost]. / Apósito de colágeno en polvo en el tratamiento de úlceras por presión. Estudio comparativo multicéntrico evaluando efectividad y coste.

INTRODUCTION: Pressure ulcers are lesions that usually occur to people to whom the social and economical repercusions are quite serious. Although present treatments with moisture cure dressings are efficient and have a lot of advantages than traditional cure, they do not solve the problem in a significant group of patients, whose ulcers do not heal or need a much longer treatment. Collagen dressings represent an important improvement, since collagen is a key element for wound scarring. PATIENTS, MATERIAL AND METHODS: We conducted a prospective, comparative and multicentrical study with Catrix, using as a control the same lesion. We compared pressure ulcers that had been previously treated on an average of 6 months without success with Catrix treatment within 7 weeks. We compared different variables, efficacy, opinion on the use of Catrix and economic cost. RESULTS: We included 104 pressure ulcers that fulfilled the inclusion requirements in the study. Three of them were excluded from the efficiency analysis because of a lack of data since they passed away 7 weeks later. We performed a statistical analysis on all the ulcers (GT) and we also analyzed the pressure ulcer subgroup (SG) included in this study because of a deterioration or a stagnation of the lesion despite previous treatments. Seven weeks after the beginning of the treatment with Catrix the healing or the stage change was observed in 73.3% of lesions of GT group and in 77.8% of lesions of SG group (p < 0.0001). The average material cost and nursing cost from all the lesions that scarred within 7 weeks (n = 39) with previous treatment was 17.234, 10 euros and 10.920 euros with Catrix. The average material cost per lesion used in the previous treatments was 441.9 euros and 280 euros with Catrix. DISCUSSION: These results prove that the treatment with Catrix significantly reduces the treatment length and therefore leads to a reduction of the sanitary cost in this kind of patients. Adding Catrix to the pressure ulcers treatment helps to increase significantly the scarring and improvement percentage of those pressure ulcers that do not respond to other treatments. It helps to improve patient's quality of life, and to reduce the costs of the treatment.

[Heel pressure ulcers. Comparative study between heel protective bandage and hydrocellular dressing with special form for the heel]. / Ulceras por presión en los talones. Estudio comparativo entre el vendaje protector de talones y un apósito hidrocelular con forma especial para los talones.

INTRODUCTION: The heels, together with the sacra area, are one of the most frequent spots where pressure sores appear here in Spain. Any preventive measure against pressure sores on heels needs be oriented towards two main objectives: effective relief of pressure and its compatibility with localized care and skin inspection in order to detect lesions early on at least once a day. PATIENTS, MATERIALS AND METHODS: The authors planned a comparative, multi-centered, open, labeled and controlled study in which patients were assigned to two groups receiving these treatments: one received traditional preventive pressure sore treatment and a protective bandage on their heels while the other used a special Allevyn Heel hydrocellular dressing to protect their heels. The patients took part in this study over an eight week period. The response variable used to determine the effectiveness of the preventive measure in this study was the appearance of pressure sores. RESULTS: At the beginning, 130 patients were included in this study, 65 in each one of the treatment groups. In the bandage group, 50 patients finished this study while 61 in the dressing group finished this study. The appearance of pressure sores in the protective bandage group occurred in 44% of the patients, 22 out of 50, while in the dressing group, the occurrence rate was 3.3%, 2 out of 61 patients with a value of "ji" squared p < 0.001. The risk factor to develop a pressure sore brought us a value of relative risk of 13.42 (IC 95%: 3.31-54.3) in the group wearing the protective bandage compared to the group wearing the dressing. COMMENTS: The results of this study allow us to accept as valid the alternate hypothesis that there exist significant statistical differences between both treatment methods in favor of the Allevyn Heel dressing instead of the protective heel bandage. The use of this dressing, even though it is more expensive a priori than the protective bandage, in terms of unit cost for the product, has proven to be more effective in preventing pressure sores, and cheaper than the protective bandage if we bear in mind these combination of variables: time of usage, application and removal.