Assuntos
Compostos Benzidrílicos/efeitos adversos , Glucosídeos/efeitos adversos , Inibidores do Transportador 2 de Sódio-Glicose/efeitos adversos , Síndrome de Sweet/induzido quimicamente , Idoso , Compostos Benzidrílicos/administração & dosagem , Feminino , Glucosídeos/administração & dosagem , Humanos , Inibidores do Transportador 2 de Sódio-Glicose/administração & dosagem , Síndrome de Sweet/diagnósticoRESUMO
PURPOSE: To evaluate the suitability of treating atypical fibroxanthoma (AFX), an uncommon skin malignancy, with electronic brachytherapy. MATERIAL AND METHODS: From Feb 2013 to Sep 2014, we were referred a total of 8 cases of AFX in 7 patients, all involving the scalp. All of them were treated with electronic brachytherapy 50 Kev radiations (Xoft Axxent®, Fremont, California). All lesions received 40 Gy in two fractions per week with 5mm margins. RESULTS: At a median follow-up of 23.7 months, the local recurrence rate is 12.5%. The single lesion that failed was not debulked surgically prior to electronic brachytherapy. CONCLUSIONS: To our knowledge, this is the first report in the literature on the use of radiation therapy as curative primary treatment for AFX. No contraindication to the use of radiations is found in the literature, with surgery being the sole treatment for AFX noted. Our recurrence rate is 0% for debulked lesions. Risk of recurrence is mitigated with surgical debulking prior to brachytherapy. Electronic brachytherapy appears to be a safe and effective treatment for debulked AFX. Multiple excisions, skin grafting, and wound care can be avoided in elderly patients by the use of electronic brachytherapy.
RESUMO
Human injuries related to stingray attacks include deep puncture wounds, envenomation, and foreign body reactions owing to retained tail fragments. Herein we report a patient who sustained a stingray injury that produced a subcutaneous granulomatous dermatitis and panniculitis with necrobiosis and review the topic of stingray injuries.
Assuntos
Mordeduras e Picadas/complicações , Infecções por Bactérias Gram-Negativas/etiologia , Stenotrophomonas maltophilia , Ferimentos Penetrantes/complicações , Animais , Antibacterianos/uso terapêutico , Mordeduras e Picadas/terapia , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Granuloma/microbiologia , Humanos , Perna (Membro) , Levofloxacino/uso terapêutico , Masculino , Pessoa de Meia-Idade , Rajidae , Úlcera Cutânea/microbiologia , Ferimentos Penetrantes/terapiaRESUMO
Extensive skin loss and chronic wounds present a significant challenge to the clinician. With increased understanding of wound healing, cell biology, and cell culture techniques, various synthetic dressings and bioengineered skin substitutes have been developed. These materials can protect the wound, increase healing, provide overall wound coverage, and improve patient care. The ideal skin substitute may soon become a reality.
Assuntos
Bioengenharia/métodos , Transplante de Pele/métodos , Pele Artificial , Pele/lesões , Cicatrização/fisiologia , Materiais Biocompatíveis , Curativos Biológicos , Procedimentos Cirúrgicos Dermatológicos , Matriz Extracelular/transplante , Feminino , Humanos , Masculino , Medição de Risco , Úlcera Cutânea/cirurgia , Transplante Autólogo , Transplante Homólogo , Ferimentos e Lesões/cirurgiaRESUMO
Calcium alginate dressings facilitate the management of highly exudating wounds such as venous ulcers. To evaluate and compare the performance of two calcium alginate dressings in the management of venous ulcers, a prospective, randomized, controlled clinical study was conducted among 19 outpatients at two wound clinics in California. Ten patients (53%) were treated with Alginate A and nine patients (47%) with Alginate B. Dressings were changed weekly and patients were followed for a maximum of 6 weeks or until the venous ulcer no longer required the use of an alginate dressing. At each dressing change, the wound was assessed and dressing performance evaluated. Absorbency of exudate, patient comfort during wear, ease of removal, adherence to wound bed, dressing residue following initial irrigation, patient comfort during removal, ease of application, and conformability were assessed. Patients using Alginate A experienced significantly less foul odor (P = 0.02) and less denuded skin (P = 0.04) than Alginate B at follow-up wound assessments. With the exception of conformability, Alginate A was rated significantly better than Alginate B (P less than or equal to 0.05) in all dressing performance assessments. No significant healing differences were observed. As the different performance characteristics of various calcium alginate dressings become more obvious in clinical practice, further study is warranted to determine their optimal effectiveness.
Assuntos
Alginatos/uso terapêutico , Coloides/uso terapêutico , Ácido Glucurônico/uso terapêutico , Ácidos Hexurônicos/uso terapêutico , Úlcera Varicosa/enfermagem , Idoso , Idoso de 80 Anos ou mais , Curativos Hidrocoloides , Pesquisa em Enfermagem Clínica , Exsudatos e Transudatos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação em Enfermagem , Odorantes , Higiene da Pele/instrumentação , Higiene da Pele/enfermagem , Fatores de Tempo , Resultado do Tratamento , Úlcera Varicosa/diagnóstico , CicatrizaçãoRESUMO
Increased research and understanding of acute and chronic wounds has led to the development of new therapies to stimulate and improve healing of difficult wounds. These include various growth factors, animal-derived wound coverings, and bioengineered human skin tissue.
Assuntos
Transplante de Pele/métodos , Úlcera Cutânea/terapia , Pele/lesões , Cicatrização , Doença Crônica , Pé Diabético/terapia , HumanosRESUMO
A prospective, randomized study was conducted to compare the performance of 2 hydrocolloid dressings, hydrocolloid A and hydrocolloid B, in the treatment of venous insufficiency ulcers. A total of 31 patients were enrolled at 2 clinical sites. Complete wound closure (100% epithelialization) was observed in 59% of the patients treated with hydrocolloid A, compared with complete wound closure in 15% of the patients in the hydrocolloid B group (P Assuntos
Coloides/normas
, Coloides/uso terapêutico
, Úlcera Varicosa/terapia
, Idoso
, Idoso de 80 Anos ou mais
, Curativos Hidrocoloides
, Feminino
, Humanos
, Masculino
, Pessoa de Meia-Idade
, Avaliação em Enfermagem
, Satisfação do Paciente
, Seleção de Pacientes
, Estudos Prospectivos
, Resultado do Tratamento
, Úlcera Varicosa/psicologia
, Cicatrização