[Microbiology of pressure and vascular ulcer infections]. / Microbiología de las infecciones de úlceras por presión y de origen vascular.

INTRODUCTION: Pressure ulcer (PU) infection is a significant clinical problem in many elderly patients. MATERIAL AND METHODS: To determine the microbiology of PU and vascular ulcer (VU) infections by conducting a cross-sectional study of outpatients treated in a chronic wounds unit over an 18 month period. RESULTS: Sixty six patients with PU infection and 159 patients with an infected VU were identified. The PUs were located below the knee in 36 patients (52%). Patients with pressure ulcers had a higher proportion of institutionalization, cognitive impairment, inability to walk, and sphincter incontinence. There was a greater number of infections caused by Enterobacteriaceae (52%, P=.002) and fewer S. aureus infections (24%, P<.001) in patients with a PU compared to those with those with a VU. Forty-one percent of S. aureus strains isolated in all the patients were resistant to methicillin (MRSA). The proportion of Enterobacteriaceae infections was similar in patients with infection of pelvic girdle PU and in those located below the knee. CONCLUSIONS: PU patients suffer a higher rate of infection by enterobacteria. The most common pathogen in UV infections is S. aureus. The proportion of MRSA infection in patients with chronic wounds is high. The microbiology of the infection in the pelvic girdle PU is similar to those located below the knee.

[Clinical cases about the therapeutic use of debriding dressing hidrodetersive polyacrylate fibers with TLC and foam dressings TLC-NOSF polyurethane in chronic wounds]. / Casos clínicos sobre el uso terapéutico en heridas crónicas de: Apósitos desbridantes de fibras hidrodetersivas de poliacrilato con TLC. Apósitos de espuma de poliuretano con TLC-NOSF.

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.

[Cost-effectiveness of a TLC-NOSF polyurethane foam dressing]. / Coste-Efectividad de un apósito de espuma de poliuretano con TLC-NOSF.

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.

[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.

[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.

[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.

[Hyaluronic acid: a new trend to cure skin injuries an observational study]. / Acido hialurónico, una nueva tendencia en la curación de heridas cutáneas.

The authors made an observational study to evaluate the efficiency of Jaloplast (hyaluronic acid AH) as treatment for skin injuries having different etiologies. The authors highlight its results regarding cicatrisation (69%) and the improvement of lesions (15.38%). Moreover 80% of lesions have cicatrized in a time less than 11 weeks, without showing any adverse effects nor secondary effects. From these observations, the authors deduce the importance of this molecule formed by glucosamine glycane (hyalyuronate) at the organic level in general and specifically in the process of cicatrisation.

[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.

[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.