Infection control in long term care institutions for the elderly: A reflection document on the situation in Spain.

A progressively increasing percentage of the elderly live during the last years of their lives in nursing homes. Although these institutions are intended to mimic life at home as much as possible, they have characteristics that make them quite similar to a "nosocomiun", i.e. an establishment for the treatment of the sick. The very coexistence among the elderly, the fact of sharing caregivers and the very significant exposure to third parties, together with the frequent predisposing diseases to infection in this population, make infection frequent among residents and also easily transmissible. This leads us to ask what can be done to prevent infection in this environment and more specifically what is the state of the art of the matter in a Western European nation such as ours. The Board of Trustees of the Health Sciences Foundation has asked itself a series of questions on the subject of infection prevention in Nursing Homes, the structure of procedures, the legislation available, compliance with the measures indicated, the best indicators of the processes and therefore, the need to promote in Spain a document of recommendations to avoid infections in this poplation whose morbidity and mortality need not be highlighted. To this end, a multidisciplinary group of experts in different aspects of this problem has been convened and asked the proposed questions. The questions were discussed by the group as a whole and led to a series of conclusions agreed upon by the participants. The results of the meeting are reported below.

[Study EMSEI-2006]. / Estudio EMSEI-2006.

To evaluate the properties of the Indafoam hydro-regulating dressing, the authors planned a study on the clinical application these materials have in relation to the evolution of injuries and their etiology at the same time evaluating the behavior of these products in diverse aspects related to the healing processes. This study is an open, multi-centric prospective observational study having repeated measurements in a group of patients who suffered from injuries having diverse etiology

Effects of an activated charcoal silver dressing on chronic wounds with no clinical signs of infection.

OBJECTIVE: This exploratory, clinical study aimed to explore the effect of an activated charcoal silver dressing (intervention) with cleansing and debridement (control) in reducing the level of bacteria in chronic wounds with no clinical signs of local infection. METHOD: Patients were randomly assigned to the intervention or control group and monitored for two weeks. Samples for bacterial status and cultivation were obtained by surface smear (spatula) and percutaneous aspiration first at baseline and then after 15 days of treatment. Sixty-seven lesions were included in the intervention group and 58 in the control group. RESULTS: At baseline, in the intervention group 71.6% of the wounds were contaminated, 7.5% had a high level of bacteria and 20.9% were infected. In the control group at baseline 65.5% of the wounds were contaminated, 6.9% colonised, 6.9% had a high level of bacteria and 20.7% were infected. There were no colonised wounds in the intervention group. After two weeks, combining totals of contaminated, colonised, a high level of bacteria and infection for each group, 85.1% (57/67) of the wounds in the intervention group had a positive bacterial level management (that is, a reduction in the number of bacteria in the wound) compared with 62.1% (36/58) in the control group (p=0.003). CONCLUSION: Activated charcoal dressings that contain silver control infection and reduce healing times, eliminating bacterial barriers.

[Advertising and health education]. / Publicidad y educación sanitaria.

Health education and advertising have a common aim: to modify human behaviour. Health education tries to induce healthy behaviours. In some occasions Publicity proposes risky behaviours. Ads appearing during a two-month period in magazines of the largest circulation in Spain are analyzed here. A total of 1,726 ads which could have a negative influence on health either because of the product or service offered or for the use of health as a persuasive argument in their text, are considered. The magazines Hola and Lecturas had the highest ratio ads/magazine. Spirits, food and drugs were the most frequently advertised products. And more than 50% of the ads used health and welfare as argument for better selling. Health educators should know and teach the critical analysis of publicity, and use advertisements as a teaching tool to enable people to see through misleading advertising.

[Treatment of chronic skin ulcers in the elderly. Descriptive study on the use of a hydrocellular dressing]. / Tratamiento de las úlceras cutáneas crónicas en el anciano. Estudio descriptivo sobre la utilización de un apósito hidrocelular.

INTRODUCTION: There are a wide variety of products to use to treat skin ulcers. Knowing the correct usage and application of each product aids in choosing the most appropriate for elderly patients. OBJECTIVE: To evaluate the use of a hydrocellular dressing and its clinical test results. METHODS AND MATERIALS: This descriptive, prospective study begun on 6/X/97 and finished on 1/XII/97 included all the moderate or severely oozing skin ulcers, those classified as stage II, III, or IV, among the elderly at a home for them. This study discarded ulcers which barely bled; however, regional or systemic infection-related ulcers were included. RESULTS: 20 skin ulcers were analyzed. At the start, these covered an average surface are of 11.76 cm2 (DT 14.44), with an average severity index of 23.79 (DT 35.81). At the end of this study, the average area was 7.92 cm2 (DT 12.11) and the average severity index was 14,60 (DT 27,18). 7 ulcers, or 35%, had epithelized completely. During the 768 day length of this study, 290 dressings were applied. 100% of these were evaluated as easy to apply and remove; patients indicated an absence of pain; no dressing was disjoined when changed and therefore left no residue in the injured area. CONCLUSIONS: The dressing studied is effective for local treatment of all types of skin ulcers, regardless of their condition; this dressing reduces the number of changes necessary, especially in curing oozing ulcers; and finally, this dressing is easy to apply and aids in keeping the patient in good spirits.

[The use of collagen in the cicatrization of wounds]. / El uso del colágeno en la cicatrización de las heridas.

The authors review the use of collagen in the cicatrization of wounds, analyzing what this process consists of and what its regeneration and reparation phases are. The authors also summarize some fundamental biological aspects collagen has, their functions in hemostasia and in cicatrization; they develop the use of heterologous collagen in the cicatrization process. Expressive illustrations and a selection of bibliographical references accompany this article.