Evaluación clínica abierta multicéntrica no aleatorizada y prospectiva de la efectividad de una emulsión a base de ácidos grasos hiperoxigenados, Aloe barbadensis y Mimosa tenuiflora (Mepentol® Leche) en diferentes tipos de pacientes con riesgo de ulceración / Multicentric prospective non randomized open clinical evaluation of the efficacy of an emulsion based on hyperoxigenated fatty acids Aloe barbadensis and Mimosa tenuiflora (Mepentol® Leche) in different types of patients with risk of ulceration

Las úlceras de la extremidad inferior suponen un grave problema sanitario que afecta a un gran número de pacientes, constituyendo por ello un gran reto de trabajo para los profesionales de la salud. Los ácidos grasos hiperoxigenados (AGHO) han demostrado tener eficacia en la prevención de este tipo de úlceras. Gracias a los buenos resultados obtenidos en un estudio previo, nos planteamos seguir evaluando la efectividad del producto Mepentol® Leche, una emulsión a base de ácidos grasos hiperoxigenados, Aloe barbadensis y Mimosa tenuiflora, en el cuidado de la piel y alivio de los síntomas en pacientes con este problema, pero ampliando el tamaño de la muestra y centrándonos en pacientes diabéticos junto con otras enfermedades concomitantes. Además, en este estudio se ha implicado a profesionales de enfermería de seis provincias: Almería, Alicante, Granada, Sevilla, Málaga y Ceuta. De nuevo con este estudio, realizado en un total de 2.145 pacientes, hemos demostrado que ningún paciente ha ulcerado durante el tiempo de seguimiento y tratamiento con Mepentol® Leche y que su aplicación sistemática mejora claramente los síntomas previos a la aparición de úlceras, evitando la sequedad cutánea, reduciendo el prurito, escozor, dolor y eccema, y devolviendo la piel de estos pacientes a su coloración normal (AU)

The lower extremity wounds are a serious health problem that affects a large number of patients, thereby assuming a great challenge to work for health professionals. Hyperoxygenated fatty acids (AGHO), have demonstrated efficacy in the prevention of this type of ulcers. Thanks to the good results obtained in a previous study, we plan to continue evaluating the effectiveness of Mepentol® Leche, an emulsion-based hyper-oxygenated fatty acids, Aloe barbadensis and Mimosa tenuiflora in skin care and relief of symptoms, in patients with this problem, but expanding the sample size and focusing on diabetic patients with concomitant diseases. Also in this study have been involving nurses in six provinces: Almería, Alicante, Granada, Seville, Malaga and Ceuta. Again with this study, a total of 2,145 patients, we demonstrated that no patient has ulcerated during the follow-up and treatment with Mepentol® Leche and its systematic application significantly improves the symptoms before the onset of ulcers, preventing dryness skin, reducing itching, burning, pain and eczema, and returning the skin of these patients to their normal color (AU)

Healthcare beliefs of Indian patients living with leg and foot ulcers.

This article presents the results of a previously unexplored aspect of qualitative leg ulcer research. The study has examined the lived experience and cultural illness explanations of a sample of British-Indian patients living with leg and foot ulceration. Semi-structured interviews were used to collect data from 16 Indian patients drawn from leg ulcer clinics and district nursing lists in Ealing Primary Care Trust and Hounslow Primary Care Trust. Eight respondents had venous ulceration, seven were diabetic and had ulcers of arterial aetiology, and one had ulceration due to lymphoedema. Popular perceptions of the cause of leg ulceration were influenced by the humoral theories of balance and imbalance. Other explanations included poor circulation, lowered immunity, bad blood, being cursed and doing something wrong in a past life or this life.

The Leg Club model in the Australian context.

Leg Clubs are an innovative approach to the holistic treatment of leg ulcers. They are run in a social context by community nurses who deliver ongoing support and treatment for a wide spectrum of lower limb pathology. This article looks at how the Leg Club model has been established in Australia.

Motivational interviewing with clients with chronic leg ulceration.

On order to meet the holistic needs of the client with chronic illness, the nurse is required to adopt many different approaches to care. This article will explore one client-centred counselling approach that can be used by community practitioners to address behavioural change and improve concordance. The techniques are illustrated with an example of where motivational interviewing has been used to great success--in the 'Look After Your Legs' (LAYL) programme undertaken by West Gloucestershire primary care trust. Interventions such as motivational interviewing have the potential to empower clients and so enhance care delivery.

Thalassemia intermedia: revisited.

Thalassemia intermedia encompasses a wide clinical spectrum of beta-thalassemia phenotypes. Some thalassemia intermedia patients are asymptomatic until adult life, whereas others are symptomatic from as young as 2 years of age. A number of clinical complications commonly associated with thalassemia intermedia are rarely seen in thalassemia major, including extramedullary hematopoiesis, leg ulcers, gallstones and thrombophilia. Prevention of these complications, possibly with blood transfusion therapy, is ideal since they may be difficult to manage. Currently, many patients with thalassemia intermedia receive only occasional or no transfusions, since they are able to maintain hemoglobin levels between 7-9 g/dl; the risk of iron overload, necessitating adequate chelation therapy, is also a contributing factor. At present, there are no clear guidelines for initiating and maintaining transfusions in thalassemia intermedia for the prevention or treatment of complications. Here, we review the major clinical complications in thalassemia intermedia and suggest some therapeutic strategies based on retrospective clinical observations.

Static magnets prevent leg ulcer recurrence: savings for the NHS?

The objectives of this survey were to examine the effectiveness of a static magnet device--4UlcerCare--in preventing recurrence of leg ulcers after healing. Two hundred and eighty-nine randomly selected purchasers of 4UlcerCare were telephoned and asked to complete a short questionnaire. Our focus was on the 211 respondents who had ulcers that had already healed. The average age of subjects was 70.6 years and sex distribution was 55% female to 45% male. Mean duration of leg ulcers before using 4UlcerCare was 4.4 years. Sixty-five per cent of those surveyed had had ulcer recurrence before using 4UlcerCare, with a mean of 2.41 episodes of ulceration. This was close to the expected recurrence rate in the population of 67%. Using 4UlcerCare daily, these respondents' ulcers had healed within an average of 3.57 months. The survey took place an average of 19.94 months after healing. The manufacturers advise wearing 4UlcerCare daily post-healing, and of those respondents that had, none had suffered any recurrence. Extrapolating these results across the health economy, an estimate has been made of a potential pound153.7 million per year saving on leg ulcer care to the NHS.

Delivering wound management in a social setting.

As a District Nursing Sister based at a small village surgery, this is a personal account of the author's experiences introducing a new approach for delivering holistic wound management to patients. It deals with the practical and emotional challenges of overcoming barriers to change and forging new working relationships, both within the nursing team and with the patients and wider community. With the encouragement and support of Ellie Lindsay, originator of the Lindsay Leg Club model, Combs Ford Leg Club was set up in 2000 to provide leg ulcer management in an empowered and stigma-free environment. Through the commitment and efforts of nurses, volunteers and patients working together, difficulties and resistance have been confronted and overcome, and Combs Ford Leg Club today is a thriving and vibrant resource, treating, supporting and educating those experiencing leg ulcers or other leg related conditions.

The Lindsay Leg Club Model: a model for evidence-based leg ulcer management.

Leg Club is a unique model of community-based leg ulcer care. By providing nursing care in a non-medical, social environment, the model has several benefits: it removes the stigma associated with leg ulcers and helps isolated older people reintegrate into their communities, which in turn improves concordance and has a positive impact on healing and recurrence rates. In an atmosphere of de-stigmatisation, empathy and peer support, positive health beliefs are promoted and patients take ownership of their treatment. The Leg Club model creates a framework in which nurses, patients and local community can collaborate as partners in the provision of holistic care. The model also provides an environment for appropriate supportive education, advice and information.

Hyperbaric oxygen initial experience with a new treatment modality in Barbados - abstract

The Decompression Chamber of the Barbados Defence Force has been used since February, 1987 for Hyperbaric Oxygen (HBO) treatment of accepted medical and surgical conditions. The treatments are administered in the chamber and are carried out at various pressures as recommended by the HBO sub-committee of the Undersea and Hyperbaric Medical Society. Thirty patients have been treated and the epidemiological details and results are reported. Improved - 25 patients, 84 percent; No change - 3 patients, 10 percent; Deteriorated - 1 patient, 3 percent; Discountinued treatment - 1 patient, 3 percent. Improvement was judged by clinical, radiological and bacteriological criteria. The results indicate that, whilst not a complete form of therapy by itself, HBO is a valuable adjunctive modality of treatment in speeding the resolution and healing of various conditions, e.g., chronic osteomyelitis, chronic leg ulcers and burns. This is in agreement with previously published studies. Barbados is fortunate in being able to provide this valuable form of therapy. HBO facilities are available in other Caribbean areas and greater use should be made of this treatment modality (AU)