Comparison of the efficacy of novel non-invasive mechanical debridement methods - sterile sponge, monofilament fibre cloth and non-woven cloth impregnated with sodium hyaluronate and phospholipids in relation to traditional sterile gauze.

Introduction: According to the European guidelines, the first step for local wound preparation is debridement, which stands for removing of devitalized tissue such as slough or necrosis. There are numerous types of debridement, but not all of them can be performed by non-specialists. Most of the research investigating efficiency of novel debridement products are carried out or funded by pharmaceutical companies. Aim: To compare the efficacy of relative necrotic tissue removal after 30 days on patients subjected to debridement with sterile sponge, monofilament fibre cloth, non-woven cloth impregnated with sodium hyaluronate and phospholipids and traditional sterile gauze. Material and methods: By use of photographic documentation at 7 days' intervals and planimetry methods, the total wound surface area and sloughy tissue area was measured. Results: Results have shown that monofilament cloth was the most effective, removing on average 63.44 ±32.91% of necrotic tissue after the first procedure and 74.65 ±30.95% within 30 days of application, in comparison to the sterile gauze group that had on average only 23.53 ±19.16% of necrotic tissue removed at day 0 and 44.95 ±31.47% removed at day 30. Moreover, patients using all 3 products tested reported higher satisfaction with that treatment than those treated with gauze. Conclusions: Results imply that all those methods could be considered as they are well accepted by patients and cause less pain during the procedure, which is essential for good compliance and complete resolution of the lesions.

Wound debridement products and techniques: clinical examples and literature review.

The term "debridement" stands for the removal of necrotic material, scabs, devitalized tissues, dried serous fluid, infected tissues, biofilm, stratified epidermis, pus, hematomas, foreign bodies, bone fragments and other impurities whose presence delays wound healing. It is an inseparable element of wound healing therapy. Properly performed debridement leads to improvement of microcirculation in the wound, reduction in inflammation and lowering of the level of metalloproteinases, stimulation of wound edges and epidermis, reduction in unpleasant odour and reduction in the risk of infection and improvement of the patient's quality of life. There are many debridement techniques approved by the European Wound Management Association. The selection of the most appropriate method depends on many factors such as tissue type, presence of biofilm, depth and location of the wound, underlying cause (venous, arterial), skills of the person performing the debridement and the preferences of the patient him/herself. In our work we present not only a systematic review of most of the debridement techniques used nowadays, but also our clinical cases showing results of those different techniques.

Chronic venous disorders - common and yet unknown - a study of public awareness and primary symptoms in a selected group of patients.

INTRODUCTION: Chronic venous disorder (CVD) is thoroughly spread across the globe. It affects about 40% of the Polish population. European guidelines underline that there are no data on the percentage of people who have first symptoms of chronic venous insufficiency. AIM: To determine the frequency and pattern of first symptoms and examine public knowledge on CVD in a selected group of patients. MATERIAL AND METHODS: Our study group consists of 175 patients who took part in preventive assessment of nevi. To determine public knowledge on CVD, we constructed a questionnaire, which consisted of two sections: one part to be completed by the patient and the other by the doctor. RESULTS: The median age was 41 years. From 175 patients, about 40% claimed that they do not recognize CVD. Only about half of them knew how to diagnose and treat it. Most of them associate telangiectasia and varicose veins as primary signs and symptoms of CVD. CONCLUSIONS: Despite the fact that the disease itself is common, the level of public awareness is astonishingly low. Majority of patients tested could not associate first signs and symptoms, even though most of them had primary symptoms of the disease. In order to avoid high-cost treatment of ulcers and varicose veins, we should spread the knowledge on CVD.

Neonatal lupus erythematosus - practical guidelines.

BACKGROUND: Neonatal lupus erythematosus is an autoimmune disease acquired during fetal life as a result of transplacental passage of maternal anti-Sjögren's-syndrome-related antigen A (anti-SSA/Ro), anti-Sjögren's-syndrome-related antigen B (anti-SSB/La) or anti-U1 ribonucleoprotein (anti-U1-RNP) antinuclear autoantibodies. CONTENTS: Clinical manifestations include skin lesions, congenital heart block, hepatobiliary involvement and cytopenias. Most of the disorders disappear spontaneously after clearance of maternal antibodies. Cardiac symptoms, however, are not self-resolving and often pacemaker implantation is required. Diagnosis is based on clinical presentation and the presence of typical antibodies in the mother's or infant's serum. OUTLOOK: Neonatal lupus erythematosus may develop in children born to anti-SSA/Ro or anti-SSB/La women with various systemic connective tissue diseases. However, in half of the cases, the mother is asymptomatic, which may delay the diagnosis and have negative impact on the child's prognosis. Testing for antinuclear antibodies should be considered in every pregnant woman since early treatment with hydroxychloroquine or intravenous immunoglobulin (IVIG) has proven to be effective in preventing congenital heart block.

A retrospective study of DRESS - drug reaction with eosinophilia and systemic symptoms. / Analiza retrospektywna DRESS ­ reakcji polekowej z eozynofilia i powiklaniami narzadowymi.

OBJECTIVES: DRESS (drug reaction with eosinophilia and systemic syndrome) is qualified as hypersensitivity after drug reaction. This syndrome may occur due to any medication intake. There are three main groups of symptoms defining DRESS: skin lesions, hematological abnormalities and internal organ involvement. METHODS: A retrospective study was performed on a group of 261 patients with drug reactions hospitalized in the Clinic of Dermatology from 2004 until 2017. RESULTS: There were ten cases of DRESS of 261 hypersensitivity drug reactions observed in the Clinic. The drug which most frequently caused DRESS in the studied group was carbamazepine - six patients (60%). Lamotrigine was the cause of DRESS in two cases, oxycarbamazepine in one patient and dexketoprofen in one patient. The skin lesion was present in 100% patients. Mainly it was coalescing hemorrhagic rash accompanied by face edema. Eosinophilia was noticed in 80% of patients and the presence of atypical lymphocytes - in 40%. The main infiltrate organ was liver in 8 cases. CONCLUSIONS: DRESS diagnosis should be taken into consideration especially in patients treated eith antiepileptic drugs. Early diagnosis and drug discontinuation can contribute to preventing serious complications of DRESS.