Uso de ácidos grasos hiperoxigenados para la protección cutánea durante la pandemia de COVID-19 en España: encuesta a profesionales / Use of hyperoxygenated fatty acids for skin protection during the COVID-19 pandemic in Spain: survey of professionals

Durante la pandemia de COVID-19, un elevado número de profesionales ha estado a riesgo de desarrollar lesiones en la piel, secundarias al uso de equipos de protección individual. Diversas guías de práctica recomiendan el uso de AGHO para reducir la aparición de úlceras por presión; se presentan los resultados de una encuesta realizada en el ámbito nacional a la que respondieron un total de 134 profesionales sobre el uso de AGHO para su prevención. El momento de la aplicación del ácido graso fue, en el 58,2 %, después de la retirada del EPI; en el 25,4 %, diez minutos antes de la colocación de los equipos de protección; en el 7,5 %, en el momento de la colocación de los equipos de protección; en el 6,7 %, entre 10-30 minutos antes de la colocación de los equipos de protección, y en el 2,2 %, treinta minutos antes de la aplicación de los equipos de protección. Los profesionales que respondieron refieren, en el 73,1 % de los casos, una mejora del eritema pre-existente; para el 56,7 %, proporciona hidratación de la piel; en el 50 % de los casos contribuye a la prevención de las lesiones cutáneas relacionadas con el uso de los sistemas de protección individuales; en el 26,1 %, aporta un efecto emoliente sobre la piel. A partir de los resultados se recomienda el uso de estas substancias tópicas (AGHO) en caso de uso de equipos de protección individual

During the Covid-19 pandemic, a high number of professionals have been at risk of developing skin lesions secondary to the use of personal protective equipment. The clinical practice guidelines recommend the use of fatty acids to reduce the appearance of pressure ulcers. Here are described the results of a survey conducted at the national level, that included a total of 134 professionals. The moment of the application of the fatty acid was, 58.2%, after the removal of the individual equipment protection; in 25.4%, ten minutes before the placement of the protective equipment; in 7.5%, at the time of the donning of the protective equipment; in 6.7%, between 10-30 minutes before putting on the protective equipment, and in 2.2%, thirty minutes before the application of the protective equipment. The professionals who responded referred, in 73.1% of the cases, an improvement of the pre-existing erythema; in 56.7%, this substance provides hydration of the skin; in 50% of the cases, it contributes to the prevention of related skin lesions with the use of individual protection systems; in 26.1%, it provides an emollient effect on the skin. Based on the results, the use of these topical substances (fatty acids) is recommended in the case of the use of personal protective equipment

A Prospective, Experimental Study to Assess the Effectiveness of Home Care Nursing on the Healing of Peristomal Skin Complications and Quality of Life.

Home care services are effective in many patient groups. PURPOSE: The authors examined the effect of specialized ostomy care in the home on peristomal skin complications and patient quality of life (QOL). METHOD: A prospective, experimental study was conducted among 35 people >18 years old with a colostomy or ileostomy and peristomal skin complications who were listed in 2 ostomy supplier databases. Participants were alternatively allocated to 6 home care visits (intervention [IG], n = 18) or 2 outpatient/clinic care [CG] visits (control, n = 17). Demographic and patient variables were assessed at the initial visit in both groups. The Ostomy Skin Tool (OST) and the Stoma-Quality of Life instrument were used to assess study characteristics; data were statistically analyzed. RESULTS: The Discoloration, Erosion, Tissue Overgrowth scores of the OST of the 2 groups were similar in the first assessment (IG = 6.22 ± 1.47; CG= 6.11 ± 1.96; P = .776), but a statistically significant difference was noted between groups at the end of study (IG = 0.44 ± 0.85, CG = 4.76 ± 2.30; P = .00). At the first assessment, QOL scores of the IG and CG groups were 72.63 ± 11.48 and 66.73 ± 17.52, respectively (P = .197). At the final assessment, QOL scores were 78.12 ± 9.66 and 71.83 ± 18.37 for IG and CG, respectively (P = .390). CONCLUSION: Home nursing care was found to be effective in treating peristomal skin complications. The QOL scores achieved at the final assessment were significantly improved compared with the initial assessment. The results demonstrated the importance of follow-up after stoma surgery.

Intervenciones de enfermería en la dermatitis asociada a la incontinencia-revisión integradora de la literatura / Intervenções de enfermagem na dermatite associada à incontinência-revisão integrativa da literatura / Nursing interventions in incontinence-associated dermatitis-integrative literature review

Introducción: La dermatitis asociada a la incontinencia se define como el daño de la piel asociado a la exposición de orina y/o heces, un tipo de dermatitis irritativa de contacto, que causa gran incomodidad y dolor y tiene tratamiento difícil, a largo plazo y caro. El objetivo principal pasa por identificar y adoptar intervenciones en la prevención, gestión y tratamiento de la dermatitis asociada a la incontinencia. Método: El método utilizado ha sido una revisión integradora de la literatura, realizada en las bases de datos establecidas: EBSCO Host Web - CINAHL Plus, MEDLINE y BOn, utilizando los descriptores 'nurse', 'nurse care' e 'incontinence associated dermatitis' y el carácter booleano 'and'. La cuestión central de esta revisión ha sido: ¿Cuáles son los cuidados de enfermería más adecuados a la dermatitis asociada a la incontinencia?. Resultados: Los resultados han sido seleccionados en tres dimensiones: I. Una primera que aclara la caracterización de la dermatitis asociada a la incontinencia efectuada en torno a dos categorías (definición de dermatitis asociada a la incontinencia y diferenciación de dermatitis asociada a la incontinencia/úlcera por presión), II. Relacionada con las cuestiones de diagnóstico y evaluación y III. Sobre las intervenciones adecuadas para la prestación de cuidados de calidad y que se ha subdividido en tres categorías (prevención, tratamiento, enseñanza y formación). Conclusión: La naturaleza comprensiva de la revisión integradora nos reveló la necesidad de inversión en la formación y adopción de una práctica basada en la evidencia que nos lleve a una prestación de cuidados de enfermería de calidad superior

Introdução: A dermatite associada à incontinência define-se como o dano da pele associado à exposição de urina e/ou fezes. É caracterizada por um tipo de dermatite irritativa de contacto que causa grande desconforto e dor, sendo de difícil tratamento, prolongado e caro. O objetivo principal passa por identificar intervenções a adotar na prevenção, gestão e tratamento da dermatite associada à incontinência. Método: O método utilizado foi a revisão integrativa da literatura, realizada nas bases de dados estabelecidas: EBSCO Host Web-CINAHL Plus, MEDLINE e BOn, utilizando os descritores 'nurse', 'nurse care' e 'incontinence associated dermatitis', auxiliando a pesquisa com o caracter booleano 'and'. A questão central desta revisão foi: 'Quais os cuidados de enfermagem mais adequados à dermatite associada à incontinência?'. Resultados: Foram selecionados onze artigos, cujos resultados foram agrupados em três dimensões: I. a primeira apresenta-nos a caracterização da dermatite associada à incontinência efetuada em torno de duas categorias (definição de dermatite associada à incontinência e diferenciação de dermatite associada à incontinência/úlcera por pressão), II. relacionada com as questões do diagnóstico e avaliação e III. sobre as intervenções adequadas a uma prestação de cuidados com qualidade e que se subdividiu em três categorias (prevenção, tratamento, ensino e formação). Conclusão: A natureza compreensiva da revisão integrativa revelou-nos a necessidade de investimento na formação e adoção de uma prática baseada na evidência, que nos leve a uma prestação de cuidados de enfermagem de qualidade superior

Introduction: Dermatitis associated to Incontinence is defined as a damage of the skin connected to the exposure to urine and/or faeces, a type of contact dermatitis, which causes a great discomfort and pain, that has a difficult treatment, extended in time and expensive. The main goal is the identification of the interventions to adopt in the prevention, management and treatment of the dermatitis associated to incontinence. Methods: The used method is the integrative review of literature, performed in established data bases: EBSCO host Web - CINAHL Plus, MEDLINE and Bon. The main question of this review was: 'Which are the most adequate nursing care to incontinence associated dermatitis?'. Results: Eleven articles were selected and the results were grouped into three dimensions: I. the first presents the characterization of incontinence-associated dermatitis around two categories (definition of incontinence associated dermatitis and differentiation of incontinence / pressure ulcer), II. Related to the issues of diagnosis and evaluation and III. On interventions appropriate to quality care and divided into three categories (prevention, treatment, education and training). Conclusion: The comprehensive nature of the integrative review has revealed to us the need for investment in training and adoption of an evidence-based practice that will lead us to a higher quality nursing care

Therapies and nursing care of women with vulvar dermatologic disorders.

Vulvar dermatologic disorders are common among women, and prevalence increases with age. Treatment can provide women with symptomatic relief and can halt further progression of disease. Numerous therapies are available, and nurses who work with women across the life span should have an understanding of vulvar dermatologic disorders and therapeutic modalities. We provide an overview of general vulvar care, four vulvar dermatologic disorders, and common treatment modalities including topical and systemic pharmacologic management.

Treating cement burns in the emergency department.

Use of cement is widespread in the UK and warnings about burns caused by contact with the material are usually printed on bags and delivery dockets. Nevertheless, about 2 per cent of people admitted to burns units have injuries, many serious, caused by prolonged contact with wet cement. This article explores the pathophysiology of cement burns, and outlines the best forms of treatment and prevention.

Clinical challenges of preventing incontinence-associated dermatitis.

Incontinence-associated dermatitis (IAD) is a common skin disorder in patients with faecal and/or urinary incontinence. The past decade has seen a huge growth in publications focusing on the complexity and inconsistency of the clinical observation of IAD and the differentiation between IAD and pressure ulcers. IAD and superficial pressure ulcers cause confusion in clinical practice when trying to determine the true nature and underlying pathology of the lesion. It is a daily challenge for health professionals in hospitals, nursing homes and community care to maintain a healthy skin in patients with incontinence. The aim of this article is to provide a brief update on recent developments regarding the differentiation between pressure ulcers and IAD and the prevention of IAD. Recommendations for clinical practice and research are provided.

Dialogue study. Evaluación de la calidad de vida y de la piel periestomal del paciente ostomizado con el nuevo dispositivo SenSura / Dialogue study. To evaluate the quality of life and peristomal skin ostomy patient with the new device Sensura

En el año 2006, Coloplast comercializó en distintos países europeos un nuevo dispositivo para ostomías llamado SenSura. El presente informe de la investigación clínica incluye exclusivamente los resultados de la subpoblación incluida en España, como parte de un estudio internacional, en el que participaron numerosos países como Dinamarca, Estados Unidos, Canadá, Australia, Polonia, Países Bajos, Francia, Eslovaquia, Alemania, Reino Unido, Italia, Islandia, Japón, República Checa, Portugal, España, Corea del Sur y Argentina. Objetivos y variables de estudio. El propósito principal es evaluar la experiencia práctica con este dispositivo, en condiciones normales de uso, con especial atención al estado de la piel y a la calidad de vida. El objetivo principal es la evaluación de la calidad de vida a través del Cuestionario de Calidad de Vida llamado «Stoma QoL». En cuanto a los objetivos secundarios encontramos el estudio de la correlación entre calidad de vida y el estado de la piel periestomal. Otros son la evaluación del dispositivo utilizado habitualmente por el paciente en el momento de entrar en el estudio, así como el dispositivo SenSura y el registro de acontecimientos adversos a lo largo de todo el proceso. Diseño del estudio. Se trata de un estudio abierto, longitudinal, internacional, no comparativo y post-comercialización. El período de estudio para cada paciente es de seis a ocho semanas +/– cuatro días, incluyendo una visita inicial y otra final. La población del estudio consiste en personas portadoras de una colostomía o una ileostomía. Metodología. En España participaron un total de 10 centros, para un total de 131 pacientes. En el presente informe únicamente se presentan resultados correspondientes a nueve centros y un total de 123 pacientes. El motivo es que el último centro comenzó el estudio con un retraso considerable. Los pacientes correspondientes a éste, junto con el resto de centros en España, serán incluidos en el próximo informe de investigación clínica internacional. Herramientas de medición. Stoma-QoL (Cuestionario de calidad de vida para personas ostomizadas). OST (Ostomy Skin Tool) Instrumento para la evaluación de la piel periestomal. Resultados. En cuanto a la calidad de vida, en la visita basal nos encontramos con una media de 59 sobre 100 (SD= 8,8), mientras que en la visita final del estudio, la puntuación media obtenida ha sido de 59,6 sobre 100 (SD= 9,3), aunque los resultados definitivos con respecto a esta variable se presentarán en el informe global, dado que no se ha alcanzado población suficiente en España para el análisis de esta variable. El estudio reveló una mejora significativa en el estado de la piel periestomal al final del mismo, medida a través de la herramienta OST (Ostomy Skin Tool). En cuanto a la evaluación del dispositivo SenSura, se registró una mejora significativa con respecto a la aparición de fugas de efluente, así como del resto de ítems evaluados en relación con el dispositivo(AU)

In 2006, Coloplast launched in several European countries a new device for ostomy care called Sensura. This clinical research report includes only the results of the subpopulation included in Spain as a part of an international study, involving many countries such as Denmark, United States, Canada, Australia, Poland, Netherlands, France, Slovakia, Germany, UK, Italy, Iceland, Japan, Czech Republic, Portugal, South Korea and Argentina. Objectives and study variables. The main purpose of the study is to evaluate the experience with Sensura, under normal conditions of use, with special attention to skin condition and quality of life. The main objective of the study is to evaluate the quality of life, through Quality of Life Questionnaire called «Stoma QoL». A secondary objective, is to study the correlation between quality of life and the peristomal skin condition. Other Secondary objectives include the evaluation of the patient's current device at the time of entering the study, and by the other hand, the device Sensura and safety evaluation throughout the study. Design study. The study was designed as an open label, non-comparative, multi-national Post Market study. The study period for each patient is 6 to 8 weeks +/– 4 days, which includes an initial visit and a final visit. The study population included people who carry a colostomy or ileostomy. Methodology. Regarding Spain, a total of 10 sites participated and included a total of 131 patients. This report only presents results for nine sites and a total of 123 patients. The reason is that the last participating site began the study with a considerable delay. The remaining subjects included in this site together with the other centers in Spain and the other participating countries will be included in the final international report, that will present the overall results. Measurement tools. Stoma-QoL (Quality of Life Questionnaire for people with an ostomy). OST (Ostomy Skin Tool) instrument for the assessment of peristomal skin. Results. As for the quality of life, at baseline we found a mean of 59 out of 100 (SD = 8.8), while the final study visit, mean score was 59.6 out of 100 (SD = 9.3), although the final results on this variable will be presented in the global report, since since it has not reached sufficient population in Spain for the analysis of this variable. The study revealed a significant improvement in the peristomal skin condition at the end of the study, measured by the tool OST (Ostomy Skin Tool). Regarding the evaluation of the SenSura device, there was a significant improvement related to the appearance of leakage of effluent, as well as other items evaluated in relation with the device(AU)

Management of skin conditions in the older population 2.

This is the second of two papers covering assessment and management of elderly skin. Part 1 of this clinical review focused on the importance of a comprehensive assessment of the skin and a detailed clinical history of the patient (Bianchi and Cameron, 2008). This second paper considers some common dermatological conditions seen in the older adult and explores suitable management strategies.

Promoting skin health.

This article outlines the nurse's role in promoting the best methods of maintaining healthy skin. It discusses the key structures of the skin and its functions, the role of emollient therapy in children and adults, and external environmental factors.

Importance of the appropriate selection and use of continence pads.

Urinary incontinence is becoming an increasingly common problem for older men and women living in the community. It can have a deleterious effect on quality of life and, although advances have been made in treatments and therapies for this condition, there is still confusion over selection of continence products. This article will explore the problems associated with product selection and discuss alternative advice.

A nurse-led clinic in chronic and allergic contact dermatitis.

It has generally been acknowledged that the incidence and prevalence of contact dermatitis has increased in recent years. It can develop at any stage of a person's life span (rare before puberty), and in many different circumstances and occupations. The demand on consultant dermatologists for contact dermatitis services has resulted in the depletion of some essential components to the investigation process, and patient outcomes have been affected. In recent years it has also resulted in the development of nurse-led contact dermatitis services. The traditional role of the dermatology nurse in contact dermatitis is to carry out patch testing. Nurse-led services require the wider acquisition of skills and knowledge in relation to contact dermatitis. This article is an attempt to introduce the complexities of contact dermatitis, and nurse-led services.

The nursing care of common raw and bleeding skin conditions.

The skin is the largest organ in the body, is vital to the maintenance and balance of the body and is an indispensable structure for human life. The maintenance of healthy skin depends on factors such as moisture, the nutritional status of the patient and mechanical forces. Clever use of barrier films, barrier creams, emollients, steroid cream and observation of the patient's tissues over time, will protect the skin from external stimulants.

Pruritic erythematous, indurated plaques on the feet.

The "Clinical Snapshot" series provides a concise examination of a clinical presentation including history, treatment, patient education, and nursing measures. Using the format here, you are invited to submit your clinical snapshot to Dermatology Nursing.