Termografía infrarroja como método de diagnóstico en quemaduras: una revisión exploratoria de la literatura / Infrared thermography as a method of diagnosis in burns: an exploratory review of the literature

Objetivos: Revisar el uso y eficacia de la termografía infrarroja como instrumento diagnóstico y de medida de las quemaduras. Metodología: Se realizan 2 búsquedas, una general y otra específica, utilizando estrategia de búsqueda mediante un lenguaje controlado con términos MESH. Para seleccionar los artículos se filtra por título, resumen y palabras clave, además de aplicarse los criterios de inclusión y exclusión. Resultados: Durante la búsqueda general, se encontraron 165 artículos en PubMed, de los cuales 7 han sido seleccionados y 6 han sido incluidos. Mientras que con la búsqueda específica se obtienen 28 artículos, de los cuales se seleccionan 7 que no aparecían en la búsqueda general y se incluyen finalmente 6 de ellos. Conclusiones: La termografía infrarroja es un instrumento con mucho potencial y que ha mostrado buenos resultados, pero en ocasiones mucha variabilidad e inconsistencia, por lo que es necesaria la estandarización de una serie de medidas que nos permitan contrarrestar las dificultades a las que se expone y minimizar los sesgos, hecho que podrá mejorar más los resultados. Además, es necesaria una mayor investigación aplicando las variables térmicas encontradas para identificar el grado de influencia e importancia que tienen y comparar las diferentes modalidades de termografía infrarroja, estática y dinámica.(AU)

Objectives: To review the use and efficacy of infrared thermography as a diagnostic instrument and measurement of burns. Methodology: Two searches were carried out, one general and the other specific, using a controlled language search strategy with MESH terms. To select the articles we filtered them by title, abstract and key words, besides applying the inclusion and exclusion criteria. Results: During the general search, 165 articles were found in PubMed, of which 7 were selected and 6 were included. The specific search yielded 28 articles, of which 7 were selected that did not appear in the general search and 6 were finally included. Conclusions: Infrared thermography is an instrument with great potential that has shown good results but much variability and inconsistency at times, so it is necessary to standardize a series of measures that allow us to counteract the difficulties to which it is exposed and minimize biases, a fact that could further improve the results. In addition, further research is needed by applying the thermal variables found to identify the degree of influence and importance that they have and by comparing the different infrared thermography modalities, static and dynamic.(AU)

Content, implementation strategies and knowledge assessment tool on venous leg ulcers: An e-Delphi study.

AIM: To get consensus on the knowledge and skills that nursing students need to acquire regarding venous leg ulcer care, the strategies that can be applied during education and to design a first draft of a questionnaire to assess knowledge to be validated. BACKGROUND: Venous leg ulcers' care is included on undergraduate nursing education programmes but without specifying the content and training implementation strategies. Different tools have been validated to assess knowledge, but have been found inadequate. DESIGN: An e-Delphi study. METHODS: The participants were Chronic Wound Care expert nurses. Two questions were constructed and agreed on by the research team to define the problem. To answer the third question, a search was conducted for publications on venous leg ulcers, to help design the questionnaire. A 2-round e-Delphi study was conducted from January to March 2022. A panel of 17 experts participated in both rounds. The data were analysed using statistical and qualitative analysis. RESULTS: Content must fulfil knowledge-skill areas: epidemiology, venous pathophysiology and aetiology, classification scales, knowing how to determine a differential diagnosis, treatment, measures for prevention and care of the venous return circuit, quality-of-life scales. As implementation strategies, proposals were made in four areas: subject profile where training is to be acquired, theoretical teaching, practical teaching in the classroom and clinical practice. The average consensus of the questionnaire proposal was high (>86 %) both in relevance and clarity in both rounds. We thereby obtained a questionnaire with 72 items. CONCLUSIONS: Seven categories and eight subcategories were created regarding knowledge/skills that nursing students should acquire. Four categories were recognised as strategies that can be implemented during education. A high level of consensus was reached on the items in the initial versions of the questionnaire.

Efectividad de los cambios posturales en la prevención de lesiones por presión en pacientes de atención primaria y domiciliaria / Effectiveness of postural changes in the prevention of pressure injuries in primary and home care patients

Objetivos: Analizar la eficacia de los cambios posturales en la prevención de lesiones por presión en atención primaria y sociosanitaria. Metodología: Se ha realizado una revisión sistemática de la literatura en bases de datos como MEDLINE (PubMed), SciELO, TSEO y Google Académico. También se ha extraído información de repositorios universitarios. Los artículos seleccionados son revisiones sistemáticas, ensayos clínicos y una revisión histórica. Resultados: Se encontraron un total de 568 artículos, de los cuales 15 cumplieron los criterios de inclusión. Los ensayos clínicos aleatorios incluidos se realizaron en residencias de ancianos u hospitales de larga estancia. Conclusiones: La frecuencia de cambios posturales implica gran controversia. No obstante, la menor incidencia de úlceras por presión se relaciona con cambios posturales cada 3 h y con colchones viscoelásticos (AU)

Objectives: To analyze the efficacy of postural changes in the prevention on pressure injuries in primary and socio-health care. Methodology: A systematic review of the literatura has been carried out in databases: MEDLINE (PubMed), SciELO, TSEO and Google Academy. Information has also been extracted from university repositories. The selected articles are systematic reviews, clinical trials and a historical review. Results: A total of 568 articles were found, of which 15 met the inclusion criteria. Included randomized clinical trials were condcuted in nursing home or long-stay hospitals. Conclusions: The frequency of postural changes implies great controversy. Nevertheless, the lower incidence of pressure ulcers is related to postural changes every 3 h and to viscoelastic mattresses (AU)

Knowledge and teaching-learning methods regarding venous leg ulcers in nursing professionals and students: A scoping review.

AIM: According to our scoping review questions, three aims were formulated to synthesize the evidence published on: (1) the content (2) the best or most appropriate teaching-learning methods for training nurses and undergraduate nursing students in venous leg ulcer care, and (3) to identify the level of knowledge in nurses and undergraduate nursing students about venous leg ulcer care. BACKGROUND: A venous leg ulcer can be defined as a skin lesion on the leg or foot that occurs in an area affected by ambulatory venous hypertension. Hence, nurse visits are the main driver of Venous Leg Ulcer-related healthcare costs. Optimal levels of knowledge obtained with appropriate methodologies tend to improve care. Nonetheless, the time devoted to chronic wound education in undergraduate nursing curricula has been considered insufficient and inadequate. METHODS: For this scoping review, a search was performed in January 2021. To identify sources of evidence, a systematic search was conducted in MEDLINE, Embase, CINAHL, Web of Science, Scopus, Cuiden, ERIC and ScienceDirect. All types of evidence associated with knowledge, teaching and/or learning methods regarding venous leg ulcers in nursing were included. RESULTS: Finally, 19 documents were included. In these articles, the content mostly widely included in teaching-learning methods was compression therapy (14/19), anatomy, physiology, aetiology and/or pathophysiology (10/19) and topical treatment and care (8/19); various other topics were mentioned but less frequently. Teaching/learning methods and interventions were heterogeneous in modality, content, and duration but the majority showed better results after implementation. When looking at knowledge level, studies mainly focused on nursing staff. In general, it seems that there is a lack of knowledge and skills. CONCLUSIONS: Regarding our three pivotal questions: (1) There is no uniform type of content over the studies analysed and the most referred was compression therapy. (2) The educational interventions studied have demonstrated effectiveness, but there is insufficient data to determine which is the most effective. (3) This scoping review has highlighted the lack of knowledge among nurses and nursing students about venous leg ulcer care. Additionally, we felt that there is no ideal assessment tool to quantify knowledge, skills, attitude, confidence, and commitment in this context. TWEETABLE ABSTRACT: A scoping review that synthesise the evidence on the level of knowledge and teaching-learning methods in nursing regarding of people with venous leg ulcers shows lack of knowledge and variability in programs.

Epidemiology of venous leg ulcers in primary health care: Incidence and prevalence in a health centre-A time series study (2010-2014).

The aims of the study were to describe and analyse the temporal trend of the prevalence and incidence of venous leg ulcers (VLU) over the years 2010 to 2014, to determine healing times and temporal trends in the study period, and to evaluate related aspects such as the use of the Ankle-Brachial Pressure Index (ABPI) in a primary care health centre. This was a retrospective study based on a time series (years 2010-2014) of the prevalence and incidence of VLUs in people aged over 40 years in a primary care centre in Barcelona City. We reviewed 3920 electronic health records selecting patients, per year (2010-2014), with VLUs based on the ICD-10 diagnoses. For prevalence, we took into account any patient with an active VLU in the year of study. For incidence, we took into account patients with a new VLU in the year of study. A descriptive analysis was carried out based on each of the collected variables. The variables were examined according to the years of study (time series) by one-factor analysis of variance (anova) or Kruskal-Wallis non-parametric test, as appropriate. A survival analysis by Kaplan-Meier curves and log-rank test was also performed. A total of 139 patients met the VLU criteria. Among them, only 79.2% were classified as having a VLU and had a correct ICD diagnosis. The prevalence and incidence increased over the years, doubling in patients aged over 65 years. Incidence increased from 0.5 new cases per 1000 people/year in 2010 to 1 new case for every 1000 people/year in 2014. Moreover, the prevalence ranged between 0.8 and 2.2 patients with VLU for every 1000 people/year. During the study period, a total of 84.2% of the VLUs healed (117/139 VLU). Regarding average annual time to healing, the trend indicates that lesions took less time to heal (Kruskal-Wallis test, P = 0.004), ranging between 453,9 weeks in 2005 to 19 weeks in 2014. The use of ABPI also evolved and was found to be increasingly performed prior to the appearance of the lesion. The epidemiological profile of people affected by VLUs continues to be, mainly, that of women of an advanced age, over 70 years. The frequency of VLU occurrence rose continually over the years, but healing took less time, and use of ABPI improved. Assigning a reference nurse in the wounds unit and the organisational structure around this problem may have an influence on improving care and the approach to these types of lesions.

HELCOS. Sistema integrado para el manejo de heridas: A propósito de un caso / HELCOS. Integrated system for the handling of wounds: about a case

El uso de las tecnologías de la información y comunicación es cada vez más extendido en las prácticas de salud-enfermedad y, por ende, también en el cuidado de las heridas. Son muchas las aplicaciones que se han desarrollado en este sentido pero pocas se han evaluado respecto a su utilidad. En este artículo se presenta, a modo de caso, HELCOS, sistema integrado para el manejo de heridas y los resultados obtenidos hasta ahora

The use of information and communication technologies is increasingly widespread in health-disease practices and, therefore, also in wound care area. There are many applications that have been developed in this regard but few have been evaluated regarding their usefulness. In this article we present, as a case, HELCOS, an integrated system for the management of wounds and the results obtained so far

Conocimientos del personal sanitario respecto al uso de la terapia de presión negativa en el tratamiento de las heridas / Health workers' knowledge regarding the use of Topical Negative Pressure Therapy in the treatment of wounds

Introducción: Las heridas crónicas representan un problema actual que genera un impacto a muchos niveles y cuyo tratamiento se basa en infinidad de productos disponibles actualmente en el mercado. A medida que avanza la tecnología se desarrollan nuevos dispositivos que mejoran el tratamiento y repercuten en beneficios para los pacientes. La terapia de presión negativa, incluida en las técnicas de curación avanzada, es un ejemplo representativo de ello, pero una correcta utilización de esta requiere de un personal entrenado capaz de hacer un uso adecuado a través de sus conocimientos. Objetivo: El objetivo principal es determinar el nivel actual de conocimientos de los profesionales sanitarios sobre generalidades y manejo de la terapia de presión negativa. Material y método: Se realizó un estudio observacional, descriptivo y analítico en el Hospital General Universitario de Alicante. La población a estudio estuvo formada por 65 profesionales del ámbito de la enfermería y la medicina que trabajaban en las unidades donde se encuentran más familiarizados con su uso, y la recogida de datos se realizó mediante un cuestionario tipo ad hoc. Resultados: El 20% de los profesionales muestran un bajo nivel de conocimientos, el 61,5%, un nivel adecuado y el 18,5%, un nivel de conocimientos alto. Por tanto, un 80% de la población estudiada tiene un nivel adecuado o alto de conocimientos. Conclusiones: Una formación específica mediante la asistencia a cursos y jornadas, el tratamiento de un mayor número de heridas con terapia de presión negativa y el hecho de sentirse capacitados se convierten en requisitos indispensables para una correcta utilización del dispositivo. El nivel de conocimientos actual no exime de la necesidad de crear un protocolo que permita la unificación de criterios entre los profesionales y la necesidad de formación para actualizar los conocimientos

Introduction: Chronic wounds represent a current problem that generates an impact on many levels and whose treatment is based on an infinite number of products available on the market nowadays. As technology progresses, new devices are developed improving the treatment and affecting in benefits for patients. Topical Negative Pressure theraphy, included in the advanced healing techniques, is a representative example of this but a correct use of it requires a trained staff able to use it suitably through their knowledge. Aim: The main objective is to determine the current level of health workers' knowledge about generalities and the handling of topical negative pressure therapy. Method: An observational, descriptive and analytical study was conducted at the Hospital General Universitario de Alicante. The study population was made up of 65 professionals in the field of nursing and medicine working in units where they are more familiar with their use, carrying out the collection of data by means of a questionnaire type ad hoc. Results: 20% of professionals show a low level of knowledge, 61.5%, an appropriate level and the 18.5%, a high level of expertise. Therefore, 80% of the studied population has an adequate or high level of expertise. Findings: Specific training through attendance at courses and conferences, the treatment of a greater number of injuries with TNP and the fact of being trained become prerequisites for a correct use of the device. The current level of knowledge does not exempt from the need to create a protocol allowing the unification of criteria between the professionals and the need for training to upgrade the expertise

Prevención de las úlceras por presión y los cambios de postura. Revisión integrativa de la literatura / Prevention of pressure ulcers and repositioning. An integrative review

Objetivo: El objetivo que se plantea en este trabajo de revisión es responder a la pregunta: ¿Son los cambios posturales efectivos en la prevención de las úlceras por presión? Metodología: Revisión integrativa de la literatura mediante la identificación de documentos en las principales bases de datos relacionadas con las ciencias de la salud: MEDLINE, CINAHL, sciELO, Cochrane y CUIDEN, y mediante búsqueda inversa en los artículos identificados. Se incluyeron estudios prospectivos, revisiones sistemáticas u otro tipo de estudios, que evaluaran la efectividad de los cambios posturales. No hubo restricciones en fechas de publicación hasta diciembre de 2014, pacientes, contexto, estado de la publicación o idioma. Resultados: De 108 artículos, potencialmente relevantes para la revisión, se incluyeron 13: 6 ensayos clínicos, 1 estudio de cohortes, 4 revisiones sistemáticas y una histórica, además de un estudio cualitativo. No se encuentran evidencias sólidas para recomendar los cambios posturales cada 2 horas, pero si hay evidencia que apoya los cambios posturales cada 4 horas combinados con una superficie de apoyo viscoelástica. Conclusiones: No existen estudios que comparen la efectividad, solamente, de los cambios posturales frente a la no realización de estos cambios. La conjunción de una superficie viscoelástica con cambios posturales cada 3-4 horas dispone de la mejor evidencia. Los pacientes en decúbito lateral de 90 grados tienen una tasa casi 4 veces superior de lesiones que los que están a 30 grados. La investigación cualitativa es casi inapreciable en los estudios sobre cambios posturales

Aim: to answer the question: Are repositioning effective in preventing pressure ulcers? Methods: Integrative review of the literature through identification of papers in the main databases related to health sciences: MEDLINE, CINAHL, sciELO, COCHRANE and CUIDEN, and by reverse search on identified articles. We included prospective studies, systematic reviews or other types of studies that evaluated the effectiveness of repositioning. There were no restrictions on publication dates until December 2014, patients, context, publication status or language. Results: From 108 articles, potentially relevant for the review, 13 were included: 6 clinical trials, 1 cohort study, 4 systematic reviews and one historical review, as well as a qualitative study. There is no solid evidence to recommend postural changes every 2 hours. But there is evidence that supports repositioning every 4 hours combined with a viscoelastic support surface. Conclusions: There are no studies that compare the effectiveness of repositioning versus nonrepositioning. The combination of a viscoelastic surface with repositioning every 3-4 hours has the best evidence. Patients in 90 degrees lateral decubitus have a rate almost 4 times higher than those who are at 30 degrees

E-salud en las heridas crónicas. Posicionamiento del GNEAUPP / E-health in chronic wounds. Positioning of GNEAUPP

Hoy día nadie duda de la importancia que tienen las nuevas tecnologías en diferentes ámbitos, siendo uno de ellos el sanitario. De un lado, aporta múltiples ventajas para el paciente, ya que permite el acceso a información sanitaria y la posibilidad de tener un papel protagonista en sus procesos. Para los profesionales también resulta de utilidad, ya que permite ofrecer recursos las 24 horas. Por último, constituyen una potencial herramienta para mejorar la gestión de los siempre limitados recursos de los sistemas de atención sanitaria. En el presente artículo se repasan las cifras acerca del uso de Internet y redes sociales en España, así como las ventajas y riesgos que presenta su uso. Posteriormente se hablará de la e-salud en las heridas crónicas (incluyendo algunos recursos) y del posicionamiento que adopta el Grupo Nacional para el Estudio y Asesoramiento en Úlceras por Presión y Heridas Crónicas (GNEAUPP) como sociedad científica en relación con la e-salud y las heridas crónicas (AU)

Today no one doubts the importance of new technologies in different areas, one of them being the sanitary. On the one hand, it provides multiple advantages for the patient, since it allows access to health information and the possibility of having a leading role in its processes. For professionals, it is also useful, since it allows to offer resources 24 hours a day. Finally, they constitute a potential tool to improve the management of the always limited resources of health care systems. In the present article, we review the figures about the use of Internet and social networks in Spain, as well as the advantages and risks of using them. Subsequently, eHealth will be discussed in chronic wounds (including some resources) and the positioning adopted by the Spanish Pressure Ulcer Advisory Panel (GNEAUPP) as a scientific society in relation to eHealth and chronic wounds (AU)

Efecto de un suplemento nutricional específico (Balnimax(R)) en la cicatrización de úlceras de la extremidad inferior de etiología venosa y úlceras por presión / Effect of a specific nutritional supplement (Balnimax(R)) on lower extremity ulcers of venous etiology and pressure ulcers

Objetivo: evaluar un suplemento nutricional específico, Balnimax(R) (ácido alfa-lipoico, L-arginina, L-metionina, complejo de vitamina B, vitamina E y selenio) junto con la práctica clínica diaria en la cicatrización de las úlceras por presión y úlceras de etiología venosa. Material y método: se llevó a cabo un estudio multicéntrico, prospectivo, de medidas repetidas en un solo grupo y postautorización en pacientes con úlceras por presión y úlceras de etiología venosa sin signos clínicos de infección local, que fueron tratados durante 8 semanas. Las medidas se registraron al inicio y en las semanas 2, 4, 6 y 8. Los pacientes recibieron una cápsula oral dos veces al día, con las comidas. La medida de resultado principal fue el porcentaje de reducción en el tamaño de la herida. Además, se estudió la cicatrización completa. El tamaño de la muestra se determinó para comparar los resultados frente a un valor de referencia. Se requería un total de 127 pacientes para detectar una diferencia igual o superior al 15% en la reducción del área. Se asumió como porcentaje de reducción de referencia un 57%. Además, se estimó un 10% de pérdidas en el seguimiento. Resultados: Se incluyeron y finalizaron el estudio 112 pacientes con 133 heridas (un 16,0% tuvieron dos o más lesiones), con una media de edad de 74,2 ± 12,0 (mediana: 77, extremos: 35-94). Un 69,8% eran mujeres, la mayoría pacientes ambulatorios (98,4%). En un 9% se utilizaron moduladores de las proteasas y solo en un 27,2% se aplicó un vendaje compresivo multicapa. Un total de 58 (43,6%) úlceras cicatrizaron durante el periodo del estudio. La evolución del tamaño de la herida y su porcentaje de reducción fueron estadísticamente significativos (p ≤ 0,001), disminuyendo a lo largo del tiempo. Hubo diferencias estadísticamente significativas entre los resultados del estudio y el valor de referencia (p ≤ 0,001). Conclusiones: a pesar de las posibles limitaciones metodológicas por ser un estudio en un solo grupo, el complemento estudiado parece tener un efecto sobre la cicatrización. Los resultados son mejores que los publicados previamente con otros suplementos nutricionales o frente a la cura en ambiente húmedo por sí sola

Objective: To evaluate a specific oral nutritional supplement, Balnimax(R) (alfa-lipoic acid, L-arginine, L-methionine, vitamin B complex, vitamin E and selenium) along with daily clinical practice on the healing of pressure and venous leg ulcers. Method: a multicentre, prospective, single-group, repeated measures and post-authorization study was carried out with pressure and venous leg ulcers’ patients without signs of local infection, to be treated for up to 8 weeks. Measures were recorded at baseline, 2, 4, 6 and 8 weeks. The patients received a tablet orally twice daily with meals. The primary outcome variable was the percentage of wound size reduction. We also analysed the complete healing. The sample size calculation was determined to compare the results against a reference value. 127 subjects would be required to detect a difference equal to or above 15%. It was assumed that the percentage of wound reduction was 57%. We estimated a loss rate of up to 10%. Results: 112 patients with 133 wounds were included and finished the study (16.0% had 2 or more wounds), with a mean age of 74.2±12.0 (median: 77, extremes: 35-94). 69.8% were women, most of them ambulatory patients (98.4%). In 9% proteases modulators were used and in only 27.2% was applied a multilayer compression therapy. 58 (43.6%) ulcers healed during the study period. The evolution of wound size and percentage reduction was, statistically significant (p ≤ 0.001), decreasing over time period. It was a statistical significant difference (p ≤ 0.001) between the results and the reference value. Conclusions: Despite the possible methodological flaws due to a single-group study, the supplement studied seems to be an effect over healing. The results are better than previous published with other nutritional supplements or with moist wound healing only

Coste-Efectividad de un apósito de espuma de poliuretano con TLC-NOSF. Estudio en el tratamiento de las úlceras venosas de pierna / Follow-up of the patients in the program of self-management of oat

Las heridas crónicas representan una carga para el sistema sanitario español; hoy en día es necesaria una optimización de los recursos empleados y por esto debe justificarse el uso de unos productos, en detrimento de otros, a través de estudios de coste-efectividad que demuestren beneficio económico para los profesionales y calidad de vida para el paciente. El presente artículo compara el uso de una nueva tecnología aplicada en formato de espuma de poliuretano, la TLC-NOSF, con los productos de uso más habitual en el tratamiento de heridas. Dicha comparativa se realiza mediante un modelo de coste- efectividad (Modelo Markov). Los resultados demuestran que los tratamientos con apósito de espuma de poliuretano con TLC-NOSF son coste-efectivos versus los realizados con espumas de poliuretano de uso más habitual en España(AU)

Development in the implementation of the programme of the anticoagulated patient self-management concludes with the follow-up. Your objective is to guide, support, advise and provide the patient with the necessary support material and training and improve their autonomy and quality of life. Contacts are established through both scheduled and unscheduled visits and phone calls. The article describes this phase interspersed, so serve as a practical example, with the experience which has resulted in our unit. Relates the workloads of different professionals and the most the recurrent causes of consultation. Also lists the contents that must be observed in the contacts: practical problems in the puncture or tables of dosing, assessment of the implementation of the programme, dump the data registered in the coagulometer to the computer system, revision of the autoanalyzer, material supply and treatment settings. Reviews of records that help us detect and assess problems that are resolved by a continuous and permanent health education almost in its entirety should periodically conduct. Finally, we present a study on the incidence of adverse effects occurring in self-controlled patients that we are witnessing in our unit(AU)

[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.

Efectividad de los ácidos grasos hiperoxigenados en la prevención 122de las úlceras vasculares. Una revisión sistemática / Hyperoxygenated fatty acid effectiveness in the prevention of thevascular ulcers

Objetivos: conocer la eficacia de los ácidos grasos hiperoxigenados (AGHO)en la prevención de las úlceras vasculares. Determinar el nivel de evidenciaexistente sobre el uso de ácidos grasos hiperoxigenados en la prevención delas úlceras vasculares. Material y método: se realizó una búsquedabibliográfica en la The Cochrane Library, The Joanna Briggs Institute, PubMed-Medline y CUIDEN. Para su evaluación se han seguido las recomendacionesdel sistema GRADE para la valoración de la evidencia y la fuerza de lasrecomendaciones. Resultados: en The Cochrane Library y en The JoannaBriggs Institute no aparece ningún documento que haga referencia a losAGHO. En el resto de bases de datos encontramos estudios observacionalesque hacen referencia a las úlceras vasculares y AGHO. Conclusiones: aun nodisponiendo de ensayos clínicos que evidencien su uso, se han venidoutilizando durante los últimos años, con resultados satisfactorios, en elcuidado de la piel de las personas con alteraciones vasculares en los miembrosinferiores. De acuerdo con la clasificación GRADE, todos los estudiosarrojan una calidad de evidencia baja, por lo cual estimamos necesario lapuesta en marcha de investigaciones que aporten mayor evidencia científica (AU)

Objectives: to determine the effectiveness of hyper-oxygenated fatty acids in theprevention of vascular ulcers. Determine the level of existing evidence the use ofhyper-oxygenated fatty acids in the prevention of vascular ulcers. Material andMethod: we performed a literature search of Cochrane Library, The Joanna Briggs Institute, PubMed, Medline and CUIDEN. For the evaluation, havefollowed the recommendations of the GRADE system for assessing evidence andstrength of recommendations. Results: The Cochrane Library and The JoannaBriggs Institute does not see any document referring to AGHO. In all otherdatabases are observational studies that relate to vascular ulcers and AGHO.Conclusions: although not having clinical trials demonstrating their use, inrecent years, have been used successfully in skin care for people with lower limbvascular disorders. According to the classification GRADE, all studies show alow-quality evidence, which we consider necessary for the implementation ofmost scientific research (AU)

3.er Estudio Nacional de Prevalencia de Úlceras por Presión en España, 2009. Epidemiología y variables definitorias de las lesiones y pacientes / 3rd National Survey of the Prevalence of Pressure Ulcers in Spain, 2009

Conocer la dimensión de un problema en el ámbito de la salud es, sin dudaalguna, la fórmula previa obligada y más eficiente para encararlo a nivelpreventivo y terapéutico. Con esa filosofía el GNEAUPP ha buscado desde sunacimiento, entre otros, el hallazgo de valores epidemiológicos de las úlceras porpresión (UPP) en España, al tiempo que determinar aspectos relacionados conactividades preventivas de las mismas en los distintos contextos asistenciales(atención primaria, especializada y sociosanitaria).En esta línea de trabajo se han desarrollado tres estudios nacionales deprevalencia en 2001, 2005 y 2009. El cuestionario postal fue el instrumentoutilizado para estimar la prevalencia puntual y media de UPP, a partir de unamuestra no aleatoria. A través de estos cuestionarios se solicitaba a losprofesionales de atención primaria que informasen acerca de su lista de usuariosmayores de 14 años (Unidades básicas asistenciales de Medicina General) y a losprofesionales de unidades de hospitalización o de centros sociosanitarios queinformasen acerca de los pacientes de sus respectivas unidades. Se definió laprevalencia como "prevalencia puntual" (información en un solo momento deltiempo). Se calculó la prevalencia cruda (PC) y media (PM).En el estudio de 2009 se reportaron datos de 1596 pacientes con UPP. 625de los pacientes procedían de cuestionarios de hospitales (39,2% del total depacientes), 347 (21,7%) de centros de atención primaria y los 624 restantes(39,1%) de centros sociosanitarios. De éstos, 1.344 (84,2%) son pacientescon UPP mayores de 65 años de los que 324 (24,1%) son de centros deatención primaria, 474 (40,6%) de hospitales y 546 (35,3%) de centrossociosanitarios (..) (AU)

Ascertaining the scale of a health problem is, without a doubt, the necessary -and most efficient- first step to approaching it in preventive andtherapeutic terms. With this philosophy in mind, the GNEAUPP has since itscreation sought to establish epidemiological values for pressure ulcers (orbedsores) in Spain, at the same time determining aspects connected withpreventive measures in the different care contexts (primary, specialised andlong-term healthcare). To this end it has conducted three national surveys of prevalence, in 2001, 2005 and 2009. The postal questionnaire was the instrument used to estimate specificand average prevalence on the basis of a non-random sample. Through thesequestionnaires primary care staff were asked to supply information about their listof users aged over 14 (in the case of basic care units for general medicine) andstaff of hospital units or long-term care centres were asked about the patients intheir respective units.Prevalence was defined as "specific prevalence" (information at a specific point intime). Gross prevalence (GP) and average prevalence (AP) were calculated.In the 2009 survey data was reported for 1,596 patients with pressure ulcers.625 of these came from hospital questionnaires (39.2% of the total of patients), 347 (21.7%) from primary healthcare centres and the remaining 624 (39.1%)from long-term care centres. Of these, 1.344 (84.2%) were patients with pressureulcers aged over 65, of whom 324 (24.1%) were from primary healthcarecentres, 474 (40.6%) from hospitals and 546 (35.3%) from long-term carecentres (AU)

[The paradigm of postural changes]. / El paradigma de los cambios posturales.

Interesting essay today on considerations about the need to make changes to prevent postural upp, how often do them and what other measures can be used.

El paradigma de los cambios posturales / The paradigm of postural changes

Ensayo de interesantísima actualidad sobre las consideraciones en torno a la necesidad de realizar cambios posturales para prevenir upp, con qué frecuencia hacerlos y qué otras medidas pueden emplearse(AU)

Interesting essay today on considerations about the need to make changes to prevente postural upp, how often do them and what other measres can be used(AU)

Úlceras tropicales: la que se nos viene encima / Tropical ulcers: that is upon us

Las úlceras en piel propias de las llamadas enfermedades del trópico seconsideran como de baja prevalencia en nuestras sociedades desarrolladas.Pero la úlcera tropical o fagedénica, aquella propia de la lepra o las que semanifiestan en diferentes parasitosis, cada vez nos llaman más la atención; enparte, por la teórica influencia de la inmigración en nuestra civilización y elmiedo a la enfermedad de afuera que lleva implícita, en parte por el turismoaventurero que muchas veces las incorpora como recuerdo del viaje a tierraslejanas. La realidad es que este tipo de lesiones merece, tanto por sugravedad como por su impacto en nuestra cultura, de los cuidados que hastael día de hoy las veía como algo lejano y ajeno, un interés concreto que lasdefina, concretice y clasifique. En cuanto al comportamiento de la cura enambiente húmedo de estas úlceras, poco sabemos por propia experiencia yaún menos en su uso como parte del tratamiento en países de esta zona delmundo, donde una pobreza extensiva condiciona la disponibilidad derecursos para el cuidado. Pero ponerse en sobre aviso con la informaciónsuficiente, nos permitirá casi siempre identificar precozmente estas lesionesy, de la misma forma, encauzar el tratamiento local más efectivo. (AU)

The sores in skin own of the so called diseases of the tropic, they are consideredlike of fall prevalencia in our developed societies. But the tropical sore orfagedénica, proper that one of the leprosy or those who demonstrate in differentparasitosis, every time they are called us more the attention; partly for thetheoretical influence of the immigration in our civilization and the fear of thedisease of out that implicit ride, partly for the adventurous tourism that oftenincorporates them as recollection of the trip to distant lands. The reality is that this type of injuries deserves so much for his your gravity, since for his yourimpact in our culture of the elegant ones, that until today it saw them assomething distant and foreign, a concrete interest that defines them, concreticeand classifies. As for the behavior of it recovers in humid environment of thesesores, little we know for proper experience and even less in his your use as reportof the treatment in countries of this zone of the world, where an extensive povertydetermines the availability of resources for the care. But to put in on notice withthe sufficient information, itwill allow us always to identify almost prematurely,these injuries and of the same form to channel the most effective local treatment (AU)

Perfil social de los cuidadores familiares de pacientes dependientes ingresados en el Hospital General Universitario de Elche / Social profile of the family caregiver of dependant patients in the University General Hospital of Elche

El objetivo de este estudio es describir el perfil social delos cuidadores familiares en el Hospital General Universitariode Elche y conocer el tipo de necesidades que cubren.Metodología: Investigación de tipo descriptivo ytransversal, mediante 32 encuestas realizadas entre eneroy febrero de 2008, en el Servicio de Medicina Interna.Se efectuó un análisis descriptivo y las variables fueronedad, sexo, ingresos económicos, vivienda, trabajo, parentescodel cuidador y permanencia en el centro hospitalario.Resultados: El perfil del cuidador informal correspondea una mujer, con una media de edad de 54años y que permanece todo el día en el hospital. Las necesidadesque el cuidador distingue como más importantesestuvieron relacionadas con la compañía, la vigilanciay las necesidades básicas. Conclusiones: El perfildel cuidador familiar es de cónyuges o madres. La realizaciónde las tareas de cuidador supone un gasto detiempo, dinero, desgaste físico, psicológico y social. Partede las necesidades del paciente son cubiertas por loscuidadores informales, que reciben poca información yasesoramiento del personal de enfermería sobre cómorealizarlas. Por tanto, ampliar la mirada enfermera esuna exigencia y demanda de nuestra sociedad (AU)

The aim of this study is to describe the social profile of the familycaregivers in the University General Hospital of Elche,and to know the sort of needs that they cater for. Methodology:This is a descriptive and transversal piece of research, performedby means of 32 surveys done between January and February2008 in the Internal Medicine service. A descriptive analysiswas carried out; such analysis bore in mind the following variables:the caregivers’ age, sex, income, dwelling, employment,their kinship with the patient and the lenght of stay at the hospital.Results: The profile of the average informal caregiver correspondsto a woman of approximately 54 years old who staysall day in the hospital. Caregivers consider that the most importantneeds they meet are related to keeping their relative company,watching over them, and meeting their basic needs. Conclusions:With respect to the profile of family caregivers, spousesand mothers account for most caregivers. The tasks carried outby caregivers imply spending their time and money, and alsophysical, pysichological and social exhaustion. Part of the patients’needs are covered by informal caregivers, who receive littleinformation and advising from the nursing staff about how toprovide care for their disabled relatives. Therefore, nurses doinga closer monitoring of patients and caregivers and paying moreattention to them is a requirement and a demand of our society (AU)

[Compilation of historical anecdotes about chronic wounds. Well-known people who have suffered from them]. / Anecdotario histórico de las heridas crónicas. Personajes ilustres que las han padecido.

Throughout the course of human history many people have been affected by the presence of chronic wounds. Millions of anonymous people have suffered bed sores, varicose ulcers, arterial ulcers or neuropathic ulcers. But there have been some famous people who, from time to time, remove these lesions from their cloak of invisibility In our day and age, every time a famous person suffers from these wounds, we observe how the means of communication publicize this health problem. However famous people also suffered from these wounds in the past. In this article, the authors will review historical figures who died due to these feared sores. Kings or saints have been affected by this problem. Specifically the authors will focus on six historical figures: three kings, one composer and two saints,; the authors shall analyze the influence of chronic wounds as a cause of their deaths. This article was submitted at the VII National Symposium on Bed Sores and Chronic Wounds and at the First Latin American Congress on Ulcers and Wounds.

Anecdotario histórico de las heridas crónicas. Personajes ilustres que las han padecido / Compilation of historical anecdotes about chronic wounds well-known people who has suffered them

A lo largo de la historia de la humanidad muchas personas se han visto afectadas por la presencia de heridas crónicas. Millones de personas anónimas han padecido úlceras por presión, venosas, arteriales o neuropáticas. Pero también han existido personajes famosos que, de vez en cuando, sacan estas lesiones de su invisibilidad. En nuestros días, cada vez que alguna persona famosa las padece, vemos cómo los medios de comunicación se hacen eco del problema. Pero, en el pasado, también personajes ilustres las sufrieron. En el presente artículo histórico efectuaremos un repaso a personajes históricos que también han muerto por las temidas «llagas». Así, reyes o santos, se han visto afectados por este problema. Concretamente nos centraremos en seis personajes históricos: tres reyes, un compositor y dos santos y analizaremos la influencia de las heridas crónicas en la causa de su muerte. Artículo expuesto en el VII Simposio Nacional de Úlceras por Presión y Heridas Crónicas y I Congreso Latinoamericano sobre Úlceras y Heridas(AU)

Throughout the course of human history, many people have been affected by the presence of chronic wounds. Millions of anonymous people have suffered bed sores, varicose ulcers, arterial ulcers or neuropathic ulcers. But there have been some famous people who, from time to time, remove these lesions from their cloak of invisibility. In our day and age, every time a famous person suffers from these wounds, we observe how the means of communication publicize this health problem. However, famous people also suffered from these wounds in the past. In this article, the authors will review historical figures who died due to these feared sores. Kings or saints have been affected by this problem. Specifically, the authors will focus on six historical figures: three kings, one composer and two saints; the authors shall analyze the influence of chronic wounds as a cause of their deaths. This article was submitted at the VII National Symposium on Bed Sores and Chronic Wounds and at the First Latin American Congress on Ulcers and Wounds(AU)