Limpieza de úlceras de etiología venosa. Una revisión sistemática / Cleansing venous leg ulcers. A systematic review

Objetivo: Evaluar los efectos de la limpieza, así como las soluciones y técnicas utilizadas, para el tratamiento de las úlceras de etiología venosa. Metodología: Se realizó una revisión sistemática siguiendo las últimas recomendaciones de la declaración PRISMA. La búsqueda se realizó en 3 bases de datos (PubMed, CINAHL, Cochrane), limitándose por idioma (inglés/español) y por año (de enero de 2011 a diciembre de 2021). Siguiendo el diagrama PRISMA, se realizó la depuración y evaluación de calidad de los estudios por pares, utilizando las normas de la Red EQUATOR, y seleccionando únicamente ensayos clínicos aleatorizados y revisiones sistemáticas de calidad media o alta. Resultados: Se identificaron un total de 790 artículos, de los cuales se eliminaron 58 por estar duplicados, 700 tras la revisión por título y resumen, y 25 en el cribado por texto completo. De los 7 artículos restantes, se incluyeron 5 al presentar alta calidad metodológica (cumplieron > 70% de los ítems), 3 con diseño de estudio clínico aleatorizado y 2 revisiones sistemáticas. Conclusiones: Actualmente, no se dispone de evidencias científicas sólidas que den valor a la limpieza dentro del tratamiento integral de las heridas. Se necesitan más estudios que permitan orientar a los profesionales en la toma de decisiones para realizar una práctica segura y una optimización de los recursos existentes, considerando a la persona, sus necesidades y su satisfacción en el proceso del cuidado de las lesiones (AU)

Objectives: To evaluate the effects of cleansing venous ulcers on the healing, as well as wound cleansing solutions available and wound cleansing techniques used. Methodology: A systematic review has been made following the PRISMA statement recommendations. This research used 3 databases (PubMed, CINAHL, Cochrane), filtering by language (English/Spanish) and by date (from January 2011 to December 2021). Diagram PRISMA was the base for filtering and evaluating the peer review quality, using the EQUATOR Network and selecting only the randomised clinical trial (RCT) and high or medium quality systematic reviews (SR). Results: A total of 790 articles were identified, of which 58 were eliminated as duplicates, 700 after reviewing by title and abstract, and 25 after screening by full text. Of the 7 remaining articles, 5 of them were included as they were of high methodological quality (more than 70% of the items were accomplished), 3 with an RCT design and 2 SR. Conclusions: Currently, there is no solid scientific evidence that gives credence that cleansing injuries, adds value, within the comprehensive treatment of wounds. More studies are needed, to give professionals decision-making guidelines for providing safe practices and optimising existing resources, considering the state of the patient, their needs and their comfort during the process of injury care (AU)

An historical ecological assessment of land-use evolution and observed landscape change in an arid aeolian sedimentary system.

Coastal areas worldwide are undergoing major changes and degradation due to a set of combined natural and anthropogenic stressors. In arid aeolian sedimentary systems these changes can be even more acute given their sensitivity to perturbances in landscape dynamics. While in many such areas recent (20 year) observations have been made regarding measurable differences in dune coverage and stability, few studies have assessed and quantified the long-term relationships of transitioning exploitation and land-use changes in order to fully evaluate their importance. Land management, therefore, does not always benefit from the more holistic picture that a combined deeper time historical ecology and geographical approach provides and can contribute to decision making. The Jandía isthmus, in Fuerteventura (Canary Islands, Spain) presented an ideal field laboratory in which to assess these phenomena in actual conditions and test a combined methodology using historical and current sources (historical documents, aerial photographs, orthophotos, LiDAR data, field work and oral sources). By doing so, different phases of land exploitation associated with changing land ownership were identified and the consequences of each on the dune system assessed. It is concluded that the transition from traditional land uses (livestock and fuel extraction) to more recent ones (aggregate extraction, construction of new roads and urban-touristic resorts, and some recreational uses) has altered aeolian sedimentary transport, inducing stabilization of the landforms, as well as producing significant changes in the vegetation. The wider application of this type of study can benefit the many other areas worldwide that are facing similar pressures.