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2.
Enferm. clín. (Ed. impr.) ; 30(2): 72-81, mar.-abr. 2020. tab, graf
Artigo em Espanhol | IBECS-Express | ID: ibc-FGT-3069

RESUMO

Objetivo: Evaluar el nivel de autocuidados en la población con diabetes y determinar el riesgo de padecer lesiones de pie diabético mediante el uso de 3 sistemas de estratificación, así como establecer el grado de concordancia entre estos sistemas. Método: Estudio observacional, transversal y descriptivo realizado en la Zona básica de salud de Santa Brígida (Gran Canaria, Islas Canarias, España) en personas diagnosticadas de diabetes (DM tipo 1/DM tipo 2) (n = 182). Se realizaron entrevista, exploración física, revisión de la historia clínica y cumplimentación del cuestionario Diabetic Foot Self-Care questionnaire of the University of Malaga. Tras ello se calculó la estratificación del riesgo con 3 sistemas (sistema del National Institute for Health Care Excellence, clasificación del International Working Group on the Diabetic Foot y High-Risk Diabetic Foot-60-Second Tool© 2012). Se calculó el índice kappa para estudiar la concordancia entre sistemas, se estimaron el riesgo relativo de screening negativo de un método frente a otro y el test exacto de Fisher para establecer si existían diferencias. Resultados: Un 30,2% de los diabéticos tenían un nivel bajo de autocuidados, un 45,1% un nivel medio y un 24,7% nivel alto. Los niveles de riesgo calculados fueron: fueron clasificación National Institute for Health Care Excellence (riesgo negativo 71,4%; riesgo positivo 28,6%), clasificación del International Working Group on the Diabetic Foot (riesgo negativo 67,0%; riesgo positivo 33,0%) y High-Risk Diabetic Foot-60-Second Tool© (riesgo negativo 62,6%; riesgo positivo 37,4%). Conclusiones: Los 3 sistemas poseen una buena concordancia entre sí. El High-Risk Diabetic Foot-60-Second Tool© solo distingue 2 niveles de riesgo pero detecta mayor porcentaje de personas en situación de riesgo. El cuestionario Diabetic Foot Self-Care questionnaire of the University of Malaga puede ser útil en el contexto de Atención Primaria para evaluar el nivel de autocuidados de las personas con diabetes


Objective: To assess the level of self-care in the population with diabetes and determine the risk of diabetic foot lesions through the use of 3 stratification systems as well as to establish the degree of concordance between these systems. Method: Observational, cross-sectional and descriptive study carried out in the Basic Health Area of Santa Brígida (Gran Canaria-Canary Islands-Spain) in people diagnosed with diabetes (DM Type 1/DM Type 2) (n = 182). Interview, physical examination, review of clinical history and completion of the Diabetic Foot Self-Care questionnaire of the University of Malaga were carried out. The risk stratification was then calculated using 3systems (System of the National Institute for Health Care Excellence, Classification of the International Working Group on the Diabetic Foot and High-Risk Diabetic Foot-60-Second Tool©-2012). The Kappa index was calculated to study the concordance between systems, the relative risk of negative screening of one method against another was estimated and the exact Fisher test to establish whether there were differences. Results: 30.2% of diabetics had a low level of self-care, 45.1% a medium level and 24.7% a high level. The risk levels calculated were: National Institute for Health Care Excellence Classification (Negative Risk 71.4%-Positive Risk 28.6%), International Working Group on the Diabetic Foot Classification (Negative Risk 67.0%-Positive Risk 33.0%) and High-Risk Diabetic Foot-60-Second Tool© (Negative Risk 62.6%-Positive Risk 37.4%). Conclusions: All 3 systems have good concordance with each other. The High-Risk Diabetic Foot-60-Second Tool© only distinguishes 2 levels of risk but detects a higher percentage of people at risk. The Diabetic Foot Self-Care questionnaire of the University of Malaga may be useful in the context of Primary Care to assess the level of self-care of people with diabetes

4.
Enferm Clin ; 2019 Sep 06.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31500959

RESUMO

OBJECTIVE: To assess the level of self-care in the population with diabetes and determine the risk of diabetic foot lesions through the use of 3stratification systems as well as to establish the degree of concordance between these systems. METHOD: Observational, cross-sectional and descriptive study carried out in the Basic Health Area of Santa Brígida (Gran Canaria-Canary Islands-Spain) in people diagnosed with diabetes (DM Type 1/DM Type 2) (n=182). Interview, physical examination, review of clinical history and completion of the Diabetic Foot Self-Care questionnaire of the University of Malaga were carried out. The risk stratification was then calculated using 3systems (System of the National Institute for Health Care Excellence, Classification of the International Working Group on the Diabetic Foot and High-Risk Diabetic Foot-60-Second Tool©-2012). The Kappa index was calculated to study the concordance between systems, the relative risk of negative screening of one method against another was estimated and the exact Fisher test to establish whether there were differences. RESULTS: 30.2% of diabetics had a low level of self-care, 45.1% a medium level and 24.7% a high level. The risk levels calculated were: National Institute for Health Care Excellence Classification (Negative Risk 71.4%-Positive Risk 28.6%), International Working Group on the Diabetic Foot Classification (Negative Risk 67.0%-Positive Risk 33.0%) and High-Risk Diabetic Foot-60-Second Tool© (Negative Risk 62.6%-Positive Risk 37.4%). CONCLUSIONS: All 3systems have good concordance with each other. The High-Risk Diabetic Foot-60-Second Tool© only distinguishes 2levels of risk but detects a higher percentage of people at risk. The Diabetic Foot Self-Care questionnaire of the University of Malaga may be useful in the context of Primary Care to assess the level of self-care of people with diabetes.

7.
Int Wound J ; 16(1): 256-265, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30393963

RESUMO

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.


Assuntos
Úlcera da Perna/epidemiologia , Úlcera da Perna/terapia , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/tendências , Úlcera Varicosa/epidemiologia , Úlcera Varicosa/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Epidemiológicos , Feminino , Previsões , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Espanha/epidemiologia , Estudos de Tempo e Movimento
8.
Rev. Rol enferm ; 41(11/12): 730-737, nov.-dic. 2018. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-179764

RESUMO

Dentro de las respuestas que han surgido a la problemática ocasionada por las heridas crónicas, la creación de unidades clínicas especializadas ha sido una de las que mayor interés ha despertado en los últimos años. Estas unidades están conformadas por profesionales de diferentes disciplinas que se organizan de acuerdo con un servicio-departamento unificado. A través de enfoques interdisciplinarios-transdisciplinarios consiguen una atención integral a estos pacientes, identificando todos los factores que pueden afectar a la cicatrización de heridas crónicas y paliando los problemas asociados a la complejidad y heterogeneidad de estas lesiones. La implantación de este modelo todavía no está completamente desarrollada en nuestro país a pesar de su conveniencia y la creación de nuevas unidades de heridas a menudo acarrea dificultades y dudas. Este trabajo aporta algunas claves de las ventajas de la adopción de este modelo organizativo y sugiere algunas ideas para aquellas personas u organizaciones que estén planteándose la instauración de este modelo


Among the responses to the problems caused by chronic wounds, the creation of specialized clinical units has been one of the most interesting in recent years. These units are made up of professionals from different disciplines who are organized on the topic of a unified department-service. Through interdisciplinary-transdisciplinary approaches, they achieve comprehensive care for these patients, identifying all the factors that can affect the healing of chronic wounds and alleviating the problems associated with the complexity and heterogeneity of these lessions. The implementation of this model is not yet fully developed in our country despite its desirability and the creation of new wounds units often carry difficulties and doubts. This work provides some keys to the advantages of adopting this organizational model and suggests some key points for those people or organizations that are considering the establishment of this model


Assuntos
Humanos , Lesão por Pressão/enfermagem , Técnicas de Fechamento de Ferimentos/enfermagem , Infecção dos Ferimentos/enfermagem , Ferimentos e Lesões/enfermagem , Unidades Hospitalares/organização & administração , Doença Crônica/enfermagem , Cuidados de Enfermagem/métodos , Equipe de Assistência ao Paciente/organização & administração
9.
Gerokomos (Madr., Ed. impr.) ; 29(4): 197-209, dic. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-182266

RESUMO

Introducción: Se han publicado diversos sistemas de clasificación para las lesiones de pie diabético, si bien ninguno de los propuestos ha sido asumido por la comunidad científica como el sistema a utilizar por todos, y esto es debido a múltiples razones. Objetivos: Dar visibilidad a los nuevos sistemas de clasificación de pie diabético surgidos en los últimos años, además de poder contrastarlos con los sistemas ya conocidos anteriormente. Material y método: Búsqueda bibliográfica en las bases de datos SCOPUS, PubMed/Medline, WOS, CINHAL, Cochrane y CUIDEN. La ecuación de búsqueda utilizada fue la combinación booleana de los términos MeSH "diabetic foot AND classification". La búsqueda se realizó entre el 1 febrero de 2018 y el 30 marzo de 2018. Resultados: Existen 25 sistemas de clasificación de úlceras de pie diabético, que se pueden dividir en sistemas de clasificación-severidad de la lesión o sistemas de predicción de curación-amputación. Muy pocos sistemas han sido validados adecuadamente. Conclusiones: La elección del sistema de pie diabético a utilizar va a estar condicionada por aspectos como el ámbito asistencial, los recursos disponibles o los objetivos que se persiguen. En los últimos años se prefiere el uso de sistemas con enfoque predictivo frente a los sistemas con enfoque descriptivo


Introduction: Various classification systems have been published for diabetic foot ulcers, although none of the proposed systems has been accepted by the scientific community as the system to be used by all, and this is due to multiple reasons. Objectives: To give visibility to the new systems of diabetic foot classification that have emerged in recent years, as well as to compare them with the systems already known previously. Methods: Bibliographic search in the SCOPUS, Pubmed/Medline, WOS, CINHAL, Cochrane and CUIDEN databases. The search equation used was the boolean combination of the MeSH terms "diabetic foot AND classification". The search was conducted between 1 February 2018 and 30 March 2018. Results: There are 25 classification systems for diabetic foot ulcers, which can be divided into classification-severity systems or healing-amputation prediction systems. Very few systems have been properly validated. Conclusions: The choice of the diabetic foot system to be used will be conditioned by aspects such as the assistencial scene, the available resources or the objectives pursued. In recent years, the use of systems with a predictive approach has been preferred over systems with a descriptive approach


Assuntos
Humanos , Pé Diabético/classificação , Cicatrização , Índice de Gravidade de Doença , Úlcera do Pé/classificação , Úlcera do Pé/terapia , Pé Diabético/fisiopatologia , Pé Diabético/cirurgia
10.
Gerokomos (Madr., Ed. impr.) ; 28(3): 142-150, sept. 2017. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-168999

RESUMO

Introducción: A pesar del interés creciente por las unidades de heridas como modelo organizativo para la prestación de servicios a las personas con heridas crónicas, no tenemos información acerca del número, distribución, funcionamiento y características de estas estructuras en España. Objetivos: Identificar las unidades de atención especializada de heridas crónicas en nuestro país y realizar el primer censo de estas. Metodología: Estudio observacional de tipo descriptivo de corte transversal. Se realizó un sistema de muestreo no probabilístico compuesto por tres escalones de muestreo. Se utilizó un cuestionario específicamente diseñado para ello (CVI-Total para Pertinencia = 0,96 y CVI-Total para Relevancia = 0,94) para la obtención de datos, que incluyó la recogida de información sobre: nombre, localización, año de creación, organismo responsable y ámbito de localización de las unidades. Resultados: Un total de 75 posibles unidades candidatas a estudio fueron detectadas en los tres escalones de muestreo realizados. Se reclutaron 44 unidades para el estudio, si bien dos debieron ser retiradas. Finalmente, se incluyó un total de 42 unidades en el primer censo de unidades de heridas en el territorio español. Conclusiones: El número de unidades de heridas en nuestro país es bajo, y existe gran disparidad con respecto a su distribución geográfica por comunidades. Además, estas estructuras están sujetas a muchos cambios. Esto conlleva la desaparición y aparición de unidades de heridas con relativa rapidez, aunque parece que es un sistema organizativo cada vez más aceptado en España, existiendo un número creciente de estas estructuras organizativas en nuestro país


Introduction: Despite the growing interest in wound care units as an organizational model for the provision of services to people with chronic wounds, we do not have information about the number, distribution, functioning and characteristics of these structures in Spain. Objectives: To identify the units of specialized care of chronic wounds in our country and to carry out the first census of these. Methodology: Observational study of a descriptive cross-sectional type. A non - probabilistic sampling system was made up of three sampling steps. A questionnaire specifically designed for this purpose (CVI-Total for Pertinence = 0.96 and CVI-Total for Relevance = 0.94) was used to obtain dates, which included the collection of information on: Name, Location, Year of creation, Agency responsible and Scope of the units. Results: A total of 75 possible candidate units were detected in the three sampling stages. 44 units were recruited for the study, although 2 units had to be retired. Finally, a total of 42 units were included in the first census of wound units in Spain. Conclusions: The number of wound units in Spain is low, with a great disparity with respect to their geographical distribution by regions. In addition, these structures are subject to many changes. This leads to the disappearance and appearance of wounded units relatively quickly, although it seems to be an increasingly accepted organizational system in Spain, with an increasing number of these organizational structures in our country


Assuntos
Humanos , Ferimentos e Lesões/epidemiologia , Censos/estatística & dados numéricos , Unidades Hospitalares/organização & administração , Unidades Hospitalares/estatística & dados numéricos , Estudos Observacionais como Assunto/métodos , Estudos Transversais/métodos , Estudos Transversais/estatística & dados numéricos , Inquéritos e Questionários
11.
Int Wound J ; 14(2): 360-368, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27112627

RESUMO

This study aims to determine health-related quality of life (HRQoL) in patients suffering with venous ulceration and to correlate wound's severity status with HRQoL loss as well as identify the aspects of HRQoL most negatively affected by the presence of venous ulcers. In this observational, cross-sectional, descriptive, analytical multi-centre study, data was compiled over a period of 3·5 months. Thrity-four patients with venous ulceration were recruited. The RESVECH 2·0 scale was used to monitor wounds. The MAID scale was used to measure wound's severity. The Charing Cross Venous Ulcer Questionnaire (CCVUQe) (Spanish version) was used to evaluate quality of life. The mean CCVUQe score was 60·58 ± 16·04. The HRQoL dimension most affected was 'Emotional state' (mean score = 77. 67 ± 17·34). The average RESVECH 2.0 score for the wounds was 13·15 ± 5·07. A statistically significant association between total CCVUQ-e score and total RESVECH 2.0 score was detected [Pearson correlation coefficient r = 0·546 (P ≤ 0·001)]. Venous ulcers affect patients' HRQoL, particularly their emotional status. There is a relationship between the severity of the wound and loss of HRQoL. The presence of non-viable tissue, poor exudate control and infection all determine loss of HRQoL. New studies are needed to confirm these findings.


Assuntos
Atividades Cotidianas/psicologia , Qualidade de Vida/psicologia , Úlcera Varicosa/psicologia , Úlcera Varicosa/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Espanha , Inquéritos e Questionários , Cicatrização , Adulto Jovem
12.
Gerokomos (Madr., Ed. impr.) ; 23(3): 118-122, sept. 2012. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-106044

RESUMO

La desnutrición es un problema grave y conlleva importantes consecuencias sociosanitarias y económicas. En pacientes inmovilizados, las úlceras por presión son una de las complicaciones más frecuentes, constituyendo una epidemia silente evitable en el mayor número de casos, donde la valoración o cribado nutricional juega un papel primordial en su prevención. La prevalencia de desnutrición cercana al 50%, observada en una muestra de 62 pacientes de un centro de salud, subrayan la necesidad de su diagnóstico precoz para poner en marcha medidas preventivas y terapéuticas que mejoren la calidad de vida de los pacientes, disminuyendo la aparición de patologías asociadas y la institucionalización/hospitalización (AU)


Undernourishment is a serious problem with important social, sanitary and economical consequences. Concerning immobilised patients, ulcers caused by pressure are the most frequent and they represent a silent epidemic which in most cases is not necessarily unavoidable because a correct nutrition screening plays a decisive role in preventing it. The alarming lack of nutrition, 50%, in a survey of 62 patients who were observed in out-patient clinics (Centros de Salud) underline the necessity of an early diagnosis so as to activate prevention and therapeutical measures to improve the patients' well-being, thereby reducing possible associated pathologies and subsequential hospitalization (AU)


Assuntos
Humanos , Avaliação Nutricional , Pacientes Domiciliares/estatística & dados numéricos , Institucionalização/estatística & dados numéricos , Programas de Rastreamento/métodos , Serviços Hospitalares de Assistência Domiciliar/estatística & dados numéricos , Lesão por Pressão/epidemiologia , Transtornos Nutricionais/complicações
13.
Gerokomos (Madr., Ed. impr.) ; 23(2): 75-87, jun. 2012. tab
Artigo em Espanhol | IBECS | ID: ibc-102954

RESUMO

La necesidad de unificar criterios empleando un mismo lenguaje que favorezca la comunicación y el intercambio de conocimientos unido al desconocimiento existente en cuanto a las distintas formas de clasificación de las heridas crónicas, ha motivado a los autores para llevar a cabo esta revisión bibliográfica en la que se analizan quince sistemas de clasificación de lesiones de pie diabético y se abordan entre otros, aspectos como la metodología, facilidad de utilización, grado de conocimiento, utilidad de la información aportada y limitaciones de cada uno de ellos. Con ello, los autores no pretenden sino facilitar que los profesionales implicados en el cuidado de las úlceras diabéticas conozcan las distintas formas de estadiaje existentes en el pie diabético y en general en las heridas crónicas (AU)


The need of unify criterions using a same idiom contributing communication and interchanging knowledge together with ignorance existing in relation to the different ways of classificating chronic wounds is the reason for the authors to carry out this review analyzing fifteen classification systems in diabetic foot wounds dealing with subjects such as methodology, simplicity of use, grade of knowledge, usefulness of the information provided and limitations of each one. And so the authors pretend helping that those professionals taking care of diabetic foot ulcers can get to know different ways of staging diabetic foot wounds and chronic wounds in general (AU)


Assuntos
Humanos , Pé Diabético/classificação , Complicações do Diabetes/classificação , Pé Diabético/enfermagem , Cicatrização , Infecção dos Ferimentos/enfermagem , Técnicas de Fechamento de Ferimentos/enfermagem
14.
Gerokomos (Madr., Ed. impr.) ; 21(4): 172-182, dic. 2010. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-95570

RESUMO

El pie diabético es una complicación crónica de la diabetes mellitus y constituye una problemática sanitaria al conllevar un enorme gasto económico a losservicios sanitarios y provocar a las personas que lo padecen y a su entorno familiar enormes repercusiones emocionales. La educación sanitaria en el cuidado de los pies de los diabéticos, así como la cuantificación del riesgo son aspectos que el enfermero debe incorporar en los planes de cuidados de los pacientes diabéticos. La detección de los posibles factores de riesgo es un paso previo imprescindible para estos cometidos. Este estudio tiene como finalidad analizar la presencia de determinados factores de riesgo en pie diabético en la población diabética del Centro de Salud de Triana, con el objetivo de poder realizar, así, una estratificación del riesgo. Para ello, se optó por la realización de un estudio observacional descriptivo. La muestra analizada estaba constituidapor 96 sujetos diabéticos pertenecientes a dicho centro de salud. Para la recogida de datos se utilizó un sistema de tres niveles consistente en entrevista,exploración física y consulta de registros disponibles (a través de las historias clínicas de los sujetos). Los datos se registraron en un formulario de recogida de datos para pie diabético. Se determinó la existencia de factores de riesgo, analizando las relaciones entre éstos y permitiendo la estratificación del riesgo en la población estudiada (AU)


The diabetic foot is a chronic complication of diabetes mellitus and constitutes asanitary problem which causes not only enormous expenses for the sanitary system but also provokes emotional repercussions for the person who suffers the illness and for the family. The sanitary education in taking care of the feet of diabetics and the identification of the health risk are both aspects that the nurse must include in the healthcare planning of diabetic patients. The detection of the possible risk factorsis an essential previous step in nursing. The purpose of this study is to detect the presence of certain risk factors in diabetic foot in the diabetic population of Triana Healthcare Centre to be able to carry out a stratification of the risk. For this research, there was chosen an observational, descriptive and transversal study.The analyzed sample was constituted by 96 diabetic subjects belonging to the Healthcare Centre. For the data collection, we use different systems such as interviews,physical exams and the available records (clinical history of the patients).The information has been recorded in a questionnaire of the diabetic foot. The existence of risk factors was determined by analyzing the relationship between them allowing the risk stratification of the studied sample (AU)


Assuntos
Humanos , Pé Diabético/classificação , Diagnóstico de Enfermagem/métodos , Neuropatias Diabéticas/complicações , Fatores de Risco , Índice de Gravidade de Doença
15.
Peu ; 30(3): 120-128, jul.-sept. 2010. ilus
Artigo em Espanhol | IBECS | ID: ibc-83782

RESUMO

A menudo es el podólogo quien debe enfrentarse a lesiones que se cronifican y que, en ocasiones, se asocian a afecciones de origen metabólico como la diabetes mellitus; desempeñando un importante papel para prevenir algunas de sus complicaciones. A pesar de ello, una vez que la lesión aparece, conseguir su cicatrización supone un reto complicado. El objetivo principal del presente artículo es aportar una perspectiva de abordaje local basado en la adecuada valoración y preparación de las características del lecho de la herida puesto que, independientemente del origen y etiología, su aspecto y características son de gran utilidad para la planificación de la estrategia terapéutica a seguir. A este respecto, el “concepto TIME” posibilita la correcta preparación del lecho de la herida mediante el empleo de productos de cura en ambiente húmedo que contribuyen a eliminar las barreras que dificultan el proceso natural de cicatrización(AU)


It is often the podiatrist the one who deals with chronic wounds as sometimes they appear associated to metabolic changes like diabetes mellitus. The podiatrist also plays an important role helping to prevent some of their common complications. Despite of that, once the wound shows up the process of healing is really a hard job. The main objective of the present article is to provide a current local strategy of treatment based on the characteristics of the wound bed because apart from wound’s origin and etiology its aspect and characteristics are useful to plan accurate treatment. According to it, the “TIME concept” allows accurate wound bed preparation by using moisture environment products that contribute to remove barriers interfering natural healing process(AU)


Assuntos
Humanos , Masculino , Feminino , Cicatrização , Infecção dos Ferimentos/terapia , Ferimentos e Lesões/terapia , Podiatria/métodos , Bandagens , Cicatriz Hipertrófica/terapia , Úlcera do Pé/terapia , Prata/uso terapêutico , Alginatos/uso terapêutico , Curativos Hidrocoloides , Cicatriz/terapia , Bandagens/tendências , Lesão por Pressão/terapia , Úlcera Cutânea/terapia , Úlcera/terapia , Anti-Infecciosos Locais/uso terapêutico , Curativos Hidrocoloides/tendências
16.
Peu ; 29(2): 92-102, abr.-jun. 2009. ilus
Artigo em Espanhol | IBECS | ID: ibc-81082

RESUMO

La importancia de la diabetes mellitus deriva de suelevada morbilidad, de la pérdida de calidad de vidade las personas afectadas, de las complicaciones queorigina y por constituir un importante factor de riesgocardiovascular. Por todo ello representa hoy díaun problema sanitario y socioeconómico de primerorden. Una de sus complicaciones que presenta peorpronóstico es el comúnmente conocido como “piediabético”, siendo los pies precisamente la zona deinicio de este tipo de lesiones.Se ha comprobado que aproximadamente el 15%de todos los diabéticos desarrollará una úlcera enel pie o en la pierna durante el transcurso de suenfermedad. Las complicaciones que se deriven deesos procesos ulcerosos representarán el 45% de lasamputaciones no traumáticas del miembro inferior.Dentro de las lesiones de pie diabético el componenteneuropático va a estar presente en un 60-70%frente a un componente isquémico (15-20%) o mixto(15-20%). Este aspecto es especialmente importanteya que se ha demostrado que son las lesiones neuropáticaslas que mejor pronóstico tienen si se realizaun tratamiento adecuado.En la práctica diaria tratamos procesos ulcerososque se hubieran podido evitar con unassimples recomendaciones y la identificación deaquellas zonas con riesgo de ulceración. Este artículopretende aportar una visión de su manejosiguiendo el algoritmo TIME y la utilizaciónde productos de cura en ambiente húmedo(AU)


The importance of the diabetes mellitus derivesfrom its high morbidity, the loss of patient’s qualityof life, its complications and because it constitutesan important cardiovascular risk factor. However itrepresents today a prime sanitary and socioeconomicproblem. One of its complications that worseprediction presents is the commonly called as“diabetic foot” because the feet are normally wherethese types of wounds appear.It’s been proved that approximately 15% of alldiabetic patients will develop a foot or leg ulcerduring his disease. The complications derived fromthe ulcers represent a 45% of all non traumaticamputations in the lower extremity. As part of thediabetic foot wounds the neuropathic componentis present in a 60-70% facing an ischaemic component15-20% or mixed 15-20%. This aspect isespecially important as neuropathic wounds havebeen accepted as those whith better prediction ifearly and appropriate treatment is applied.In common practice we treat ulcerations that wouldhave been prevented with simple recommendationsand by identifying the areas in risk of ulceration.This article pretends to bring a view of its managementfollowing the TIME algorithm and the useof moist environment dressings(AU)


Assuntos
Humanos , Pé Diabético/terapia , Neuropatias Diabéticas/complicações , Qualidade de Vida , Fatores de Risco , Umidade
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