Alginate hydrogel containing hydrogen sulfide as the functional wound dressing material: In vitro and in vivo study.

Functional and bioactive wound dressing materials are revolutionary for wound care and healing applications. In this concept, we fabricated alginate hydrogel (Alg) containing H2S as the wound dressing materials and assessed the morphology, swelling, degradation, and release behavior, as well as the biocompatibility, cytocompatibility, and wound healing activity. The results depicted that the prepared hydrogels have a porous structure with the pore size in the range of 50 to 100 µm. Swelling and degradation studies showed that the hydrogel absorbed water about 179 ± 5% of initial dry weight during 96 h and loos about 80% of the initial dry weight after 7 days. The in vitro assessments illustrated that the optimum concentration of H2S was 0.5% and the higher concentration induced hemolysis and cell toxicity. The in vivo study revealed that the treatment by Alg/H2S 0.5% induced the highest wound closure percent with a value of 98 ± 1.22%. Moreover, the treatment by Alg/H2S 0.5% elicited the formation of sebaceous glands, hair follicles, and complete epithelization without any fibroplasia or inflammation, revealed by the histopathological observations. Accordingly, these results illustrated that the prepared Alg/H2S 0.5% could be applied as the functional and bioactive wound dressing materials.

Casos clínicos tratados con la tecnología lípido coloidal (TLC) / Clinical cases treated with tecjnology lipid colloidal (TLC)

Introducción. En este estudio se exponen casos clínicos que recogen las etiologías más frecuentes en el campo de las heridas complejas. Todas requieren un abordaje específico, además de la participación interdisciplinar de diferentes miembros del equipo. Sin embargo, en general, los planes de cura locales establecidos pueden ser bastante similares. Se les aplica la tecnología lípido coloidal (TLC) que consiste en la combinación de partículas de hidrocoloide (carboximetilcelulosa) con componentes lipídicos. Son productos con una tecnología diseñada para cada momento de la cicatrización. Objetivo. Dar a conocer nuestra experiencia en la utilización de productos con TLC en pacientes con úlceras de diferentes etiologías. Método. Se han utilizado los siguientes productos dependiendo del caso que tratar: UrgoTul® Absorb Border, Urgoclean® (mecha o placa), UrgoStart®, UrgoK2® y UrgoK2 LITE®. Estos productos se aplicaron en pacientes que presentaban cuatro etiologías de úlcera diferentes: úlcera hipertensiva, traumática, venosa e isquémica (arterial). La utilización de Urgoclean® mecha favoreció la limpieza del lecho ulceral y se aplicó Urgoclean® placa con alginato reforzado para controlar los exudados abundantes, con cobertura de UrgoTul® Absorb Border. Una vez limpios los lechos, pasamos a UrgoStart® y usamos en todo momento vendaje UrgoK2®, en los casos que precisaban terapia compresiva. A los pacientes que presentaban intolerancia a ese tipo de compresión se les aplicó el vendaje UrgoK2 LITE® (que toleraron sin problema), lo que redujo notablemente el edema y favoreció el control del exudado. Los pacientes con heridas de larga evolución se mostraron al inicio reticentes a la aplicación de nuevas tecnologías, pero, trascurridas las primeras curas, y al percibir una buena evolución, confiaron y se adhirieron al tratamiento hasta la resolución. Resultados. Se muestran casos clínicos de diferentes contextos etiológicos y personales, de los que, con un abordaje integral e interdisciplinar, junto con la aplicación de productos con TLC, se consiguió resolver la problemática. Conclusión. Los materiales utilizados han sido satisfactorios en todos los casos, con una implicación directa en la resolución de las lesiones que conllevaban un largo tiempo sin resolver y, en alguno de ellos, incluso con un diagnóstico de mal pronóstico. En la práctica clínica del cuidado de las heridas es muy importante el conocimiento y la investigación de nuevos materiales que mejoren la calidad de vida de los pacientes y reduzcan el tiempo de evolución de las lesiones. Sin olvidar que la educación para la prevención de su salud debe ser uno de los objetivos para evitar las recidivas (AU)

Introduction. This study presents clinical cases collecting etiologies that are more frequent in the field of complex wounds. All require a specific approach, as well as the interdisciplinary participation of different members of the team. But in general, established local cure plans may be quite similar. Applies them technology lipid colloidal (TLC) which consists of the combination of particles of hydrocolloid (carboxymethylcellulose) with lipid components. Products with a technology designed for every moment of healing. Objective. Show our experience in the use of products with TLC in patients with ulcers of different etiologies. Method. The following products depending on the case have been used to treat: UrgoTul® Absorb Border, Urgoclean® (rope or plate), UrgoStart®, UrgoK2® and UrgoK2 LITE®. These products were applied in patients presenting four different etiologies of ulcer: hypertensive, traumatic, venous and ischemic ulcer. The use of Urgoclean® rope favored cleaning the bed ulceral and applied Urgoclean® plate with reinforced alginate to control the abundant exudates, with coverage of UrgoTul ABsorb Border®. Once clean beds pass UrgoStart® and at all times UrgoK2® bandage, cases that required compressive therapy. Intolerance to that kind of compression applied to patients presenting bandage UrgoK2 LITE® (which tolerated without problem) which significantly reduced edema, favoring the control of exudate. Patients with ulcer of long evolution, at the start were reluctant to the application of new technologies, but after the first cures and sensing a good evolution, we get their confidence and commitment to the resolution. Results. Are displayed clinical cases of different etiologic and personal contexts that an integral and interdisciplinary approach together with the application of products with TLC, managed to solve the problem. Conclusion. The materials used have been satisfactory in all cases, with a direct involvement in the resolution of lesions which carries a long unresolved, and in any of them, even with a diagnosis of poor prognosis. In the clinical practice of the wound care knowledge and research of new materials that improve the quality of life of patients, reducing the time evolution of the lesions is very important. Not to mention that education for the prevention of their health should be one of the objectives to prevent recurrences (AU)

Lenguaje NNN en los cuidados locales de las quemaduras / Use of NNN language in local care of burn injuries

Las quemaduras son lesiones tisulares resultado de un traumatismo físico o químico. En sus distintos grados, pueden producir desde una leve afectación de la piel hasta la destrucción total de los tejidos implicados. Además, si la superficie corporal quemada es muy extensa, puede verse seriamente comprometida la vida de la persona que las sufre. Una vez estabilizado y controlado el riesgo vital de la víctima, con este capítulo se pretende clarificar los cuidados de enfermería en el área lesionada, que se basan en el planteamiento de un manejo local correcto de las quemaduras, una vez definidos su gravedad y su pronóstico. Para ello, se utilizará el lenguaje estandarizado NNN, que hace referencia a los diagnósticos enfermeros NANDA (North American Nursing Diagnosis Association), a la Clasificación de Resultados de Enfermería (Nursing Outcomes Classification, o NOC) y a la Clasificación de Intervenciones de Enfermería (Nursing Interventions Classification, o NIC). Este lenguaje es muy útil para la descripción de la práctica clínica en el cuidado de las quemaduras, siendo de fácil manejo para las enfermeras que participan en el cuidado de este tipo de pacientes, ya que puede adaptarse al uso de las aplicaciones informáticas existentes en la actualidad (AU)

Burn injuries are tissue injuries originated as a result of a physical or chemical trauma. They can cause from a mild skin affectation to the total destruction of the affected tissues, depending on various levels of severity. Moreover, if the affected body surface is very large, patient life can seriously be compromised. In this chapter, the intention is to clarify the nursing care for the affected area, once patient´s life risk is stabilized and controlled. This care should be based on an adequate approach to local handling of burn injuries, after their severity and prognosis have been stated. To do this, It will be used the standardized nursing language NNN, referring to Nursing Diagnosis NANDA (North American Nursing Diagnosis Association), Nursing Outcomes Classification (NOC) and Nursing Interventions Classification (NIC). This taxonomy is very useful to describe the Nursing clinical practice of burns care because it can easily be used by nurses participating in the care of this type of patients. Nursing plans using the NNN taxonomy can be designed using existing software applications (AU)

Aplicación del concepto “preparación del lecho de la herida” en el abordaje local de las lesiones crónicas / No disponible

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)

Clinical evaluation of hydrocolloid dressings for neurosurgical wounds.

BACKGROUND: Empirical methods in postoperative wound care have been performed by individual neurosurgeons. We evaluated a hydrocolloid dressing for neurosurgical wounds according to the modern concept of wound healing. METHODS: From May 2005 to March 2007, we performed 117 cranial neurosurgical procedures in consecutive 100 patients. Karayahesive (ALCARE, Tokyo, Japan), a transparent hydrocolloid dressing, was affixed onto all wounds immediately postoperatively. Clinical evaluations were performed for wound healing, wound infection, and cost-effectiveness. RESULTS: Excellent wound healing and cosmetic results were obtained in all patients. There was no incisional surgical site infection. Analysis of cost-effectiveness suggested Karayahesive as superior to conventional gauze-and-tape dressings. CONCLUSION: Karayahesive fits with the modern concept of wound healing and is a useful dressing for neurosurgical wounds.

[Development of new biologically active dressings and methodology of their use]. / Razrabotka novykh biologicheski aktivnykh pereviazochnykh sredstv i metodologiia ikh primeneniia.

Results of development of new biologically active dressings and up-to-date methodology of local treatment of wounds (based on their differential application according to phase and features of wound process) are demonstrated. Data about main properties and specific activity of new biologically active dressings based on natural and synthetic polymers with immobilized drugs are presented. Future trends and efficacy of their appliance in complex treatment of purulent and necrotic wounds are demonstrated.