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Introduction: According to the European guidelines, the first step for local wound preparation is debridement, which stands for removing of devitalized tissue such as slough or necrosis. There are numerous types of debridement, but not all of them can be performed by non-specialists. Most of the research investigating efficiency of novel debridement products are carried out or funded by pharmaceutical companies. Aim: To compare the efficacy of relative necrotic tissue removal after 30 days on patients subjected to debridement with sterile sponge, monofilament fibre cloth, non-woven cloth impregnated with sodium hyaluronate and phospholipids and traditional sterile gauze. Material and methods: By use of photographic documentation at 7 days' intervals and planimetry methods, the total wound surface area and sloughy tissue area was measured. Results: Results have shown that monofilament cloth was the most effective, removing on average 63.44 ±32.91% of necrotic tissue after the first procedure and 74.65 ±30.95% within 30 days of application, in comparison to the sterile gauze group that had on average only 23.53 ±19.16% of necrotic tissue removed at day 0 and 44.95 ±31.47% removed at day 30. Moreover, patients using all 3 products tested reported higher satisfaction with that treatment than those treated with gauze. Conclusions: Results imply that all those methods could be considered as they are well accepted by patients and cause less pain during the procedure, which is essential for good compliance and complete resolution of the lesions. [ABSTRACT FROM AUTHOR]

The term "debridement" stands for the removal of necrotic material, scabs, devitalized tissues, dried serous fluid, infected tissues, biofilm, stratified epidermis, pus, hematomas, foreign bodies, bone fragments and other impurities whose presence delays wound healing. It is an inseparable element of wound healing therapy. Properly performed debridement leads to improvement of microcirculation in the wound, reduction in inflammation and lowering of the level of metalloproteinases, stimulation of wound edges and epidermis, reduction in unpleasant odour and reduction in the risk of infection and improvement of the patient's quality of life. There are many debridement techniques approved by the European Wound Management Association. The selection of the most appropriate method depends on many factors such as tissue type, presence of biofilm, depth and location of the wound, underlying cause (venous, arterial), skills of the person performing the debridement and the preferences of the patient him/herself. In our work we present not only a systematic review of most of the debridement techniques used nowadays, but also our clinical cases showing results of those different techniques. [ABSTRACT FROM AUTHOR]

Introduction: One of the methods to accelerate skin epithelialisation is skin grafting. Various methods of skin transplantations are available, such as full thickness skin transplantation, intermediate-thickness skin transplant using a dermatome, and epidermal islet transplantation using vacuum apparatus an epidermal harvesting system. These methods, however, require the use of specialised and expensive equipment. An alternative is to perform full-thickness skin grafts with a dermatological punch. Objective: The aim of the study was to utilize the new technique of punch grafting and evaluate it's effect on wound healing. Material and methods: Five patients with granulating venous ulcers, which were not infected or cancerous, underwent the procedure. Full thickness punch grafts were placed every 2 cm2. Patients were followed up every week for 3 months and assessed for the number of micrografts rejected and percentage of the wound that has epithelialised. We have also noted the VAS pain scale. Results: Reduction in the wound area after 30 days was observed in all patients. In 2 patients, complete resolution was observed. No adverse effects were recorded. Average visual analogue scale (1-10) for pain was 4.4 ±0.927. The procedure took on average 39 ±4.3 minutes. Conclusions: Micrografts have a very high potential to accelerate the epithelialisation of chronic ulcers. Compared to the conventional procedures, they are costeffective and easier to perform. It is an effective method that can be used in outpatient settings. [ABSTRACT FROM AUTHOR]

Introduction: Chronic venous disorder (CVD) is thoroughly spread across the globe. It affects about 40% of the Polish population. European guidelines underline that there are no data on the percentage of people who have first symptoms of chronic venous insufficiency. Aim: To determine the frequency and pattern of first symptoms and examine public knowledge on CVD in a selected group of patients. Material and methods: Our study group consists of 175 patients who took part in preventive assessment of nevi. To determine public knowledge on CVD, we constructed a questionnaire, which consisted of two sections: one part to be completed by the patient and the other by the doctor. Results: The median age was 41 years. From 175 patients, about 40% claimed that they do not recognize CVD. Only about half of them knew how to diagnose and treat it. Most of them associate telangiectasia and varicose veins as primary signs and symptoms of CVD. Conclusions: Despite the fact that the disease itself is common, the level of public awareness is astonishingly low. Majority of patients tested could not associate first signs and symptoms, even though most of them had primary symptoms of the disease. In order to avoid high-cost treatment of ulcers and varicose veins, we should spread the knowledge on CVD. [ABSTRACT FROM AUTHOR]

Due to constantly growing population of immunocompromised patients the fungi became a widespread threat to modern medicine. HIV carriers, solid organ transplant recipients constitute most of those patients. Cryptococcosis is a frequent cause of life-threatening infections, affecting mostly immunosuppressed patients. This article presents current knowledge on cryptococcal infections, including epidemiology, clinical aspects, diagnosis and recommended treatment. In reference to our patient, who developed a disseminated and fulminant subtype of the disease, we wanted to underline the need to examine patients thoroughly. The highest aim of those measures would be to avoid lethal consequences. [ABSTRACT FROM AUTHOR]

Porphyria cutanea tarda belongs to the group of porphyrias. Porphyria is a heme disorder caused by an acquired or congenital defect of hepatic enzymes. This consequently leads to the accumulation of porphyrins in various organs. In porphyria cutanea tarda, there is a deficiency of the enzyme uroporphyrinogen decarboxylase. The most frequent factor that leads to damage of this enzyme is drug- or alcohol-induced liver insufficiency. In porphyria cutanea tarda typical clinical manifestations include blisters, erosions, crusts, and milia, that arise predominantly in sun-exposed areas. Furthermore, the skin becomes atrophic, susceptible to injuries and scarring. In our patient, the skin chances were induced by estrogen treatment of endometriosis in combination with UV-exposure. In this case the diagnosisi was established early and significant clinical consequences could be avoided. [ABSTRACT FROM AUTHOR]