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A progressively increasing percentage of the elderly live during the last years of their lives in nursing homes. Although these institutions are intended to mimic life at home as much as possible, they have characteristics that make them quite similar to a "nosocomiun", i.e. an establishment for the treatment of the sick. The very coexistence among the elderly, the fact of sharing caregivers and the very significant exposure to third parties, together with the frequent predisposing diseases to infection in this population, make infection frequent among residents and also easily transmissible. This leads us to ask what can be done to prevent infection in this environment and more specifically what is the state of the art of the matter in a Western European nation such as ours. The Board of Trustees of the Health Sciences Foundation has asked itself a series of questions on the subject of infection prevention in Nursing Homes, the structure of procedures, the legislation available, compliance with the measures indicated, the best indicators of the processes and therefore, the need to promote in Spain a document of recommendations to avoid infections in this poplation whose morbidity and mortality need not be highlighted. To this end, a multidisciplinary group of experts in different aspects of this problem has been convened and asked the proposed questions. The questions were discussed by the group as a whole and led to a series of conclusions agreed upon by the participants. The results of the meeting are reported below., (©The Author 2023. Published by Sociedad Española de Quimioterapia. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)(https://creativecommons.org/licenses/by-nc/4.0/).)

Objective: Wound assessment is an essential part of wound management and has traditionally focused on the wound bed. The Triangle of Wound Assessment (Triangle) is a new assessment tool that includes a holistic evaluation of the patient with a wound. The aim of this pilot study was to describe the use of the Triangle in our clinical practice in Spain., Methods: Prospective, consecutive patients, male and female, over 18 years old, with wounds of any aetiology and duration, who attended the centres involved in the study, were recruited between May and June 2017. The TWA was used during the first presentation, to assess the wound bed, edge and periwound skin. The study's expert panel met to discuss the results collected by the assessment, as well as the advantages and disadvantages of the system., Results: We recruited 90 patients. Non-viable tissue (necrotic/sloughy) was recorded in 57.8% of the patients, elevated exudate (medium/high) in 52.2%. Approximately 25% of the patients had signs or symptoms of local infection. Maceration was the most prevalent issue recorded on the wound edge and periwound skin assessment, affecting 31.1% and 30.0% of the patients, respectively. The presence of hyperkeratosis was high for the study population as the main aeitologies of the wounds identified here were DFU., Conclusions: The implementation of Triangle Wound Assessment could help in the holistic approach to patient care by focusing on more than local wound care, identifying barriers to achieving wound healing and evaluating wound response and patient compliance.

Unlabelled: Ulcers and chronic wounds are an ideal medium for bacterial growth. This growth occurs in both number and variety of species, resulting in lesions with polymicrobial flora. The use of antimicrobial treatments to control and/or prevention of infection is discussed. Silver dressings as an alternative safe and effective for treating infected wounds and/or in situations of critical colonization. There are already evidence of what kind of silver-containing dressings are more cost-effective. The aim of this study is to evaluate the efficacy and effectiveness of Atrauman Ag dressing in the treatment of skin lesions in acute and chronic, as to the resolution of signs of infection and progression of healing during a period of four weeks., Material and Methods: we performed an observational, prospective, multicenter open study where the patient inclusion period was from April to August 2007. The sample consisted of patients seen giving their informed consent in primary care centers, health centers and hospitals throughout the country and met the inclusion criteria and had none of the exclusion criteria. The study variables were collected sociodemographic, injury-related variables to study with the dressing and the ratings of professionals and patients. The values of each variable were collected weekly in a CRD. The recorded data are processed in a database originally composed of 116 variables, which were analyzed with SPSS software., Results: we evaluated 219 patients finally included 147 who met the inclusion criteria and no exclusion. At the end of the study had chronic injuries granulation tissue in 84.8% and 100% acute wounds with statistically significant differences with respect to the initial assessment. Exudate levels in wounds evaluated at 4 weeks of treatment show a significant reduction, from exudate abundant or very abundant in 81.8% to a level of low or moderate exudate in 80.5% of the cases end of the study The evolution of clinical signs of infection by 87% (n=91) of the lesions disappeared after 4 weeks. 11.7% of lesions were healed in the study period. In the case of chronic wounds, we go from a median of 17.5 cm2 to 9.9 cm2, this means a relative reduction of 39.05% and a speed of 1. 12 cm2/week healing. In the case of acute wounds, a move from a median of 8.25 cm2 to 3.0 cm2 and a relative reduction of 65.03% with a healing rate of 2.28 cm2/week, with statistically significant differences both cases. The permeability of the dressing exudate was evaluated as good or very good in 88% of cases and the perilesional skin care by 79.9% as good or very good. The pain in the wounds was evaluated as nothing or very little, in 72% of cases.

The aging process and environmental aggressions will leave their imprints on the state of a person's skin, possibly compromising some of its functions. Age is a risk factor for the development of bed sores, but not the only factor nor the most important one; therefore, we need to develop prevention programs directed to all patients who spend long periods of time sedentary or bedridden. Prevention programs for bed sores must be based on the best evidence available and include a risk evaluation on these factors: suffering a lesion due to pressure, specific skin treatment, incontinence control, excessive humidity posture changes and the use of special surfaces to manage pressure during an increase in mobility or activity by the patient, local pressure reducing devices as well as paying attention to special situations. All of these care measures have to be developed based on a continuity of treatment among the institutions and caretakers involved with treating each patient.

Introduction: The presence on the market of new dressings to cure injuries makes it necessary for professionals to know their peculiarities for use in order to optimize their applications. The main objective of this study is to know the clinical behavior of a polymer sponge dressing having a porous grade called PermaFoam in the treatment of chronic ulcers caused by various etiologies., Material and Methods: The authors carried out an open observational, prospective and multi-centric study during the first semester in 2004 on patients who suffered from chronic lesions sent by the Primary Health Care Centers and Social-Sanitary Centers. The injuries under study showed states II, III or IV with moderate to high oozing and whose follow-up took place during a maximum of 8 weeks of treatment., Results: 53 patients, 31 women and 22 men, formed part of this study; their average age was 76.1 (+/- 13.18). 56 lesions were treated; 26 bedsores, 11 venous sores, 10 mixed lesions and 9 other types, they had an average presence on the patient of 270 (+/- 684) days, the medium was 85 days and the mode 365 days. Complete cicatrisation occurred in 21 lesions (37.5%), the absolute average surface reduction was 13.42 cm2 squared (IC 95%: 7.39-19.45) and the relative mean reduction was 61.31% (IC 95%: 50.66-71.97), Conclusions: The use of the PermaFoam dressing permitted complete cicatrisation of an improvement in the final surface area in all lesions treated regardless of their etiology state, or length of presence. The use of this dressing has controlled the levels of oozing, diminished the number of changes of the dressing, respected the skin surrounding the lesion, and favored a reduction in the number of alterations in the surrounding area.

The authors presented a conference at the 5th National Symposium on Bedsores, or Decubitus Ulcers, and Chronic Injuries which dealt with all the dimensions related to this problem: epidemiological data, economic costs, social repercussions and possible alternative treatments; their goal was to raise the consciousness of nursing professionals so that they realize decubitus ulcers are a public health problem for which a solution exists if nursing professionals so desire.

Objective: This exploratory, clinical study aimed to explore the effect of an activated charcoal silver dressing (intervention) with cleansing and debridement (control) in reducing the level of bacteria in chronic wounds with no clinical signs of local infection., Method: Patients were randomly assigned to the intervention or control group and monitored for two weeks. Samples for bacterial status and cultivation were obtained by surface smear (spatula) and percutaneous aspiration first at baseline and then after 15 days of treatment. Sixty-seven lesions were included in the intervention group and 58 in the control group., Results: At baseline, in the intervention group 71.6% of the wounds were contaminated, 7.5% had a high level of bacteria and 20.9% were infected. In the control group at baseline 65.5% of the wounds were contaminated, 6.9% colonised, 6.9% had a high level of bacteria and 20.7% were infected. There were no colonised wounds in the intervention group. After two weeks, combining totals of contaminated, colonised, a high level of bacteria and infection for each group, 85.1% (57/67) of the wounds in the intervention group had a positive bacterial level management (that is, a reduction in the number of bacteria in the wound) compared with 62.1% (36/58) in the control group (p=0.003)., Conclusion: Activated charcoal dressings that contain silver control infection and reduce healing times, eliminating bacterial barriers.

The authors carried out an observational, descriptive, prospective and multi-centric study on 49 infected lesions which had clinical signs of local infection as well as infection from a positive sprinkler method culture. These lesions were treated over a three week period with argentic sulfadiazine and a semi-permeable dressing; afterward, treatment continued for seven weeks more based on cures in a humid environment by means of a semi-permeable dressing. After three weeks of treatment, two-thirds of these lesions showed a negative exudative culture, the number of strains present in the rest of the cultures diminished to at least half of those present at the start of this study. 15 of these lesions completely closed over during the period of study (mean = 46.73 +/- 22.74 days) and the absolute cicatrisation surface area varied, on average, from 23.46 square cm at the start to 12.39 square cm at the end of this study. In relation to the relative cicatrisation an average reduction of 76.5% (IC 95= (66.85% - 86.2%)) occurred. Variance analysis (ANOVA) over repeated measurements established significant differences (p = 0.001) having a tendency toward a lineal decrease. The authors also found statistically significant differences regarding the mean relative cicatrisation in the subgroup having lesions which stopped being infected during the third week of treatment when compared to those lesions which continued being infected. In conclusion, the authors state the topical treatment using argentic sulfadiazine in combination with a semi-permeable dressing has been favorable in treating two of every three lesions which stopped being infected in the third week of treatment, furthermore, this treatment produced a reduction in the size of these lesions, both in terms of the absolute mean cicatrisation area as in the relative mean cicatrisation area cicatrisation area for the lesion group in this study.

Introduction: Pressure ulcers are lesions that usually occur to people to whom the social and economical repercusions are quite serious. Although present treatments with moisture cure dressings are efficient and have a lot of advantages than traditional cure, they do not solve the problem in a significant group of patients, whose ulcers do not heal or need a much longer treatment. Collagen dressings represent an important improvement, since collagen is a key element for wound scarring., Patients, Material and Methods: We conducted a prospective, comparative and multicentrical study with Catrix, using as a control the same lesion. We compared pressure ulcers that had been previously treated on an average of 6 months without success with Catrix treatment within 7 weeks. We compared different variables, efficacy, opinion on the use of Catrix and economic cost., Results: We included 104 pressure ulcers that fulfilled the inclusion requirements in the study. Three of them were excluded from the efficiency analysis because of a lack of data since they passed away 7 weeks later. We performed a statistical analysis on all the ulcers (GT) and we also analyzed the pressure ulcer subgroup (SG) included in this study because of a deterioration or a stagnation of the lesion despite previous treatments. Seven weeks after the beginning of the treatment with Catrix the healing or the stage change was observed in 73.3% of lesions of GT group and in 77.8% of lesions of SG group (p < 0.0001). The average material cost and nursing cost from all the lesions that scarred within 7 weeks (n = 39) with previous treatment was 17.234, 10 euros and 10.920 euros with Catrix. The average material cost per lesion used in the previous treatments was 441.9 euros and 280 euros with Catrix., Discussion: These results prove that the treatment with Catrix significantly reduces the treatment length and therefore leads to a reduction of the sanitary cost in this kind of patients. Adding Catrix to the pressure ulcers treatment helps to increase significantly the scarring and improvement percentage of those pressure ulcers that do not respond to other treatments. It helps to improve patient's quality of life, and to reduce the costs of the treatment.

The authors review the use of collagen in the cicatrization of wounds, analyzing what this process consists of and what its regeneration and reparation phases are. The authors also summarize some fundamental biological aspects collagen has, their functions in hemostasia and in cicatrization; they develop the use of heterologous collagen in the cicatrization process. Expressive illustrations and a selection of bibliographical references accompany this article.

Introduction: There are a wide variety of products to use to treat skin ulcers. Knowing the correct usage and application of each product aids in choosing the most appropriate for elderly patients., Objective: To evaluate the use of a hydrocellular dressing and its clinical test results., Methods and Materials: This descriptive, prospective study begun on 6/X/97 and finished on 1/XII/97 included all the moderate or severely oozing skin ulcers, those classified as stage II, III, or IV, among the elderly at a home for them. This study discarded ulcers which barely bled; however, regional or systemic infection-related ulcers were included., Results: 20 skin ulcers were analyzed. At the start, these covered an average surface are of 11.76 cm2 (DT 14.44), with an average severity index of 23.79 (DT 35.81). At the end of this study, the average area was 7.92 cm2 (DT 12.11) and the average severity index was 14,60 (DT 27,18). 7 ulcers, or 35%, had epithelized completely. During the 768 day length of this study, 290 dressings were applied. 100% of these were evaluated as easy to apply and remove; patients indicated an absence of pain; no dressing was disjoined when changed and therefore left no residue in the injured area., Conclusions: The dressing studied is effective for local treatment of all types of skin ulcers, regardless of their condition; this dressing reduces the number of changes necessary, especially in curing oozing ulcers; and finally, this dressing is easy to apply and aids in keeping the patient in good spirits.

Health education and advertising have a common aim: to modify human behaviour. Health education tries to induce healthy behaviours. In some occasions Publicity proposes risky behaviours. Ads appearing during a two-month period in magazines of the largest circulation in Spain are analyzed here. A total of 1,726 ads which could have a negative influence on health either because of the product or service offered or for the use of health as a persuasive argument in their text, are considered. The magazines Hola and Lecturas had the highest ratio ads/magazine. Spirits, food and drugs were the most frequently advertised products. And more than 50% of the ads used health and welfare as argument for better selling. Health educators should know and teach the critical analysis of publicity, and use advertisements as a teaching tool to enable people to see through misleading advertising.