Search

An adaptation of a clinical study of 130 patients at risk of developing a pressure ulcer on the heels was performed using Canadian costs. The aim of the study was to compare the cost effectiveness of a specially shaped hydrocellular dressing (ALLEVYN HEEL) versus that of a protective heel bandage (SOFFBAN and gauze) in pressure ulcer prevention over an 8-week period. [ABSTRACT FROM AUTHOR]

Article whose content was exposed in the workshops of the GNEAUPP Congress, held in Seville in November2012, and which refers to ulcers by pressure on the heels as a location exposed to the analysis. A pressure ulcer is a lesion located in skin I underlying tissue usually over a bone prominence, as a result of the pressure, or pressure in combination with the shears. A number of contributing factors or confounding factors are also associated with ulcers by pressure; the importance of these factors still not been elucidated. The heels are next to the sacred area, parts of the body that most frequently presents ulcers by pressure, The importance of the predisposing factors for ulcers in the sacral area as humidity has been studied in recent years, but in heels, remains one of the most important locations in the extremities, which entails adverse outcomes such as amputation in persons with comorbid diseases like Diabetes Mellitus (DM). The incidence of ulcers on heels in patients with DM and without it, is approximately 19-32%. Everything and be a problem associated with elderly people and chronic pathologies, in acute patients are a problem that this underrated, but not devoid of controversy. In hospitals of treble in 2006, the NPUAP encrypted the incidence of UPPin heels in a 43%; in one systematic review conducted by Reddy et al. (2006) puts revealed that 60% of pressure ulcers is produced. The problem of the UPP in heels is present in all the areas of intervention and particularly in paediatric units intensive care, where the first localization it is the occipital area followed by the heels.

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.

An adaptation of a clinical study of 130 patients at risk of developing a pressure ulcer on the heels was performed using Canadian costs. The aim of the study was to compare the cost effectiveness of a specially shaped hydrocellular dressing (Allevyn Heel) versus that of a protective heel bandage (Soffban and gauze) in pressure ulcer prevention over an 8-week period.

To evaluate the properties of the Indafoam hydro-regulating dressing, the authors planned a study on the clinical application these materials have in relation to the evolution of injuries and their etiology at the same time evaluating the behavior of these products in diverse aspects related to the healing processes. This study is an open, multi-centric prospective observational study having repeated measurements in a group of patients who suffered from injuries having diverse etiology

Incontinence presents an additional problem for a bedridden patient, among other reasons because incontinence increases the risk of perineal dermatitis. Recently evaluation scales have been drawn up which permit evaluating the effects incontinence provokes on the integrity of the skin and new products have been developed which act as non-irritating barriers and which permit professionals to visually inspect the affected area. These new products increase the arsenal of already known products and tools such as bed pans, catheters, etc. which professionals have at their disposal to control incontinence.

The ADDERMIS protective cream has these properties: it prevents skin maceration, exercises a regenerative effect, has bacteriostatic and bactericide activity, possesses a noted anti-inflammatory effect and reduces the risk of mycotic infections. Its application is indicated for use in cases of: skin lesions, such as bed sores or leg ulcers, which require the use of a barrier product; dermatitis lesions in zones of skin folds or due to diaper use; to prevent friction zones; fragile skin; peeling, zones where cracks in the skin appear...and to use for cases of incontinence when diapers are required.

The authors present an observational evaluation on the effectiveness of a dressing included in the Indafoam brand for treatment of skin lesions due to different etiology which have an acute or chronic diagnosis; the authors include some very valuable information for professionals who use combined polyurethane foam and hydrogel dressings in their daily practice. Due to their composition, these dressings may be considered combined dressings having only one structure which maintains a stable temperature at the lesion site; these dressings have a high absorption capacity which prevents maceration of the skin surrounding lesions and protects lesions from contamination by exogenous germs.

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.

Urinary incontinence is grave health problem which causes severe repercussions in the quality of life of those patients which suffer it and it is a serious risk factor in the development of pressure sores or ulcers. Urinary collecting sacks provide an option to deal with this problem even though up to present time these collecting sacks were only available for male patients. In this instrument usage article, the authors introduce a new device, VILUC, commercialized by Lauclar Laboratories in Spain, for feminine urinary incontinence as a possible alternate treatment for women affected by this problem who are incapable of maintaining a progressive and complete vesicle reeducation. The authors inform about how to install this device, its different components, how to care for it and the indications for its use in females who suffer from incontinence.

Treatment for varicose ulcers is based on treating an ulcer as a chronic injury and its primary cause, hypertension in the veins, by means of a system of decreasing and sustained high compression. In Spain patients suffering from varicose ulcers are treated mainly with systems based on the use of crepe bandages which have a low compression effectiveness. In order to bring to light information on this important facet of health care and to generate evidence on this topic, the authors present a comparative study of a standard therapy method utilizing compression on patients suffering from varicose ulcers in Spain, a crepe bandage, against the use of a Profore multi-layer system. The authors studied 30 varicose ulcers on 24 patients who met the criteria to be included in this study; 17 of these, 70.8%, in women and 7, 29.2%, in men. The average treatment period of these lesions with crepe bandages on these lesions was 1045 +/- 2370 (DS) days (mean of 120). At the start of treatment with the multi-layer system, the average lesion surface area reached 10.64 +/- 9.45 (DS) cm2 (mean 7.28). After treatment with this multi-layer system, all these lesions cicatrized entirely. In order for this to happen, an average of 43.73 +/- 27.38 (DS), (mean 34) was required. Based on our results, we can state that the use of the multi-layer system in this study compared to a crepe bandage allowed for the reduction in cicatrisation time, in the number of bandage changes, in the number of visits, in the professional time needed, and reduced by a factor of 20 the cost of the material involved.

Introduction: Hyper-oxygenized acidic fats are a very useful topical use product for preventing pressure ulcers and to treat stage I pressure ulcers. Mepentol is a hyper-oxygenized acidic fats product (linoleic acid, gamma linolenic acid, oleic acid, palmitic acid, stearic acid, palmitoleic acid, arachidonic acid and eicosenoic acid) with extracts of Equisetum Avrense and Hypericum Perforatum. It works in three main facets: improve as is possible the epidermis's resistance, repair the damage to the epidermis produced by a prolonged pressure, and restore capillary circulation and counter arrest the effect of oxygen radicals produced during reactive hyperemia which are caused by periods of prolonged pressure. The exclusive formula, based on hyperoxygenized acidic fats and the above referred plant extracts, gives to Mepentol a demonstrated effectiveness, and also special features, like speed of action, great speed of topical absorption and a peculiar fragrance. PATIENTS, MATERIAL AND METHOD: In order to evaluate the tissue level effect of Mepentol, we carried out an experimental research project based on two different objectives: determine the effect at capillary circulation level in heels of healthy volunteers and in patients under risk of developing pressure ulcers, a well as in the treatment of stage I pressure ulcers in patients under high risk of developing pressure ulcers. To do so, the authors determined the capillary blood flow by means of a Doppler laser flow meter., Results: After the application of a hyper-oxygenized acidic fats product, the authors noted an increase of 122.29 +/- 68.74% in flow units related to base values. The authors also observed an increase in microcirculation in heels of patients under high risk of developing pressure ulcers, as well as those who suffer from stage I lesions. These increases remain constant over long periods of time., Commentary: Based on the tests carried out, Mepentol shows an undoubtable effect which improves local circulation in zones under risk of developing pressure ulcers as well as for stage I lesions; this supports the use of this product as a preventive measure against pressure ulcers and as treatment for stage I lesions.

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.

Introduction: The heels, together with the sacra area, are one of the most frequent spots where pressure sores appear here in Spain. Any preventive measure against pressure sores on heels needs be oriented towards two main objectives: effective relief of pressure and its compatibility with localized care and skin inspection in order to detect lesions early on at least once a day., Patients, Materials and Methods: The authors planned a comparative, multi-centered, open, labeled and controlled study in which patients were assigned to two groups receiving these treatments: one received traditional preventive pressure sore treatment and a protective bandage on their heels while the other used a special Allevyn Heel hydrocellular dressing to protect their heels. The patients took part in this study over an eight week period. The response variable used to determine the effectiveness of the preventive measure in this study was the appearance of pressure sores., Results: At the beginning, 130 patients were included in this study, 65 in each one of the treatment groups. In the bandage group, 50 patients finished this study while 61 in the dressing group finished this study. The appearance of pressure sores in the protective bandage group occurred in 44% of the patients, 22 out of 50, while in the dressing group, the occurrence rate was 3.3%, 2 out of 61 patients with a value of "ji" squared p < 0.001. The risk factor to develop a pressure sore brought us a value of relative risk of 13.42 (IC 95%: 3.31-54.3) in the group wearing the protective bandage compared to the group wearing the dressing., Comments: The results of this study allow us to accept as valid the alternate hypothesis that there exist significant statistical differences between both treatment methods in favor of the Allevyn Heel dressing instead of the protective heel bandage. The use of this dressing, even though it is more expensive a priori than the protective bandage, in terms of unit cost for the product, has proven to be more effective in preventing pressure sores, and cheaper than the protective bandage if we bear in mind these combination of variables: time of usage, application and removal.

Unlabelled: Skin care in general and, more specifically, the use of hyper-oxygenated fatty acids to protect zones at risk, constitute a very useful method in the prevention of dedubitus ulcers and to reverse stage one lesions., Patients and Methods: Retrospective evaluation on the systematic use of hyper-oxygenated fatty acids inside the parameters accepted for the prevention and care of decubitus ulcers at the Clinical University Hospital Puerta de Hierro in Madrid in its Internal Medicine Nursing Unit during 1999 and 2000., Results: 853 patients were studied, of whom 524 entered the hospital without any bedsore. Of these 524 patients who entered without a bedsore, 5, or 1% of these cases, developed new lesions. Of the 163 patients suffering a stage one decubitus ulcer upon entering the hospital, 131 or 80% saw their status reserve to not being a bedsore., Commentary: The use of hyper-oxygenated fatty acids is an effective measure in the prevention of bedsores and in the reversal of stage one lesions.

Introduction: The handling of pressure is a basic measure in the prevention and treatment of bed sores. It is possible to reduce and ease pressure by various means including changes in posture, use of special surfaces for handling pressure as well as the use of local applications or external applications which reduce pressure. Today nurses have a large quantity of external applications available to use although only some hydrocellular ones are capable to reduce pressure due to their hydrocellular structure., Methods and Materials: An experimental study was designed to calculate the level of pressure before and after applying an Allevyn hydrocellular external application in the area of the sacrum, ischium, and heel of three healthy volunteers; first, Volunteer A, a 85 kg. 170 cm man; second, Volunteer B, a 54.3 kg. 159 cm woman; and third, Volunteer C, a 69.4 kg 164 cm man. Measures were taken on two types of surfaces: a viscoelastic foam mattress and a conventional hospital mattress. All measurements were repeated at 0, 30, 45 and 60 degrees of inclination. Pressure was determined by means of a Talley pressure monitor, Oxford Pressure Monitor MK II., Results: A total of 144 pressure reading were taken. The overall average reduction after applying a external hydrocellular application on all volunteers, at all inclinations and on all surfaces for each of the three zones were 19.5% in the sacrum, 13.8% in the ischium and 20.15% in the heel., Commentary: Even though our study has its limitations, such as young, healthy volunteers, we can establish that the external hydrocellular application studied does have a local reducing effect on pressure. Since every external hydrocellular application has its own specific structure, the results of our study can not be applied with certainty to other external applications inside the hydrocellular group.