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Hidrocoloides de segunda generación. Desarrollo en beneficio de la cicatrización. Estudio multicéntrico

Authors: Rueda López, Justo; Arboix Perejamo, Montserrat; Muñoz Bueno, Ana Mª; Blanco Blanco, Joan; Ballester Torralba, Jordi; Gago Fornells, Manuel; García González, R. Fernando; +1 Authors

Hidrocoloides de segunda generación. Desarrollo en beneficio de la cicatrización. Estudio multicéntrico

Abstract

Introducción: Los hidrocoloides actuales o de segunda generación, son el resultado del desarrollo biotecnológico, que ha permitido la sustitución de determinados compuestos (gelatinas) por aceites y resinas de origen vegetal. Con ellos se ha logrado disminuir el riesgo de efectos adversos y reacciones locales secundarias al uso de determinados productos para la curación de heridas como la irritación, prurito y/o maceración de la zona perilesional. Los hidrocoloides de segunda generación acumulan la experiencia clínica de los hidrocoloides tradicionales y aportan mejoras en aspectos como la flexibilidad, absorción y disminución de lesiones derivadas de la adhesividad. Se trata de productos que facilitan y mejoran el proceso de curación de las heridas, además de aportar beneficios para el paciente y los profesionales en la calidad de cuidados. En el presente estudio se evalúa el comportamiento y la eficacia de la gama de apósitos 110 hidrocoloides SureSkin® II en el tratamiento de heridas de piel de diferente etiología en relación a la tasa de cicatrización de las lesiones tratadas. Objetivos del estudio: Evaluar la eficacia de los apósitos SureSkin II en el tratamiento de lesiones cutáneas de diferente etiología. Evaluar la eficacia en relación a la cicatrización, teniendo en cuenta los parámetros de las lesiones previos a la inclusión en el estudio. Evaluar la percepción de los pacientes al realizar las curas en cuanto al dolor. Conocer la aceptación de los profesionales investigadores mediante parámetros determinados (manejo del exudado, adaptabilidad, etc.). Material y método: Es un estudio observacional, longitudinal y multicéntrico, en el que han participado profesionales de enfermería con una larga experiencia en el tratamiento de lesiones de piel de diferente etiología. Se han incluido un total de 37 casos clínicos, el tiempo de seguimiento de los casos se estableció en 10 semanas o hasta que la lesión estuviera cicatrizada. De las lesiones evaluadas, 18 son de evolución crónica y 19 agudas; en cuanto a su etiología: 13 traumáticas, 4 quemaduras, 5 UPP, 6 úlceras venosas, 4 úlceras mixtas, 2 vasculares no filiadas y 3 en otras (2 dehiscencias y 1 zona donante). La distribución por sexo de los pacientes incluidos en el estudio ha sido de 37,8% (n= 14) hombres y 62,2% (n= 23) mujeres. En cuanto a la edad media de los pacientes para el total de lesiones ha sido de 69,31 ± 16,21 (media ± DE) años, en el caso de los pacientes con lesiones agudas la edad media ha sido de 64,72 ± 18,59 años y los que presentaban lesiones crónicas ha sido de 73,89 ± 12,29 años. El tejido presente en la lesiones antes del inicio del estudio, en las lesiones crónicas el 84% presentan tejido desvitalizado y las agudas un 32%. El tiempo de evolución de las lesiones previo al estudio era de 9,37 ± 15,19 días, para las lesiones agudas y 53 ± 98,69 días para las crónicas. Con respecto al dolor en el cambio de apósito, el 94,4% de los pacientes con lesiones crónicas manifiestan que el proceso de cambio de apósito SureSkin II no les produce dolor o éste es muy leve (44,4%). De los pacientes con lesiones agudas, el 69,4% manifiestan que el cambio de apósito es indoloro y el 21,1% que éste es muy leve. El tiempo de evolución medio de las lesiones tratadas con SureSkin II ha sido de 38,38 ± 27,36 días para las lesiones crónicas y de 16,33 ± 7,62 días para las lesiones agudas. De las lesiones incluidas en la evaluación (n= 37), 31 (83,8%) han finalizado la evaluación, 6 (16,2%) no finalizan la evaluación; de aquéllas, 4 (10,8%) por ingreso en centros hospitalarios, 1 (2,7%) por reacción local y 1 (2,7%) por exitus. Las lesiones crónicas tratadas en el período de estudio (8 semanas) han cicatrizado en un 72,2%, y las agudas, en un 94,7%. En cuanto a las propiedades de los apósitos manifestadas por los investigadores, destacar la adaptabilidad y fijación a la zona. Discusión y conclusiones: Los investigadores que han participado en este estudio avalan una larga experiencia en el tratamiento y utilización de productos de CAH. En esta evaluación describen como aspectos destacables de los apósitos SureSkin II la facilidad de aplicación, su adaptabilidad a las diferentes zonas de aplicación y su flexibilidad, como los tres cualidades a destacar sobre el resto de los apósitos utilizados habitualmente. De las características destacables de esta evaluación es la capacidad y rapidez en la cicatrización de las lesiones tratadas con SureSkin II, que es de 0,48 cm2 cicatrizados por día de tratamiento. Estos datos permiten afirmar que la utilización de los HC de segunda generación suponen un ahorro importante en los costes derivados del tratamiento de las lesiones de piel, sea cual sea su etiología.

Introduction: Current or second generation hydrocolloids are the result of biotechnological development, which has allowed the substitution of certain compounds (gelatines) for oils and resins of vegetable origin. Thanks to them, it has been possible to reduce the risk of adverse effects and local reactions secondary to the use of certain wound-healing products, such as irritation, pruritus and/or maceration of the perilesional area. Second generation hydrocolloids have the accumulated clinical experience of the traditional hydrocolloids and bring improvements in aspects such as flexibility, absorption and reduction in the number of wounds caused by adhesives. These are products that facilitate and improve the wound-healing process, in addition to bringing benefits to the patient and the healthcare workers, in the quality of care. In this study, the behaviour and efficacy of the SureSkin® II range of hydrocolloid dressings is evaluated in the treatment of skin wounds with differing aetiology in relation to the healing rate of the wounds treated. Objectives of the study: To evaluate the efficacy of the SureSkin II dressings in the treatment of skin wounds with differing aetiology. To evaluate the efficacy in relation to healing, taking into account the parameters of the wounds prior to inclusion in the study. To evaluate the patients’ perception of pain when the dressings are being applied. To find out how acceptable it is to the professional investigators using certain parameters (handling of the exudate, adaptability, etc.). Material and methods: This is a multi-centre, longitudinal, observational study in which nursing professionals with long experience in the treating of skin wounds of differing aetiology have participated. A total of 37 clinical cases have been included; the duration of the monitoring of cases was set at 10 weeks or until the wound healed. Of the wounds evaluated, 18 are chronic and 19 acute; the aetiology being: 13 traumatic; 4 burns; 5 PUs; 6 venous ulcers; 4 mixed ulcers, 2 vascular of unknown aetiology, and 3 others (2 dehiscences and 1 donor site). The distribution of the patients by sex was 37.8% (n= 14) men and 62.2% (n=23) women. The mean age of the patients for all wounds was 69.31 ± 16.21 (mean ± SD) 112 years; the mean age of the patients with acute wounds was 64.72 ± 18.59 years and those with chronic wounds was 73.89 ± 12.29 years. Tissue present in the wounds prior to the start of the study: 84% have devitalised tissue in the chronic wounds, and 32% in the acute wounds. The length of time the patients had had the wounds prior to the study was 9.37 ± 15.19 days, for the acute wounds and 53 ± 98.69 days for the chronic wounds. As regards pain during dressing changes, 94.4% of the patients with chronic wounds state that the process of changing SureSkin II dressings does not cause them any pain or only slight pain (44.4%). Of the patients with acute wounds, 69.4% state that the change of dressing is painless and 21.1% that the pain is only slight. The average length of time the patients had had the wounds which were treated with SureSkin II, was 38.38 ± 27.36 days for the chronic wounds and 16.33 ± 7.62 days for the acute wounds. Of the wounds included in the evaluation (n= 37), 31 (83.8%) finished the evaluation, 6 (16.2%) did not finish the evaluation; of these, 4 (10.8%) due to admission to other hospitals, 1 (2.7%) due to local reaction and 1 (2.7%) due to death). The chronic wounds treated in the study period (8 weeks) have healed by 72.2%, and the acute, by 94.7%. Among the properties of the dressings described by the investigators, adaptability and adhesion to the area are those which stand out. Discussion and conclusions: The investigators who have participated in this study have long experience in treatment with and use of MWH products. In this evaluation, the aspects of the SureSkin II dressings which they describe as most noteworthy are its ease of application, its adaptability to different areas of application and its flexibility. These were the qualities which stood out over those of the other dressings generally used. The aspects worth highlighting from this evaluation are the capacity of SureSkin II to heal the wounds treated and the speed at which it was effective; 0.48 cm2 healing per day of treatment. These data allow us to state that using second generation HCs means a significant saving in terms of the costs involved in the treatment of skin wounds, whatever the aetiology.

Keywords

Treating of skin wounds, Healing efficacy, Apósitos hidrocoloides, healing efficacy, Hydrocolloid dressings, Tratamiento de heridas, Eficacia en la cicatrización

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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