https://doi.org/10.4081/ijwc.2021.76
Management and antisepsis in wound care: The experience of an Italian region (Liguria) in the treatment of older people affected by chronic ulcers
Submitted: February 19, 2021
Accepted: June 30, 2021
Published: July 30, 2021
Accepted: June 30, 2021
Abstract Views: 1585
PDF: 203
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Liguria is one of the Italian regions with the highest percentage of elderly people. The European Union declared the region as a "reference site", for experimenting cutting-edge solutions and assistance models in health management of elderly people. Chronic ulcers become a problem of considerable importance looking at the number of involved elderly patients and of the necessary resources for their care, as well for the impact on the patient's quality of life, due to the painful and limiting nature of the pathology. This study aims to evaluate the appropriate wound management in older people affected by chronic ulcers. A group of wound care experts operating in the Liguria region met with the aim of reviewing the epidemiology of chronic skin lesions, analyzing the diagnostic/therapeutic approach currently in use, focusing on the importance of the antisepsis in wound management. In Liguria region general practitioners reported a 3.9% prevalence of chronic skin lesions in 2018, and up to 7.35% in women over 85 years; about 90% of the lesions managed at home were pressure lesions. An overall assessment of the patient and the lesion, appropriate cleansing and antisepsis phases and a multidisciplinary management are essential to facilitate the wound's healing process among the elderly.
ISTAT. Rapporto annuale 2019. ISTAT: 2019.
Agale SV. Chronic Leg Ulcers: Epidemiology, Aetiopathogenesis, and Management. Ulcers 2013;2013:1–9.
DOI: https://doi.org/10.1155/2013/413604
Chatterjee SS. Venous ulcers of the lower limb: Where do we stand? Indian J Plast Surg 2012;45:266–74.
DOI: https://doi.org/10.4103/0970-0358.101294
Franks PJ, Morgan PA. Health-related quality of life with chronic leg ulceration. Expert Rev Pharmacoecon Outcomes Res 2003;3:611–22.
DOI: https://doi.org/10.1586/14737167.3.5.611
Kahle B, Hermanns HJ, Gallenkemper G. Evidence-Based Treatment of Chronic Leg Ulcers. Dtsch Aerzteblatt Onlin 2011; 108:231–7.
DOI: https://doi.org/10.3238/arztebl.2011.0231
Lazarus GS, Cooper DM, Knighton DR, et al. Definitions and guidelines for assessment of wounds and evaluation of healing. Arch Dermatol 1994;130:489-93.
DOI: https://doi.org/10.1001/archderm.130.4.489
Valencia IC, Falabella A, Kirsner RS, Eaglstein WH. Chronic venous insufficiency and venous leg ulceration. J Am Acad Dermatol 2001;44:401-21.
DOI: https://doi.org/10.1067/mjd.2001.111633
Markova A, Mostow EN. US skin disease assessment: ulcer and wound care. Dermatol Clin 2012;30:107-11.
DOI: https://doi.org/10.1016/j.det.2011.08.005
Nussbaum SR, Carter MJ, Fife CE, et al. An economic evaluation of the impact, cost, and medicare policy implications of chronic nonhealing wounds. Value Health 2018;21:27-32.
DOI: https://doi.org/10.1016/j.jval.2017.07.007
Guest JF, Fuller GW, Vowden P. Venous leg ulcer management in clinical practice in the UK: costs and outcomes. Int Wound J 2018;15:29-37.
DOI: https://doi.org/10.1111/iwj.12814
Guest JF, Fuller GW, Vowden P, Vowden KR. Cohort study evaluating pressure ulcer management in clinical practice in the UK following initial presentation in the community: costs and outcomes. BMJ Open 2018;8:e021769.
DOI: https://doi.org/10.1136/bmjopen-2018-021769
Grimaldi G, Lacaita MV, Faggiano ME. Cross-Resistenze tra antibiotici ed agenti disinfettanti: una problematica emergente. G Ital Farm Clin 2017;31:101–14.
Duschek N, Trautinger F. Ulcus cruris beim alten Patienten [Chronic leg ulcers in older patients]. Z Gerontol Geriatr 2019;52:377-90.
DOI: https://doi.org/10.1007/s00391-019-01567-7
Cerny M, Hellmich S, Schwarz-Boeger U, et al. DRG revenues and costs of multimorbid patients in the German DRG system - Analysis of the surgical treatment of chronic wounds at a university hospital based on the example of pressure ulcers. Handchirurgie Mikrochirurgie Plast Chir 2018;50:284-90.
DOI: https://doi.org/10.1055/a-0621-9324
Petrella F, Abbritti F, Bachetti F, et al. I.S.U.S. PROJECT (ITALIAN SKIN ULCER STUDY) (1 January 2015-31 December 2016). Final data. Ital J Wound Care. 2017;1:1.
DOI: https://doi.org/10.4081/ijwc.2017.1
Callam MJ, Ruckley CV, Harper DR, Dale JJ. Chronic ulceration of the leg: Extent of the problem and provision of care. Br Med J (Clin Res Ed) 1985;290:1855-6.
DOI: https://doi.org/10.1136/bmj.290.6485.1855
Landi F, Onder G, Russo A, Bernabei R. Pressure ulcer and mortality in frail elderly people living in community. Arch Gerontol Geriatr 2007;44:217-23.
DOI: https://doi.org/10.1016/j.archger.2007.01.030
Levine JM. Clinical aspects of aging skin: considerations for the wound care practitioner. Adv Skin Wound Care 2020;33:12–9.
DOI: https://doi.org/10.1097/01.ASW.0000613532.25408.8b
Levine JM. Historical perspective on pressure injury classification: the legacy of J. Darrell Shea. Adv Skin Wound Care 2019;32:103-6.
DOI: https://doi.org/10.1097/01.ASW.0000553113.63128.a5
European Pressure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel PPPIA. Prevention and treatment of pressure ulcers: quick reference guide. Clinical Practice Guideline. 2014. 1–75 p.
Lundgren H. Positioning of advanced wound care. In: Dealey C, Hofman D, Gottrup F, Nelson EA, Vowden P. (eds). The Ewma University Conference Model. Management. 2008;8:5-10.
Rabe E, Partsch H, Morrison N, et al. Risks and contraindications of medical compression treatment – A critical reappraisal. An international consensus statement. Phlebology 2020;35:447–60.
DOI: https://doi.org/10.1177/0268355520909066
WHO. Patient Safety Curriculum Guide: Multi-professional edition. 2011 Available from: http://apps.who.int/iris/bitstream/handle/10665/44641/9789241501958_eng.pdf;jsessionid=D68B8D0580251B74268A8E032324F22E?sequence=1
Neri L, Fattori A, Rowan S, et al. Wound bed preparation: What is needed? Acta Vulnolologica 2015;13:179-83.
Warren D. Wound healing and skin integrity. Prim Heal Care 2013;23:13-13.
DOI: https://doi.org/10.7748/phc2013.09.23.7.13.s13
Snyder RJ, Bohn G, Hanft J, et al. Wound biofilm: current perspectives and strategies on biofilm disruption and treatments. Wounds Compend Clin Res Pract 2017;29:S1–17.
Ricci E. The management of chronic ulcers with an acidoxidising solution. J Wound Care 2016;25:443-50.
DOI: https://doi.org/10.12968/jowc.2016.25.8.443
Scalise A, Torresetti M. Ruolo della soluzione elettrolitica di ipoclorito di sodio 0,05% nel moderno approccio alla gestione delle lesioni cutanee. Medicinae Doctor 2017;24:8.
Messina M. Le soluzioni di ipoclorito nel trattamento delle ulcere cutanee croniche infette. Una revisione della letteratura. Acta Vulnologica 2009;7:13-19
Santo G, D'Atanasio N, Capezzone De Joannon A, et al. Valutazione della attività e tossicità di una soluzione di ipoclorito di sodio elettrolitico allo 0,05% nel processo di riparazione tissutale. Gazz Medica Ital Arch Sci Med 2012;171:795-805.
Cassino R, Ippolito AM. Chloroxidating solution vs. superoxide solution: a comparison in wound cleansing. Acta Vulnologica 2012;10:143-52.
Gruber RP, Vistnes L, Pardoe R. The effect of commonly used antiseptics on wound healing. Plast Reconstr Surg 1975;55:472-6.
DOI: https://doi.org/10.1097/00006534-197504000-00013
Reid CJ, Alcock M, Penn D. Hydrogen peroxide--a party trick from the past? Anaesth Intensive Care 2011;39:1004–8.
DOI: https://doi.org/10.1177/0310057X1103900604
Khan ZH, Farzan M. A fatal gas embolism following the use of intraoperative hydrogen peroxide as an irrigation fluid. Acta Med Iran 2004;42:151–3.
Echague CG, Hair PS, Cunnion KM. A comparison of antibacterial activity against Methicillin-Resistant Staphylococcus aureus and gram-negative organisms for antimicrobial compounds in a unique composite wound dressing. Adv Skin Wound Care 2010;23:406–13.
DOI: https://doi.org/10.1097/01.ASW.0000383213.95911.bc
Leaper DJ, Durani P. Topical antimicrobial therapy of chronic wounds healing by secondary intention using iodine products. Int Wound J 2008;5:361-8.
DOI: https://doi.org/10.1111/j.1742-481X.2007.00406.x
Sibbald RG, Leaper DJ, Queen D. Iodine made easy. Wounds Int 2011;2:1–6.
Ward RS, Saffle JR. Topical agents in burn and wound care. Phys Ther 1995;75:526–38.
DOI: https://doi.org/10.1093/ptj/75.6.526
How to Cite
Parodi, A., Messina, V. M., Cannavale, T., Sorbara, S., Pestarino, A. F., & Cozzani, E. C. (2021). Management and antisepsis in wound care: The experience of an Italian region (Liguria) in the treatment of older people affected by chronic ulcers. Italian Journal of Wound Care, 5(2). https://doi.org/10.4081/ijwc.2021.76
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