Management of painful and potentially infected skin lesions: Transversal activities of community and family nursing

Chronic skin lesions can result from a combination of pathophysiological alterations, comorbidity, risk factors both extrinsic and intrinsic to the elderly person, who often lives alone or together with elderly family members in unfavourable socio-economic conditions and whose functional capacities and other health indicators are compromised. The community and family nurse carries out transversal activities in taking care of citizens with health needs in a community-based proactive way with a view to increasing integration and collaboration among the different health and social care professionals, also by harnessing the community resources on the territory. The four people identified with chronic skin lesions are taken care of both at home and at a nursing outpatient department. Their average age is 76 and they have skin lesions on the lower limbs with chronic venous insufficiency and diabetes. The patients showed major painful symptoms (VNR 8-10) which were managed, while changing the dressing and before debridement, with lidocaine hydrochloride 5% (cream) for 15 minutes and systemic antalgic therapy (NRS 3-4). The timely actions taken with the general practitioner, vascular specialist, social worker and other professionals on the territory by means of instrumental and laboratory investigations made it possible to remarkably improve the lesion bed and reduce the size of the lesion within 6 weeks. The Therapeutic Education applied by the community and family nurse and shared with the family, caregiver and patient helps understand the condition and the relevant treatment, participate in health care, assume responsibility for one’s own state of heath, preserve and improve one’s own quality of life.