scholarly journals Studi Kasus Efektivitas Penggunaan Cairan Pembersih Luka Polyhexamethylene Biguanide Dengan Nano Silvosept Spray Dalam Mengurangi Biofilm Pada Ulkus Kaki Diabetik

2021 ◽  
Vol 2 (1) ◽  
pp. 51
Author(s):  
Aisyah Nurlany ◽  
Chrisyen Damanik ◽  
Hamka Hamka
Keyword(s):  
Leg Ulcer ◽  
Measurement Tool ◽  
Leg Ulcers ◽  
Polyhexamethylene Biguanide ◽  
Measurement Tools

Latar belakang: Ulkus kaki diabetik merupakan salah satu komplikasi kronik dari diabetes yang sering ditemui. Kehadiran biofilm bakteri dianggap sebagai penghalang bagi perkembangan alami luka menuju penyembuhan dan memfasilitasi bioburden transisi dari kolonisasi sederhana ke kolonisasi kritis dan infeksi. Tujuan: Diketahuinya efektivitas penggunaan cairan pembersih luka polyhexamethylene biguanide dengan nano silvosept spray terhadap kemampuan mengurangi biofilm pada ulkus kaki diabetik. Metode: Kualitatif dengan pendekatan studi kasus, menggunakan teknik sampling, dengan jumlah partisipan 2. Pengukuran observasi dengan menggunakan Leg Ulcer Measurement Tool, dokumentasi dari rekaman arsip, dan triangulasi berupa wawancara dengan terapis yang mengetahui perkembangan luka dari awal hingga penelitian dilaksanakan. Hasil: Didapatkan keefektivan tindakan proses pencucian luka kaki diabetik dengan biofilm menggunakan pengkajian leg ulcers measurement tools pada setiap kasus terdapat penurunan skor baik dengan cairan pembersih luka polyhexamethylene biguanide maupun pembersih luka nano silvosept spray. Penurunan pada setiap skor terjadi baik secara keseluruhan maupun yang berfokus terhadap kondisi biofilm yang salah satunya ditandai dengan penurunan eksudat pada luka. Kedua cairan ini cukup baik untuk membersihkan luka dalam mengurangi biofilm yang mengganggu dalam proses penyembuhan luka. Kesimpulan: Keduanya efektif digunakan dalam perawatan luka kaki diabetik dengan biofilm baik polyhexamethylene biguanide maupun nano silvosept spray karena mempunyai cara tersendiri dalam menghilangkan bakteri selama proses pencucian luka.

Causes and the way of treatment of patients with chronic leg ulcers

Phlebologie ◽  
2009 ◽  
Vol 38 (05) ◽  
pp. 211-218 ◽  
Author(s):  
C. Wax ◽  
A. Körber ◽  
J. Dissemond ◽  
J. Klode
Keyword(s):  
Treatment Period ◽  
General Practitioners ◽  
Peripheral Arterial Occlusive Disease ◽  
Mean Value ◽  
Arterial Occlusive Disease ◽  
Leg Ulcer ◽  
Leg Ulcers ◽  
Patient Will ◽  
Peripheral Arterial ◽  
Chronic Leg Ulcers

SummaryChronic leg ulcer may have various causes, which are currently not centrally recorded in Germany. It is also unclear who treats patients with chronic leg ulcers in Germany and how the basic implementation of diagnosis and treatment of these patients looks like. Patients, methods: Therefore, we started a survey of 1000 general practitioners and practising specialists in dermatology, surgery and phlebology in five different regions of Germany. We carried out the genesis of a total of 6275 patients from 62 different practising therapists, 33 specialists in dermatology, surgery or phlebology and 29 general practitioners. Results: In 66.1% of all patients we found a venous leg ulcer, in 9.1% a leg ulcer from peripheral arterial occlusive disease, and in 8.5% a mixture of both. Thus there suffered a total of 83.8% of patients on chronic venous insufficiency or peripheral arterial occlusive disease as a major factor in the genesis of the chronic leg ulcer. However, even the rarely diagnosed entities such as exogenous factors, vasculitis, pyoderma gangrenosum or infectious diseases are occur in summation in 16.2% of all patients and should therefore be known and excluded. In addition, the treatment periods and referral routes of patients with chronic leg ulcer should be identified. The analysis showed that the vast majority (86.8%) of patients with chronic ulcers who were investigated by us is treated by specialists. The treatment duration of general practitioners is 6.3 weeks (mean value) before the patient will be referred to a specialist. This treatment period is significantly shorter compared to the treatment period of the specialists, who treat their patients 14.1 weeks (mean value) before the patient will be referred to another specialist or to a clinic. Conclusion: Our results show the current aspects of aetiology and the way of treatment of patients with chronic leg ulcers in Germany.

scholarly journals A Scoping Review of Health Literacy Measurement Tools in the Context of Cardiovascular Health

2019 ◽  
Vol 46 (4) ◽  
pp. 677-688 ◽  
Author(s):  
Rita Wai Yu Chan ◽  
Adnan Kisa
Keyword(s):  
Health Literacy ◽  
Scoping Review ◽  
Cardiovascular Health ◽  
Measurement Tool ◽  
Care Providers ◽  
Valid Measurement ◽  
Broad Concept ◽  
Measurement Tools ◽  
Health Literacy Measurement ◽  
Print Literacy

Background. Despite the strong link between health literacy and cardiovascular health outcomes, health literacy measurements remain flawed and fragmented. There exists a gap in the knowledge when formulating a valid measurement to capture the broad concept of health literacy. The existence of various tools for health literacy measurement also hampers the availability of health literacy data. Additionally, little research is available on a valid measurement tool for cardiovascular health literacy. Objective. This study aims to provide an overview of the health literacy measurement tools used in the context of cardiovascular health. Method. A scoping review was conducted. Two electronic databases, Medline and Embase, were searched to identify studies that described a tool for the measurement of health literacy in the context of cardiovascular health. Results. After reviewing the available studies, 53 studies met the inclusion criteria. A total of 26 health literacy measurement tools were identified in the studies. Among the 26 tools, 16 used an objective measurement approach, 9 adopted a subjective approach, and 1 employed a mixed approach. Additionally, 28 studies used tools to measure print literacy, 15 studies measured print literacy and numeracy, and 5 studies measured print literacy, oral literacy, and numeracy. Conclusions. STOFHLA, TOFHLA, and REALM were the mostly commonly used tools in the selected studies. The majority of tools were based heavily on reading skills and word recognition. Researchers should focus on the development of more comprehensive and reliable health literacy measurement tool(s) specific to cardiovascular health to assist health care providers to more efficiently and accurately identify people with cardiovascular problems who have inadequate health literacy.

Updated leg ulcer pathway: improving healing times and reducing costs

2019 ◽  
Vol 28 (20) ◽  
pp. S21-S26
Author(s):  
Leanne Atkin ◽  
Alison Schofield ◽  
Anita Kilroy-Findley
Keyword(s):  
Quality Of Life ◽  
Leg Ulcer ◽  
Leg Ulcers ◽  
Nursing Time ◽  
Venous Leg Ulcers ◽  
Reduced Costs ◽  
Reducing Costs

Regardless of the amount of literature and evidence on leg ulcer management, there are still significant variations in treatment. Implementing a standardised leg ulcer pathway to ensure patients are appropriately and timely assessed could help reduce nursing time and overall costs, while improving healing outcomes and patients' quality of life. Such a pathway was introduced in Lincolnshire and Leicestershire, UK, to treat venous leg ulcers (VLUs). The results showed improved healing times, reduced costs and fewer nurse visits, among other findings.

scholarly journals Suitability of Measurement Tools for Assessing the Prevalence of Child Domestic Work: A Rapid Systematic Review

2021 ◽  
Vol 18 (5) ◽  
pp. 2357
Author(s):  
Nicola S. Pocock ◽  
Clara W. Chan ◽  
Cathy Zimmerman
Keyword(s):  
Systematic Review ◽  
Domestic Work ◽  
Quality Measurement ◽  
Measurement Tool ◽  
Current Standard ◽  
Middle Income ◽  
Middle Income Countries ◽  
Measurement Tools ◽  
Survey Instruments ◽  
Nationally Representative

Child domestic work (CDW) is a hidden form of child labour. Globally, there were an estimated 17.2 million CDWs aged 5–17 in 2012, but there has been little critical analysis of methods and survey instruments used to capture prevalence of CDW. This rapid systematic review identified and critically reviewed the measurement tools used to estimate CDWs in Low- and Middle-Income Countries, following PRISMA guidelines (PROSPERO registration: CRD42019148702). Fourteen studies were included. In nationally representative surveys, CDW prevalence ranged from 17% among 13–24-year-old females in Haiti to 2% of children aged 10–17 in Brazil. Two good quality studies and one good quality measurement tool were identified. CDW prevalence was assessed using occupation-based methods (n = 9/14), household roster (n = 7) and industry methods (n = 4). Six studies combined approaches. Four studies included task-based questions; one study used this method to formally calculate prevalence. The task-based study estimated 30,000 more CDWs compared to other methods. CDWs are probably being undercounted, based on current standard measurement approaches. We recommend use of more sensitive, task-based methods for inclusion in household surveys. The cognitive and pilot testing of newly developed task-based questions is essential to ensure comprehension. In analyses, researchers should consider CDWs who may be disguised as distant or non-relatives.

scholarly journals Compression Therapy Is Not Contraindicated in Diabetic Patients with Venous or Mixed Leg Ulcer

2020 ◽  
Vol 9 (11) ◽  
pp. 3709
Author(s):  
Giovanni Mosti ◽  
Attilio Cavezzi ◽  
Luca Bastiani ◽  
Hugo Partsch
Keyword(s):  
Treatment Protocol ◽  
Compression Therapy ◽  
Healing Time ◽  
Leg Ulcer ◽  
Venous Disease ◽  
Diabetic Patients ◽  
Leg Ulcers ◽  
Foam Sclerotherapy ◽  
Compression Pressure ◽  
A Minor

The aim of this study was to investigate if compression therapy (CT) can be safely applied in diabetic patients with Venous Leg Ulcers (VLU), even when a moderate arterial impairment (defined by an Ankle-Brachial Pressure Index 0.5–0.8) occurs as in mixed leg ulcers (MLU). Materials and methods: in one of our previous publications we compared the outcomes of two groups of patients with recalcitrant leg ulcers. Seventy-one patients were affected by mixed venous and arterial impairment and 109 by isolated venous disease. Both groups were treated by tailored inelastic CT (with compression pressure <40 mm Hg in patients with MLU and >60 mm Hg in patients with VLU) and ultrasound guided foam sclerotherapy (UGFS) of the superficial incompetent veins with the reflux directed to the ulcer bed. In the present sub analysis of the same patients we compared the healing time of 107 non-diabetic patients (NDP), 69 with VLU and 38 with MLU) with the healing time of 73 diabetic patients (DP), 40 with VLU and 33 with MLU. Results: Twenty-five patients were lost at follow up. The results refer to 155 patients who completed the treatment protocol. In the VLU group median healing time was 25 weeks for NDP and 28 weeks in DP (p = 0.09). In the MLU group median healing time was 27 weeks for NDP and 29 weeks for DP (p = −0.19). Conclusions: when providing leg ulcer treatment by means of tailored compression regimen and foam sclerotherapy for superficial venous refluxes, diabetes has only a minor or no effect on the healing time of recalcitrant VLU or MLU.

scholarly journals Up-Regulation of Mir-21 and Mir-130a and Serum Leptin Levels on Leg Ulcers Development in Sickle Cell Anemia

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 975-975
Author(s):  
Thais Helena Chaves Batista ◽  
Rodrigo Marcionilo Santana ◽  
Marcondes José de Vasconcelos Costa Sobreira ◽  
Gabriela da Silva Arcanjo ◽  
Diego Arruda Falcao ◽  
...  
Keyword(s):  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Leg Ulcer ◽  
Acute Chest Syndrome ◽  
Control Group ◽  
Blood Collection ◽  
Leg Ulcers ◽  
Serum Leptin ◽  
Ulcer Group ◽  
And Control

Introduction: Leg ulcers (LUs) are a cutaneous complication of sickle cell anemia (SCA), whose etiology is considered multifactorial. In the search for new candidates for modulators of SCA clinical events, recent evidence suggests the significant role of mechanisms related to post-transcriptional regulation, especially microRNAs (miRNAs). Thus, the analysis of miRNAs miR-21 and miR-130a differential expression in patients with SCA becomes an interesting approach, since both act in the regulation of several biological mechanisms related to the pathophysiology of LU, especially the tissue repair process. In addition, these miRNAs have already been related to the regulation of serum leptin levels, a strong angiogenic pleiotropic hormone that acts in the healing process of skin lesions. Therefore, the aim of the study was to investigate the influence of miR-21 and miR-130a and serum leptin levels on the development of LUs in SCA patients. Methods: After analyzing medical records, 60 SCA patients were selected. Patients who presented some of the main clinical manifestations that may have etiology due to the underlying disease (for example: osteonecrosis, stroke, priapism and acute chest syndrome) were not included. Patients with a history of LU were considered cases, and those who did not develop this complication (n=20), were considered control (median age: 26 years, range: 19-61, 50% males). The control group was called "HbSS-Control" and the case group was divided into two subgroups: Active leg ulcer group, composed of 19 patients with active LU at the time of blood collection (median age: 35 years, range: 24-56, 68% males), and healed leg ulcer group, composed of 21 patients with healed LU at the time of blood collection (median age: 34 years, range: 22-52, 43% males). In addition, it was analyzed a group of 10 donors with normal hemoglobin profile (median age: 25 years, range: 20-30, 50% males), identified as "HbAA-Control". Expression levels of miRNAs extracted from peripheral blood, using mirVanaTM PARIS Kit (Invitrogen™) were evaluated by RT-qPCR technique utilizing TaqMan® probes. Serum leptin levels of the patients were evaluated employing the ELISA method (Human Leptin ELISA Kit, Millipore®). Mann-Whitney and Kruskal-Wallis tests were applied to compare continuous variables. Results: Up-regulation of both miRNAs was observed in the active leg ulcer group in contrast to the healed leg ulcer (miR-21: P&lt;0.0001, Figure 1A, Fold change [FC]=14,2; miR-130a: P=0.0004, FC=18,8, Figure 1B) and Control-HbSS groups (miR-21: P&lt;0.0001, FC=34,4, Figure 1A; miR-130a: P=0.0006, FC=15,3, Figure 1B) and the HbAA-Control group (miR-21: P&lt;0.0001, FC=5,8, Figure 1C; miR-130a: P=0.0009, FC=10,9, Figure 1D). However, there was no significant difference between the healed leg ulcer, HbSS-Control and HbAA-Control groups (miR-21: P=0.1829, Figure 1E; miR-130a: P=0.3537; Figure 1F). Furthermore, the active leg ulcer group had lower serum leptin levels when compared to the healed leg ulcer and Control-HbSS groups (P=0.0058; Figure 2A). The levels of leptin in the healed leg ulcer group did not differ from the Control-HbSS group (P=0.5929; Figure 2B). Conclusion: Our results demonstrated an inverse relation between the miRNAs miR-21 and miR-130a expression with serum leptin levels, suggesting that the up-regulation of these miRNAS may be related to the chronicity and healing of LUs in individuals with SCA through decreased of serum leptin levels. Disclosures No relevant conflicts of interest to declare.

Cutaneous Arteriolosclerosis Is Not Specific to Ischemic Hypertensive Leg Ulcers

Dermatology ◽  
2018 ◽  
Vol 234 (5-6) ◽  
pp. 194-197
Author(s):  
Jean-Benoît Monfort ◽  
Karine Cury ◽  
Philippe Moguelet ◽  
François Chasset ◽  
Claude Bachmeyer ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Retrospective Study ◽  
Skin Biopsy ◽  
Leg Ulcer ◽  
Lower Limbs ◽  
Leg Ulcers ◽  
Independent Factor ◽  
Histological Characteristic

Background: The histological characteristic of hypertensive leg ulcers (HLU) is the presence of “arteriolosclerosis.” The pertinence of performing a skin biopsy to diagnose HLU is questionable, as cutaneous arteriolosclerosis may be related to patient comorbidities. The objective here was to evaluate the frequency of arteriolosclerosis in skin leg biopsies performed in patients without ulcer and in control patients with HLU. Methods: We performed a retrospective study between January 2013 and July 2014. Patients were included if they had undergone a deep skin biopsy on the lower limbs, in the absence of any leg ulcer. Controls were patients with typical HLU. Results: Fifty-eight patients and 6 controls were included. Hypertension was present in 25 patients (43%). Arteriolosclerosis, defined as fibrous endarteritis, was present in 35 out of 58 patients (60%) and in all of the controls. No hyalinosis or hyperplastic proliferative arteriolosclerosis was observed in the patients or controls. Only age was an independent factor associated with the presence of cutaneous arteriolosclerosis (p &x#3c; 0.0001). Conclusion: Cutaneous arteriolosclerosis is significantly and independently associated with age. Thus, skin biopsy seems not to be necessary for the diagnosis of HLU but only for a differential diagnosis.

Leg ulcer

2015 ◽  
Author(s):  
Hugo Farne ◽  
Edward Norris-Cervetto ◽  
James Warbrick-Smith
Keyword(s):  
Diabetes Mellitus ◽  
Time Course ◽  
Pressure Ulcers ◽  
Leg Ulcer ◽  
The Other ◽  
Venous Stasis ◽  
Leg Ulcers ◽  
Venous Ulcers ◽  
Patients With Diabetes ◽  
Neuropathic Ulcers

Venous ulcers account for by far the majority (about 70%), with mixed arterial/venous (about 10%) and arterial (about 10%) most of the remainder. Pressure ulcers have become increasingly common because of the increase in elderly, frail, and relatively immobile patients. The other causes are relatively rare with the exception of neuropathic ulcers in patients with diabetes mellitus. Note that many leg ulcers may have a multifactorial aetiology, i.e. they may involve more than one of the pathologies listed in Figure 29.1. The first thing is to ask about the ulcer. You should consider: • Is the ulcer painful? ■ Venous ulcers are caused by venous stasis in the leg and are thus less painful when elevated and drained of blood. However, only about 30% of venous ulcers are painful. ■ Arterial (atherosclerotic) ulcers are caused by ischaemia to the leg and are thus more painful when elevated and drained of blood. Patients often say the ulcers are painful enough to wake them up at night and that they obtain relief by lowering their leg over the side of the bed. ■ Neuropathic ulcers are caused by loss of sensation (which predisposes to constant trauma) and are thus not painful. ■ Pressure ulcers are caused by, as the name suggests, prolonged pressure on the affected site. They tend to be exquisitely tender but not necessarily painful if no pressure is being applied. • How long has the ulcer been there? ■ Venous ulcers are less painful and can therefore present late. They often have a long and recurring history. ■ Arterial ulcers tend to present relatively early because of pain. They often occur secondary to trivial trauma. ■ Neuropathic ulcers are associated with a loss of sensation and thus often present late. ■ Pressure ulcers can develop surprisingly rapidly (e.g. days in immobile patients if they are not turned regularly during their admission, even hours in patients who suffer a long lie following a fall), but can have a more indolent course depending on how much pressure is put on for how long. Thus the time course is not especially helpful. ■ A long history should arouse suspicion of a Marjolin ulcer, which only occurs in long-standing ulcers.

Using a health improvement methodology to standardise leg ulcer management

2020 ◽  
Vol 25 (Sup9) ◽  
pp. S20-S25
Author(s):  
Kirsten Mahoney ◽  
Wendy Simmonds
Keyword(s):  
Clinical Practice ◽  
Patient Outcomes ◽  
Best Practice ◽  
Leg Ulcer ◽  
Health Improvement ◽  
Evidence Based ◽  
Leg Ulcers ◽  
Venous Leg Ulcers ◽  
Poor Patient ◽  
Pdsa Cycle

Despite guidelines, best-practice statements and CQUIN targets, venous leg ulcers have been highlighted as an area that continues to demonstrate lack of evidence-based practice and variation in practice, which contribute to poor patient outcomes and escalating costs. Leg ulcer services that use a systematic and standardised approach to leg ulcer management are highly successful in improving healing rates, preventing recurrence and contributing to patients' wellbeing. This article seeks to explore the use of the plan-do-study-act (PDSA) cycle in clinical practice to improve and standardise leg ulcer management.

Controlling compression bandaging pressure in leg ulcer research trials: A summary of the literature

2019 ◽  
Vol 34 (8) ◽  
pp. 501-514 ◽  
Author(s):  
Sharon L Boxall ◽  
Keryln Carville ◽  
Gavin D Leslie ◽  
Shirley J Jansen
Keyword(s):  
Ulcer Healing ◽  
Gold Standard ◽  
Reliability And Validity ◽  
Leg Ulcer ◽  
Evidence Based ◽  
Leg Ulcers ◽  
Venous Leg Ulcer ◽  
Practice Recommendations ◽  
Compression Bandaging ◽  
Literature Searches

Compression bandaging remains the ‘gold standard’ intervention for the treatment of venous leg ulcers. Numerous studies have investigated the effect of a large variety of compression bandaging techniques and materials on venous leg ulcer healing. However, the majority of these studies failed to monitor both actual bandage application pressures and the bandaging competency of participating clinicians. A series of literature searches to explore the methods, practices, recommendations and results of monitoring compression bandaging pressures in leg ulcer research trials were undertaken. This included investigating the reliability and validity of sub-bandage pressure monitors and the degree to which compression bandaging achieves the recommended sub-bandage pressure. The literature revealed inconsistencies regarding the monitoring of sub-bandage pressure and in sub-bandage pressures produced by clinicians. This creates difficulties when comparing study outcomes and attempting to develop evidence-based practice recommendations.

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