Chronic wounds in Murcia area health

Objetivo: Identificar la prevalencia de heridas crónicas en el Área VI del Servicio Murciano de Salud e identificar, dentro de ellas, la proporción en base a las siguientes variables: por presión, vasculares, diabéticas, traumáticas o no conocidas/otros. Material y Método: Estudio descriptivo, transversal y retrospectivo. La muestra estuvo compuesta por todas las personas mayores de 13 años de edad, que presentaron al menos una herida crónica, en base a los registros clínicos del año 2014. La fuente de datos utilizada fue la historia clínica electrónica del paciente, en el ámbito de atención primaria de un Área de Salud de Murcia. Análisis estadístico descriptivo. Resultados: Se identificaron 639 personas con alguna herida crónica identificada en su historia clínica. La media de edad fue de 75,7 años. El género femenino fue significativamente el más frecuente (p<0,05). Se obtuvo una prevalencia de 1 individuo con úlcera por cada 225 analizados. Las proporciones y distribución de úlceras encontradas fueron: úlcera por presión (44%), úlceras vasculares (29%), úlceras traumáticas (15%), diabéticas (11%) y úlceras no conocidas (1%). Conclusiones: La prevalencia de úlceras en las zonas estudiadas asciende a un 0,45% lo que va en sintonía con otros estudios. La úlcera más frecuente es la úlcera por presión, seguidas por vasculares, traumáticas, diabéticas y otras.Objective: To identify the prevalence of chronic wounds in the area VI of Murcia Health Service and identify, within them, the share on the basis of the following variables: by pressure, vascular, diabetic, traumatic or not known/other. Material and Method: Descriptive, cross-sectional and retrospective study. The sample was composed of all persons over 13 years of age, who presented at least a chronic wound, on the basis of the clinical records of the year 2014. The data source used was the electronic clinical history of the patient, in the field of primary care in a Health Area of Murcia. Descriptive statistical analysis. Results: We identified 639 people with some chronic wound identified in its history. The average age was 75.7 years. The female gender was significantly the most frequent (p<0.05). It was obtained a prevalence of 1 individual with ulcer by each 225 analyzed. The proportions and distribution of ulcers found were: pressure ulcer (44%), vascular ulcers (29%), traumatic ulcers (15%), diabetes (11%) and ulcers do not know (1%).Enfermerí

Heridas crónicas en un área de salud de murcia

Objective: To identify the prevalence of chronic wounds in the area VI of Murcia Health Service and identify, within them, the share on the basis of the following variables: by pressure, vascular, diabetic, traumatic or not known/other. Material and Method: Descriptive, cross-sectional and retrospective study. The sample was composed of all persons over 13 years of age, who presented at least a chronic wound, on the basis of the clinical records of the year 2014. The data source used was the electronic clinical history of the patient, in the field of primary care in a Health Area of Murcia. Descriptive statistical analysis. Results: We identified 639 people with some chronic wound identified in its history. The average age was 75.7 years. The female gender was significantly the most frequent (p<0.05). It was obtained a prevalence of 1 individual with ulcer by each 225 analyzed. The proportions and distribution of ulcers found were: pressure ulcer (44%), vascular ulcers (29%), traumatic ulcers (15%), diabetes (11%) and ulcers do not know (1%). Conclusions: The prevalence of ulcers in the studied areas amounts to a 0.45% which is in line with other studies. The ulcer is the most frequent pressure ulcer, followed by vascular, traumatic, diabetic and others.Objetivo: Identificar la prevalencia de heridas crónicas en el Área VI del Servicio Murciano de Salud e identificar, dentro de ellas, la proporción en base a las siguientes variables: por presión, vasculares, diabéticas, traumáticas o no conocidas/otros. Material y Método: Estudio descriptivo, transversal y retrospectivo. La muestra estuvo compuesta por todas las personas mayores de 13 años de edad, que presentaron al menos una herida crónica, en base a los registros clínicos del año 2014. La fuente de datos utilizada fue la historia clínica electrónica del paciente, en el ámbito de atención primaria de un Área de Salud de Murcia. Análisis estadístico descriptivo. Resultados: Se identificaron 639 personas con alguna herida crónica identificada en su historia clínica. La media de edad fue de 75,7 años. El género femenino fue significativamente el más frecuente (p<0,05). Se obtuvo una prevalencia de 1 individuo con úlcera por cada 225 analizados. Las proporciones y distribución de úlceras encontradas fueron: úlcera por presión (44%), úlceras vasculares (29%), úlceras traumáticas (15%), diabéticas (11%) y úlceras no conocidas (1%). Conclusiones: La prevalencia de úlceras en las zonas estudiadas asciende a un 0,45% lo que va en sintonía con otros estudios. La úlcera más frecuente es la úlcera por presión, seguidas por vasculares, traumáticas, diabéticas y otras

Decisiones basadas en la evidencia: mejorando la calidad de la atención en un caso clínico de úlcera venosa

Introducción: Se presenta un caso de herida crónica en miembro inferior asociada a patología vascular con mala evolución. El objetivo es constatar la resolución del caso con apoyo de una guía de práctica clínica. Caso clínico: A través de un caso clínico, se contrastaron las recomendaciones para la cura de úlceras y heridas crónicas de la “Guía de Práctica Clínica de Enfermería para la Prevención y Tratamiento de Úlceras Por Presión y Otras Heridas Crónicas», de la Generalitat Valenciana. Alta del paciente tras tres meses de evolución. La cura en ambiente húmedo (CAH) y elección del tratamiento adecuado (terapia compresiva), permitió espaciar la frecuencia de atenciones, oscilando esta, entre las 48-72 horas, cuando se trababa de controlar la infección, hasta los siete días cuando el lecho y características de la herida, así lo permitieron. Conclusión principal: Los tratamientos de úlceras basados en la evidencia disponible y apoyado por guías de práctica clínica, constituyen un apoyo efectivo para la consecución de los objetivos de cierre del deterioro de la integridad cutánea.Introduction: We present a case of chronic wound in lower limb associated with vascular pathology with bad evolution. The objective is to ensure the resolution of the case with the support of a guide clinical practice. Clinical Case: through a clinical case, contrasting the recommendations for the healing of ulcers and chronic wounds of the “Guide Practice Nurse Clinic for the Prevention and Treatment of Pressure Ulcers and Other Chronic Wounds”, of the Generalitat Valenciana. Patient discharge after three months of evolution. The cure in moist environment (CME) and choice of treatment (compressive therapy), allowed spacing the frequency of attentions, ranging this, between the 48-72 hours, when it was trying to control the infection, up to seven days when the bed and features of the wound, so allowed. Main conclusion: treatments of ulcers based on the available evidence and supported by clinical practice guidelines, constitute an effective support to the achievement of the objectives of closure of the deterioration of the skin integrity

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care