To investigate whether the addition of human recombinant epidermal growth factor (h-EGF) to 2% carboxymethyl cellulose gel is more effective in diabetic wound healing than standard treatment, a pilot, double-blind, randomized and controlled clinical trial with therapeutic intervention was performed at a university hospital. The sample consisted of 25 patients (14 in the intervention group that used rh-EGF and 11 in the control group that used 2% carboxymethyl cellulose gel). Data were tabulated in SPSS and analysed by intention to treat, without loss or exclusion of participants. Twenty-five subjects participated with a mean age of 60.6 years, a predominance of males in both groups and 100% prevalence of type-2 diabetes. Within 12 weeks, complete wound healing occurred in three ulcers in the intervention group versus one ulcer in the control group.The percent reduction in the wound area was significantly higher in the intervention group than in the control group (p = 0.049). Concerning the types of tissue, an increase in granulation and epithelial tissue and a reduction in exudate levels were observed in both groups. Decreased slough occurred only in the intervention group. No participant experienced serious or local adverse events during the study period. This study shows that h-EGF is effective, with a statistically significant reduction in wound area, improvement of tissue quality, and safe treatment of chronic wounds. In addition, this study demonstrated that blinding of participants during research using h-EGF is feasible.

A presença de infecção em feridas retarda o processo de cicatrização. Os principais microrganismos isolados são Staphylococcus aureus e Pseudomonas aeruginosa. Objetivo: analisar o perfil fenotípico e genotípico de cepas de Staphylococcus aureus em lesões crônicas de pacientes ambulatoriais tratadas com hidrogel a 2% ou poliuretano. Tal análise dará subsídios para a decisão do tratamento adequado e maior rapidez no processo de reparo tecidual. Método: Pesquisa descritiva com abordagem quantitativa, por meio da coleta de espécime clínico das lesões por swab com cultura bacteriana, identificação e caracterização molecular.

The aim of the study was to evaluate the healing process of chronic wounds treated with carboxymethylcellulose loaded with recombinant human epidermal growth factor in patients with diabetes. The case series consisted of 10 patients treated at the university hospital for 12 weeks. Data were analyzed using SPSS version 22.0. according to the intention to treat the principle, without the loss or exclusion of the participants. The sample consisted of 70% (7/10) males with a mean age of 61.9 years (±9.4); all (100%) had diabetes mellitus and 70% (7/10) had systolic hypertension associated with diabetes mellitus. Sixty percent (6/10) presented lesions of diabetic etiology and 40% (4/10) presented lesions of venous etiology; 70% (7/10) had had lesions for less than 5 years. The mean glycated hemoglobin was 7.8% (±2.7%), while the mean ankle-arm index (AAI) was 0.94 (±0.21). The mean initial area of all wounds was 13.4 cm², and the mean final area was 7.8 cm2, with a reduction rate of 28.9% over the 12 weeks of treatment. The reduction rate of diabetic ulcers was higher (33.4%) than that of venous ulcers (22.1%). Regarding the type of tissue, there was an increase in granulation and epithelialization, and a decrease in slough and the amount of exudate that were statistically significant (p = 0.021). No participant had severe or local adverse events during the study period. Epidermal growth factor was effective in the treatment of chronic wounds, especially diabetic ulcers, resulting in the reduction of the wound area and the improvement of tissue and exudate quality.

Assistência de enfermagem a idosos com traumas ósseos: uma revisão integrativaNursing care to elderly with bone fractures: an integrative review Cuidados de enfermería para la tercera edad con fracturas óseas: una revisión integrativa Objetivo: Describir el perfil de los ancianos que fueron víctimas de traumas óseos y cómo la enfermería ha actuado en la asistencia a estos clientes. Método: revisión Integradora, realizada em la base de datos LILACS a partir de los descriptores: Anciano, Enfermería y Trauma, con el intuito de responder a la siguiente pregunta:<< "Cuál es el perfil de los ancianos que sufren traumas óseas y cuál es el papel de la enfermería en la asistencia a estos clientes?">>. Resultados: sufren más traumas individuos prioritariamente con más de 80 años, con debilidades neuromotoras, usando múltiples medicaciones y con comorbilidades. El cuidado de enfermería a los ancianos traumatizados todavía es deficiente, ya que se observa una incidencia significativa de iatrogenias. Conclusión: los factores de riesgo para la ocurrencia de eventos traumáticos en el anciano favorecen la pérdida de la calidad de vida, aumento de la dependencia funcional, sobrecarga a los cuidadores y institucionalización. Los registros de los cuidados prestados proporcionan visibilidad y garantizan la continuidad del cuidado de forma calificada. Descriptores: Enfermería, Anciano, Traumatología, Heridas y Lesiones.

Diabetic patients frequently develop wounds, which can be colonized by bacteria, mainly Staphylococcus aureus and Pseudomonas aeruginosa, with the ability to form biofilms. This study aimed to evaluate the colonization and biofilm formation of Staphylococcus aureus and Pseudomonas aeruginosa in chronic wounds of diabetic patients treated with a bioactive dressing (EGF-CMC), which consisted of a 2% carboxymethylcellulose (CMC) hydrogel loaded with epidermal growth factor (EGF). This randomized clinical trial was conducted with 25 participants: 14 treated with EGF-CMC hydrogel and 11 treated with CMC hydrogel for 12 weeks. Participants with type 2 diabetes mellitus were selected. All had diabetic foot ulcers or chronic venous ulcers. Swab collections were performed on weeks 1, 6, and 12. The laboratory analyses included the identification of strains, microbial quantification, virulence gene investigation, and the evaluation of biofilm formation. In total, 13 S. aureus strains and 15 P. aeruginosa strains were isolated. There were no statistically significant differences regarding bacterial loads and virulence genes. However, EGF-CMC-hydrogel-treated wounds were colonized by strains with lower biofilm formation abilities. The probability of isolating biofilm-producing strains from CMC-hydrogel-treated wounds was 83% greater than the probability of isolating biofilm-producing strains from EGF-CMC-treated wounds.