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.
Objetivo: realizar a adaptação transcultural e teste de praticabilidade para uso do instrumento Critical Care, Pressure Ulcer Assessment Tool Made Easy, no Brasil. Métodos: estudo metodológico de adaptação transcultural, incluindo cinco etapas: tradução inicial, síntese da tradução inicial, retrotradução, avaliação por um comitê de especialistas e a realização do teste de praticabilidade, aplicado à avaliação do risco de lesões por pressão em pacientes em tratamento intensivo. Resultados: O índice de validade de conteúdo (IVC) foi calculado para análise do comitê de especialistas e a taxa de concordância (TC) para a praticabilidade no pré-teste. A partir disso, considerou-se como favoráveis IVC >0,8 e TC > 80% e as equivalências semântica e idiomática foram julgadas como adequadas, com IVC de 0,85 e TC de 84,38%. Considerações finais: a escala foi adaptada para uso no Brasil, apresentou alto nível de concordância entre os especialistas durante todas as etapas e demonstrou validade de conteúdo.
Background: The study provides results from a double-blind clinical trial of 25 patients with diabetic or venous chronic ulcers. The main focus was to evaluate the assessing cost of outpatient treatment with two technologies: 2% carboxymethylcellulose hydrogel or human recombinant Epidermal Growth Factor carbogel. Methods: Patients were randomly allocated to two ulcer treatment groups, human recombinant Epidermal Growth Factor carbogel treated (intervention group, n = 14), and 2% carboxymethylcellulose hydrogel (CMC) (control group, n = 11); both treated during 90 days. To calculate the costs of each patient's procedures, direct costs and human resources costs were measured in Brazilian currency and converted into US dollars. Statistical analysis of clinical data was performed based on intention to treat. For each treatment were analyzed the proportion of cases with wound reduction; cost benefit of the treatment given by the average value of each 1cm2 wound reduction; statistics on the cost of reducing each cm2 of wound for each patient presenting wound reduction. Results: In all evaluated periods, the proportion of cases with decreased lesion area was higher in the intervention group; It presented better cost-benefit ratio and lower average and median reduction cost for each reduced cm2 of the wound. Conclusion: Data suggested that growth factor therapy may be cost-effective and innovative complement to standard wound care.
Objetivo: O objetivo deste estudo foi descrever um caso de tratamento de uma úlcera do pé diabético com S. adstringens com uma formulação magistral. Método: Trata-se de um relato de experiência sobre atendimento a uma paciente com úlcera do pé diabético submetida a tratamento com solução de barbatimão a 20% e fibra de alginato durante os meses de fevereiro a abril de 2021. Resultado: Na primeira consulta de enfermagem, foi realizado o histórico de enfermagem, o diagnóstico de enfermagem, “Integridade tissular prejudicada evidenciada por exposição do tecido abaixo da epiderme (úlcera do pé diabético em hálux esquerdo) relacionada a nível inadequado de glicose no sangue (diabetes mellitus tipo 1)”. Posteriormente foram descritas as intervenções de enfermagem para tal diagnóstico, seguido da implementação e avaliação das intervenções. Conclusão: Essa experiência permitiu ampliar os horizontes de aplicabilidade do barbatimão do tratamento de feridas também para casos de hipergranulação.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.