The Italian National Healthcare System (NHS) processes data concerning outpatient services at public facilities based exclusively upon the weight of services provided. It is the Ministry of Health which initially determines the types of services that can be provided for each pathology. In Italy today (as we await the publication of the new Essential Care Levels already identified by the Ministry of Health) there are still no medical codes specifically associated with specialist outpatient services for the treatment of skin ulcers. This means that not all patients affected by this pathology who turn to public facilities are traceable. It is different where hospital admission is concerned because data is usually obtained from the discharge forms. Unfortunately, the data obtained is not always a true expression of the prevalence of skin ulcers in the hospital environment. In many cases the prevalence of pressure ulcers is not properly reported. This is because their appearance during hospitalization is an indicator of poor hospital care. The lack of data makes it impossible for our NHS to plan appropriate interventions in this area, both organizationally and economically. Scarce financial resources are allocated for the treatment of skin ulcers and their costs fall almost entirely upon the patients and their families. Furthermore, there are no national care networks dedicated specifically to their treatment.
L’insorgenza di infezione su una lesione cutanea cronica determina un arresto del processo di riparazione tessutale e impone l’instaurazione di una terapia antibiotica sistemica che, in una fase iniziale, sarà empirica e, dunque, non scevra di insuccessi. L’utilizzo di antimicrobici con ridotto potere citotossoco/istiolesivo può essere considerata, in molti casi, una valida alternativa per il controllo della carica batterica e dell’infezione locale. L’associazione di antimicrobici a base di poliesanide biguanide, betaina e cadexomero iodico, in molti casi, permette di controllare/ridurre la carica batterica e l’infezione locale fungendo da starter per la ripresa del processo di riparazione tessutale. The onset of infection on a skin ulcer (chronic wound) leads to a halt in the tissue repair process and requires a systemic antibiotic therapy which, at an early stage, will be empirical and, therefore, not free from setbacks. The use of antimicrobials with reduced cytotoxic/histiolesive power can be considered, in many cases, a valid alternative for bacterial burden and local infection control. The combination of antimicrobials based on polystyrene biguanide, betaine and iodine cadexomer, in many cases, allows to control/reduce the bacterial burden and local infection by acting as a starter for the resumption of the tissue repair process.
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