The aims of the study were to describe and analyse the temporal trend of the prevalence and incidence of venous leg ulcers (VLU) over the years 2010 to 2014, to determine healing times and temporal trends in the study period, and to evaluate related aspects such as the use of the Ankle‐Brachial Pressure Index (ABPI) in a primary care health centre. This was a retrospective study based on a time series (years 2010‐2014) of the prevalence and incidence of VLUs in people aged over 40 years in a primary care centre in Barcelona City. We reviewed 3920 electronic health records selecting patients, per year (2010‐2014), with VLUs based on the ICD‐10 diagnoses. For prevalence, we took into account any patient with an active VLU in the year of study. For incidence, we took into account patients with a new VLU in the year of study. A descriptive analysis was carried out based on each of the collected variables. The variables were examined according to the years of study (time series) by one‐factor analysis of variance (anova) or Kruskal–Wallis non‐parametric test, as appropriate. A survival analysis by Kaplan–Meier curves and log‐rank test was also performed. A total of 139 patients met the VLU criteria. Among them, only 79.2% were classified as having a VLU and had a correct ICD diagnosis. The prevalence and incidence increased over the years, doubling in patients aged over 65 years. Incidence increased from 0.5 new cases per 1000 people/year in 2010 to 1 new case for every 1000 people/year in 2014. Moreover, the prevalence ranged between 0.8 and 2.2 patients with VLU for every 1000 people/year. During the study period, a total of 84.2% of the VLUs healed (117/139 VLU). Regarding average annual time to healing, the trend indicates that lesions took less time to heal (Kruskal–Wallis test, P = 0.004), ranging between 453,9 weeks in 2005 to 19 weeks in 2014. The use of ABPI also evolved and was found to be increasingly performed prior to the appearance of the lesion. The epidemiological profile of people affected by VLUs continues to be, mainly, that of women of an advanced age, over 70 years. The frequency of VLU occurrence rose continually over the years, but healing took less time, and use of ABPI improved. Assigning a reference nurse in the wounds unit and the organisational structure around this problem may have an influence on improving care and the approach to these types of lesions.
Trabajo originado en el transcurso del desarrollo de la edición 2011-2012 del Máster Universitario en la Gestión Integral e Investigación en Heridas Crónicas fruto de la colaboración entre la Universidad de Cantabria, el Grupo Nacional para el Estudio y Asesoramiento en Úlceras por Presión y Heridas Crónicas-GNEAUPP y Smith&Nephew AWM Iberia.
Correspondencia:Joan-Enric Torra i Bou E-mail: jetorrabou@hotmail.com / Joanenric.torra@smith-nephew.com
RESUMENActualmente se percibe una indefinición manifiesta acerca de la conceptualización y abordaje de las llamadas lesiones por humedad en los entornos clínicos, docentes e investigadores de nuestro país, que muy frecuentemente relacionan este término solo con las lesiones producidas por la orina y las heces. Dadas las diversas repercusiones que se intuye pueden tener este tipo de lesiones, se hace necesario consensuar y unificar los distintos aspectos relacionados con el cuidado de estas heridas. En el presente artículo, y siguiendo la tendencia internacional, se propone la adopción del término lesiones cutáneas asociadas a la humedad (LESCAH) para referirnos a la inflamación y erosión de la piel causada por la exposición prolongada a diversas fuentes de humedad, incluyendo la orina o las heces, el sudor, el exudado de la herida, el moco o la saliva. Desde esta premisa, se presentan y describen los diferentes tipos de LESCAH identificados en la clínica. Y finalmente, para facilitar la integración de la valoración,
INTRODUCCIÓNEl contacto prolongado de la piel de los pacientes con determinados fluidos orgánicos -orina, heces, sudor, exudado de heridas,…-es una circunstancia muy frecuente a la que se enfrentan los profesionales clíni-cos en todos los niveles asistenciales que, si no es abordada de manera correcta y decidida, puede traducirse en: a) Lesiones cutáneas debidas a este contacto -ya sea por la humedad intrínseca de estos fluidos, el carácter irritante de las sustancias que contie-
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