Wskaźnik terapeutyczny miejscowego zakażenia rany (TILI) jako przydatne narzędzie w efektywnej pielęgnacji ran niegojących się dla lekarzy i pielęgniarek podstawowej opieki zdrowotnej, lekarzy rodzinnych i personelu zakładów opiekuńczo-leczniczych

Abstract

The problem of hard-to-heal wounds is associated with an increase in the incidence of civilization diseases. Venous leg ulcers, ischemic ulcers and wounds in diabetic foot syndrome are a particular problem, and the early detection of local wound infections is a serious interdisciplinary challenge in everyday practice. Local wound infections are often undetected or detected too late. They can impair physiological wound healing as well as lead to systemic infection and even sepsis. According to the statements that: “The fate of the wounded rests with the one who applies the first dressing” (Col. Nicholas Senna, 1897), and “The responsibility for the patient rests with the doctor who comes to the patient first” (John Murphy, Medical Society, Chicago, 1889) the success of the treatment of infected wounds depends to a particular extent on the prompt and proper response of those who come in contact with the patient first. The purpose of this document is to briefly present issues related to the problem of hard-to-heal wounds, indicate the direction of therapeutic management and diagnostic support for the staff (doctors and nurses) of primary healthcare units, care and treatment institutions and social welfare centers, general physicians and medical careers of patients suffering from hard-to-heal wounds. The developed TILI score is to facilitate the decision whether or not to use antiseptics and/or antimicrobial dressings in the effective therapy of a hard-to-heal wound.

Management of a heel wound as part of the holistic care of patients at the end of their lives – a literature review and own professional experience

“…Zaopatrzenie ran u pacjenta u kresu życia [23,63] therapeutic index for local infektions), które opiera się na stanie klinicznym rany, co może ograniczyć zbyt wczesne wdrażanie leczenia przeciwdrobnoustrojowego. Prosta ocena zakłada wykorzystanie sześciu zmiennych charakterystycznych dla infekcji ranywzrost temperatury, ból, zaczerwienienie, obrzęk, wysięk, zatrzymanie procesu gojenia [61]. Do oceny destrukcji i głębokości uszkodzenia tkanek zalecana jest czterostopniowa skala NPIAP opisująca poziom destrukcji tkanek w urazach ciśnieniowych (ryc.…”

Defensins of Lucilia sericata Larvae and Their Influence on Wound Repair Processes in Practical Assessment—A Study of Three Cases

“…Wounds that do not respond to treatment in accordance with accepted standards and remain in a prolonged inflammatory-proliferative phase are defined as difficult to heal [ 3 ]. Prolonged healing processes lasting more than 6 weeks give the basis to label the wound as chronic (the exception of 14 days or more is a wound in the course of a diagnosed diabetic foot) [ 4 , 5 ]. The wound hygiene concept developed by European experts was based on the assumption that biofilm-forming microbes are the main cause of delayed healing in 60–90% of cases, which is noticeable just a few days after the potential injury [ 3 , 6 , 7 , 8 ].…”