USE  OF  A  NEW  ULCER  CLEANSING  SYSTEM  AND  OF  PLATELET  GEL  IN  THE  MANAGEMENT  OF  “NON  

HEALING”  LEG  ULCERS  IN  ELDERLY  

 PALUMBO  F.P.1  –  SERANTONI  S.2  –  ABBRITTI  F.3  –  MAZZOLA  G.

4-­‐  FAILLA  G.5-­‐  DI  SALVO  M.M.5  

1  –  LABORATORIO  DI    VULNOLOGIA  –  PALERMO  2  –  CASA  DI  CURA  “VILLA  FIORITA”  –  PRATO    3  –  U.O.  CHIRURGIA  VASCOLARE  –  A.O.  G.  SALVINI,  GARBAGNATE  MILANESE  4  –  U.O.  MEDICINA  TRASFUSIONALE  –  A.O.U.  POLICLINICO,  PALERMO  5    -­‐  U.O.  ANGIOLOGIA  –  A.O.U.  VITTORIO  EMANUELE  –  “FERRAROTTO”,  CATANIA

     

USE OF A NEW ULCER CLEANSING SYSTEM AND OF PLATELET GEL IN THE MANAGEMENT OF “NON HEALING” LEG ULCERS IN ELDERLY

Age: 74 - 92 years Average age 81,6 yy

AETIOLOGY Venous 5 Arterial 2 Mixed 3 Vasculitis 3 Diabetic 3

A  new  technological  advanced  device  was  tested  on  27  lesions  selected  in  16  paTents  in  a  mulTcentric  observaTonal  study.    

PALUMBO F.P. – SERANTONI S. – ABBRITTI F.– MAZZOLA G.- FAILLA G.- DI SALVO M.M.

0  

2  

4  

6  

8  

10  

6  

10  

MALES   FEMALES  

METHODS  

All   paTents   underwent   to   an   anamnesTc   and   clinical     and   instrumental   evaluaTon   (when  required).  Data   were   collected   using   a   schedule   to   detect   wound   characterisTcs.   QL   index   was  administred  to  all  paTents.  In  selected  paTents,  a  mulTlayer,  mulTcomponent,  inelasTc  bandage  was  applied.    Ulcer  Cleansing  System  Device  was  administred  before  platelet  gel  applicaTon.  Autologous  PLT  Gel  was  administred  in  14  paTents.  Only  in  2  paTents  homologous  PLT  Gel  was  administred.    

PaTents  were  selected  according  to  condiTons  of  the  injury  at  Tme  T0,  regardless  of  Tme  of  onset  and  treatment  prior  to  enrollment  date.  Criteria  exclusion:  severe  infected  lesions.      

PALUMBO F.P. – SERANTONI S. – ABBRITTI F.– MAZZOLA G.- FAILLA G.- DI SALVO M.M.

USE OF A NEW ULCER CLEANSING SYSTEM AND OF PLATELET GEL IN THE MANAGEMENT OF “NON HEALING” LEG ULCERS IN ELDERLY

USE  OF  A  NEW  SURFACTANT  GEL  WITH  SILVER  SULPHADIAZINE  IN  THE  TREATMENT  OF  CHRONIC  LEG  ULCERS  AND  DIABETIC  FOOT:  ITALIAN  MULTICENTRIC  EXPERIENCE  

ULCERS  AREA   PLANIMETRIC  METHOD  

PAIN   VISUAL  SCALE  

EXUDATE   N.  DRESSING  CHANGE/WEEK  

QUALITY  OF  LIFE  INDEX  (QL)   ACTIVITY,  DAILY  LIVING,  HEALTH,  SUPPORT,  OUTLOOK  

PALUMBO F.P. – SERANTONI S. – ABBRITTI F.– MAZZOLA G.- FAILLA G.- DI SALVO M.M.

USE OF A NEW ULCER CLEANSING SYSTEM AND OF PLATELET GEL IN THE MANAGEMENT OF “NON HEALING” LEG ULCERS IN ELDERLY

USE  OF  A  NEW  SURFACTANT  GEL  WITH  SILVER  SULPHADIAZINE  IN  THE  TREATMENT  OF  CHRONIC  LEG  ULCERS  AND  DIABETC  FOOT:  ITALIAN  MULTICENTRIC  EXPERIENCE  

 RESULTS    In  all   almost  paTents  an   improvement  of  obiecTve  data  was  observed.  ReducTon  of  exudaTon  and  of   inflamaTon   in   the   skin   around   the  ulcers  were  observed   since   the  first   week   of   gel   applicaTon.   These   were   accompanished   by   reducTon   of   average  wound  areas  and  of  pain.  Also  malodour  decreased  since  the  first  week.  Some  paTents  have  reported  the  occurrence  of  burning  in  the  first  two  days  of  applicaTon  of  platelet  gel.              

PALUMBO F.P. – SERANTONI S. – ABBRITTI F.– MAZZOLA G.- FAILLA G.- DI SALVO M.M.

USE OF A NEW ULCER CLEANSING SYSTEM AND OF PLATELET GEL IN THE MANAGEMENT OF “NON HEALING” LEG ULCERS IN ELDERLY

   

USE  OF  A  NEW  SURFACTANT  GEL  WITH  SILVER  SULPHADIAZINE  IN  THE  TREATMENT  OF  CHRONIC  LEG  ULCERS  AND  DIABETIC  FOOT:  ITALIAN  MULTICENTRIC  EXPERIENCE  

PAIN  WOUND  AREAS  

0  

5  

10  

15  

20  

25  

30  

t0   t1  

29,2  

20,1  

0  1  2  3  4  5  6  7  

t0   t1  

6,6  2,7  

PALUMBO F.P. – SERANTONI S. – ABBRITTI F.– MAZZOLA G.- FAILLA G.- DI SALVO M.M.

USE OF A NEW ULCER CLEANSING SYSTEM AND OF PLATELET GEL IN THE MANAGEMENT OF “NON HEALING” LEG ULCERS IN ELDERLY

-­‐  59,9  %  -­‐  31,1  %  

USE  OF  A  NEW  SURFACTANT  GEL  WITH  SILVER  SULPHADIAZINE  IN  THE  TREATMENT  OF  CHRONIC  LEG  ULCERS  AND  DIABETIC  FOOT:  ITALIAN  MULTICENTRIC  EXPERIENCE  

QL-­‐INDEX  EXUDATE  

PALUMBO F.P. – SERANTONI S. – ABBRITTI F.– MAZZOLA G.- FAILLA G.- DI SALVO M.M.

USE OF A NEW ULCER CLEANSING SYSTEM AND OF PLATELET GEL IN THE MANAGEMENT OF “NON HEALING” LEG ULCERS IN ELDERLY

0  

0,5  

1  

1,5  

2  

2,5  

3  

3,5  

t0   t1  

3,4  

1,3  

8,2  8,4  8,6  8,8  9  

9,2  9,4  9,6  9,8  

t0   t1  

8,8  

9,7  

-­‐61,7%   10,2%  

USE  OF  A  NEW  SURFACTANT  GEL  WITH  SILVER  SULPHADIAZINE  IN  THE  TREATMENT  OF  CHRONIC  LEG  ULCERS  AND  DIABETIC  FOOT:  ITALIAN  MULTICENTRIC  EXPERIENCE  

PALUMBO F.P. – SERANTONI S. – ABBRITTI F.– MAZZOLA G.- FAILLA G.- DI SALVO M.M.

USE OF A NEW ULCER CLEANSING SYSTEM AND OF PLATELET GEL IN THE MANAGEMENT OF “NON HEALING” LEG ULCERS IN ELDERLY

Cleansing of a pressure ulcer in a patient affected of PAD by device and application of PLT Gel. After 2 weeks growth of proliferative tissue.

Cleansing of an ulcer occurring in a woman affected of thrombocytemia and application of PLT Gel.

USE  OF  A  NEW  SURFACTANT  GEL  WITH  SILVER  SULPHADIAZINE  IN  THE  TREATMENT  OF  CHRONIC  LEG  ULCERS  AND  DIABETIC  FOOT:  ITALIAN  MULTICENTRIC  EXPERIENCE  

DISCUSSION    The  aim  of  the  study  was  to  verify  the  effecTveness  a  new  system  of  debridment  using  a  soluTon  based  on  poloxamer  and  moisturisers  like  aloe  vera.  Cleansing  and  debridment,  obtained  with  a  tovel  soaked  in  this  liquid,  was  followed  immediately  by  a  feeling  of  freshness  even  on  very  exuding  and  inflamed  ulcers.  The  applicaTon  of  platelet  gel  in  some  paTent  was  followed  by  the  onset  of  burning  of  vaTable  duraTon  from  a  few  hours  up  to  two  days.  Since  the  first  two  applicaTons  it  was  observed  a  decrease  of  exudate  and  dressing  changes  to  the  reducTon  of  inflamaTon  of  the  Tssue  surrounding  the  wound.  Also  the  bad  odor  was  reduced  unTl  the  disappareance  and  this  has  improved  the  social  life  of  the  elderly  subjects.  The  handling  and  ease  of  use  of  the  new  debridment  system  has  considerably  shortened  Tme  of  PLT  gel  applicaTon.          

PALUMBO F.P. – SERANTONI S. – ABBRITTI F.– MAZZOLA G.- FAILLA G.- DI SALVO M.M.

USE OF A NEW ULCER CLEANSING SYSTEM AND OF PLATELET GEL IN THE MANAGEMENT OF “NON HEALING” LEG ULCERS IN ELDERLY

USE  OF  A  NEW  SURFACTANT  GEL  WITH  SILVER  SULPHADIAZINE  IN  THE  TREATMENT  OF  CHRONIC  LEG  ULCERS  AND  DIABETIC  FOOT:  ITALIAN  MULTICENTRIC  EXPERIENCE  

AKNOWLEDGEMENTS    A  SPECIAL  THANKS  TO  DR.  ELSA  LO  IACONO  AND  DR.  ELENA  PATORNO  FOR  THE  PREPARATION  OF  DATA  ON  PATIENTS.            

   

PALUMBO F.P. – SERANTONI S. – ABBRITTI F.– MAZZOLA G.- FAILLA G.- DI SALVO M.M.

USE OF A NEW ULCER CLEANSING SYSTEM AND OF PLATELET GEL IN THE MANAGEMENT OF “NON HEALING” LEG ULCERS IN ELDERLY

CONCLUSIONS    In  almost  all  cases    we  observed  an  improvement  in  the  wounds,  indicated  by:  §  Regression  of  signs  of  inflamaTon;  §  ReducTon  of  exudate  and  fibrin;  §  ReducTon  of  pain  assessed  by  the  paTents;  §  Good  compliance  at  dressing  change;  §  ReducTon  of  malodour;  §  Improving  QL-­‐Index  rate.    These  result  suggest  that  a  good  bed  wound  preparaTon  is  important  to  the  next  PLT  gel  acTon,  No  collateral  effects  and  complicaTons  were  reported  in  all  paTents: