Objective: Leprosy is a disease that affects the peripheral nerves and ulcers are among the main complications of the disease. The laser is a tool with wide use in physiotherapy, with proven efficacy in the improvement of pressure ulcers, which creates the possibility of studies on its action in leprosy lesions. The aim of this study was to review the literature on the efficacy of low-level laser therapy (LLLT) in the healing process of leprosy lesions. Method: Articles were sought in databases according to specific search criteria for each database as results of the descriptors included using EndNote Web (Clarivate, UK). The risk of bias (RoB) was analysed using Cochrane's ROBINS-I and RoB2 tools. Results: A total of 259 studies were included, involving 49 patients. After exclusion of duplicates and following a full reading, three articles remained for inclusion in this review. Of the three studies, only two had positive results for LLLT on the healing of leprosy ulcers; however, no study showed low RoB. Conclusion: The findings of this review concluded that use of LLLT in the study population was effective in reducing the size of leprosy lesions. Due to the lack of primary studies with low RoB, more primary studies are required to provide stronger evidence on the use of LLLT in the treatment of leprosy ulcers.
Objective: To compare the clinical outcome criteria between treatments of repetitive mechanical debridement, conventional dressings, and the use of collagenase and hyaluronic acid gel for patients with Fournier's gangrene (FG). Method: A retrospective analysis was made of the records of 56 patients with FG who were classified into two groups. In both groups, appropriate surgical debridement treatment was applied under operating room conditions at the time of diagnosis and as required. Group 1 comprised patients subsequently treated with daily repetitive mechanical debridement and conventional dressings. The patients in Group 2 were treated with mechanical debridement once per three days with the use of collagenase and hyaluronic acid cream after the initial surgical debridement. The two groups were compared in respect of the need for repeated surgical debridement, number of dressing changes, colostomy requirement, need to change the antibiotics and length of stay in hospital. Results: The mean age of the patients was 54.72±15.15 years and 26 patients had diabetes. The need for repetitive mechanical debridement and the number of dressing changes were significantly lower in the collagenase–hyaluronic acid group (p<0.05). There was no significant difference between the groups in respect of the need to change antibiotics, the need for colostomy and the length of hospital stay (all p>0.05). Conclusion: Collagenase-hyaluronic acid gel can be considered safe and useful in the management of FG to reduce the number of repeated mechanical debridements and dressing changes. This is the first study in the literature to have evaluated the use of this combination in the management of FG.
Objective: To assess accuracy of nurses’ knowledge and practices regarding medical device-related pressure injuries (MDRPIs) in Türkiye. Method: This cross-sectional study included 384 nurses who had at least one year of professional experience and were working in hospitals across different regions of Türkiye. Data were collected online between November 2023 and May 2024 using the Medical Device-Related Pressure Injuries Knowledge and Practice Assessment Tool (MDRPI-ASSET). Results: A total of 89.8% of the nurses reported providing care to patients with medical devices. The most frequently encountered devices were oxygen masks (76.5%), nasal cannulas (74.2%), blood pressure cuffs (68%) and Foley catheters (62%). Nurses’ knowledge and practices regarding MDRPIs were moderately accurate, with a mean score of 11.11±4.01 out of a maximum possible score of 21. The lowest score was observed in the preventive interventions subdimension (3.47 out of 7.0). Nurses with ≥10 years’ professional experience, those working in hospitals other than private hospitals, those with a master's degree, those who had received education on MDRPIs (particularly through courses) and those who considered themselves competent in preventing and managing these injuries had significantly higher knowledge and practice scores (p<0.05). Conclusion: The findings indicated that nurses’ knowledge and practices regarding MDRPIs were moderately accurate, with particular deficiencies in preventive measures. Updating nurses’ knowledge and practices based on evidence-based guidelines through courses and in-service training programmes is essential for ensuring patient safety.
This case series describes the benefits of using of a non-cytotoxic acidic pH cleansing solution in the treatment of complex wounds in paediatric patients, at two health centres in Santiago, Chile. The use of a cleansing solution composed of hypochlorous acid, at a concentration of 330ppm, pH 5.5 (Vashe ® Wound Solution, Urgo Medical, US) is proposed as a treatment in addition to aetiological management. This preparation has been shown to be safe and effective in the management of wounds in paediatric patients. Benefits in terms of accelerated healing and reduction in pain were observed in the treated patients. Although the current evidence has limitations, preliminary results suggest that pH 5.5 hypochlorous acid may be an effective therapeutic option in the management of wounds and skin disorders in paediatric patients.
