| Abstract: |
Traditionally, the managing of chronic wounds includes measures that facilitate the healing, such as a good surgical or medical debridement, occlusive dressings, infection treatment and good nutrition; nevertheless, it is important the valuation and the treatment of the periwound skin. In this sense, recently diverse authors have described the coexistence of nutritional and development disorders, many of them of iatrogenic cause, and where the use of no-sting barrier film 3M Cavilon can be an important tool for a good respond to the treatment. The present study tries to identify the confocal characteristics of the periwound skin of venous leg ulcers and to evaluate the dynamic changes observed in periwound skin after 3M Cavilon treatment. Patients with chronic venous leg ulcers were treated for one week with 3M Cavilon only in one section of periwound area in addition to standard care. The other periwound skin section without 3M Cavilon treatment was used as control. Ulcers were evaluated visually using digital photography and confocal microscopy before and after one week of 3M Cavilon daily application. Evaluation with reflectance confocal microscopy showed and important histological improvement of periwound area treated with 3M Cavilon compared to section not treated with it. At preliminary stage, periwound skin showed necrosis areas in epidermis, spongiosis, infiltration of inflammatory cells and prominent vasodilatation. After one week of treatment there were a general improvement of periwound skin but in the section treated with Cavilon necrosis nearly disappeared and there were a significant reduction of exocitosis (presence of lymphocytes at epidermis) and spongiosis (oedema in epidermis) and a better structured epidermis than in section not treated with 3M Cavilon. In addition, it was observed an important reduction of diameter of vascular lumens what means an improvement regarding inflammation. These results allow us to conclude that reflectance confocal microscopy is a helpful non invasive technique for ulcer evaluation and for monitoring of wound treatments. Also, this study confirms that no-sting barrier film 3M Cavilon represents an efficient treatment of periwound skin in high exudative ulcers. |
