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      Uso de jabón en heridas: encuesta a profesionales sanitarios Translated title: Use of soap in wounds: a health professionals survey

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          Abstract

          RESUMEN Objetivos: General: conocer el uso de jabón en las heridas por parte de los profesionales sanitarios. Específicos: conocer las características de las heridas tratadas con jabón, conocer el tipo de jabón utilizado en el tratamiento de heridas y conocer los documentos en los que se basan los profesionales para el uso de jabón en las heridas. Metodología: Estudio descriptivo observacional de carácter transversal. Se ha realizado un cuestionario ad hoc a profesionales sanitarios de tres asociaciones relacionadas con el tratamiento de personas con heridas. Los cuestionarios se cumplimentaron on-line a través de la plataforma Google Drive. Resultados: Se cumplimentaron un total de 179 cuestionarios. Utilizan jabón para el tratamiento de las heridas un 74% de los encuestados (de estos, lo usan de forma habitual un 43% y ocasional el 57%), mientras que se refirió el uso de jabón en heridas sucias (96,7%), con presencia o sospecha de infección (55,4%) o superficiales (50%). Los principales tipos de jabón utilizados fueron antisépticos jabonosos (65,4%) y geles (22%), y un 82% refirió desconocer protocolos o guías que recomienden el uso de jabón para las heridas. Se recogieron respuestas en texto libre que mostraron gran variedad de opiniones. Discusión y conclusiones: Los resultados del estudio muestran un uso habitual de jabón para el tratamiento de las heridas, así como falta de consenso y una práctica clínica heterogénea. Los datos señalan la experiencia de los profesionales como principal fuente de conocimiento.

          Translated abstract

          ABSTRACT Objectives: General: to know the use of soap in wounds by health professionals. Specific: to know the characteristics of the wounds treated with soap, the type of soap used in the treatment of wounds and the documents on which professionals rely for the use of soap in wounds. Methodology: Cross-sectional descriptive observational study. An ad hoc questionnaire was carried out to health professionals from three associations related to the treatment of people with injuries. The questionnaires were completed online through the Google Drive platform. Results: A total of 179 questionnaires were completed. 74% of respondents use soap for the treatment of wounds (of these, they use it regularly 43% and occasionally 57%), also the use of soap was referred in dirty wounds (96'7%), with presence or suspicion of infection (55,4%) or superficial (50%). The main types of soap used were soapy antiseptics (65,4%) and gels (22%), and 82% reported not knowing protocols or guidelines that recommend the use of soap for wounds. Other responses were collected in free text, which showed a wide variety of opinions. Discussion and conclusions: The results of the study show a habitual use of soap for the treatment of wounds, as well as a lack of consensus and a heterogeneous clinical practice. The data points to the experience of professionals as the main source of knowledge.

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          Most cited references38

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          Preoperative bathing or showering with skin antiseptics to prevent surgical site infection

          Surgical site infections (SSIs) are wound infections that occur after invasive (surgical) procedures. Preoperative bathing or showering with an antiseptic skin wash product is a well-accepted procedure for reducing skin bacteria (microflora). It is less clear whether reducing skin microflora leads to a lower incidence of surgical site infection.
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            A toxicity index of skin and wound cleansers used on in vitro fibroblasts and keratinocytes.

            To determine toxicity indexes of commercially available skin, wound, and skin/wound cleansers on in vitro fibroblasts and keratinocytes. Seventeen cleansers and 3 liquid bath soaps were evaluated for cytotoxic effect on human infant dermal fibroblasts and epidermal keratinocytes. Both skin cell types were exposed to serial 10-fold dilutions of each cleanser until treated cell viability was comparable to untreated controls. The experimental design allowed calculation of relative toxicity indexes ranging from 0 to 100,000. Shur-Clens, SAF-Clens, and saline were found to be the least toxic to fibroblasts (toxicity index 0); Dial Antibacterial Soap and Ivory Liqui-Gel were the most toxic (toxicity index 100,000). Biolex, Shur-Clens, and Techni-Care were the least toxic to keratinocytes (toxicity index 0); hydrogen peroxide, modified Dakin's solution, and povidone (10%) were found to be the most toxic (toxicity index 100,000). Successful cutaneous tissue repair depends on the viability of the principal cell types involved (fibroblasts and keratinocytes). Toxicity indexes provide helpful guidelines for subsequent in vivo evaluations and clinical applications. The study findings also suggest that judicious use of these supposedly innocuous agents should be considered in a clinical setting.
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              Comparison of soap and antibiotic solutions for irrigation of lower-limb open fracture wounds. A prospective, randomized study.

              Irrigation of open fracture wounds is a commonly performed procedure, and irrigation additives have been used in an attempt to reduce the risk of infection. In vitro and animal studies have suggested that irrigation with detergent solution is more effective than irrigation with a solution containing antibiotic additives. This study was performed to compare the efficacy of those two solutions in the treatment of open fractures in humans. Adult patients with an open fracture of the lower extremity were prospectively randomized to receive irrigation with either a bacitracin solution or a nonsterile castile soap solution. The patients were followed clinically to assess for the development of infection, healing of the soft-tissue wound, and union of the fracture. Between 1995 and 2002, 400 patients with a total of 458 open fractures of the lower extremity were entered into the study. One hundred and ninety-two patients were assigned to the bacitracin group (B), and 208 were assigned to the castile soap group (C). Outcomes were available for 171 patients with a total of 199 fractures in group B and 180 patients with a total of 199 fractures in group C. The mean duration of follow-up was 500 days. There was no difference between groups B and C in terms of gender, the Gustilo-Anderson grade of the open fracture, the time between the injury and the irrigation, smoking, or alcohol use. There were significant differences in the mean age (thirty-eight compared with forty-two years, p = 0.01), duration of follow-up (560 compared with 444 days, p = 0.01), prevalence of hypotension (23% compared with 14%, p = 0.04), and duration of treatment with intravenous antibiotics (eleven compared with nine days, p = 0.02). An infection developed at thirty-five (18%) of the 199 fracture sites in group B and at twenty-six (13%) of the 199 fracture sites in group C. This difference was not significant (p = 0.2). Bone-healing was delayed for forty-nine (25%) of the 199 group-B fractures and forty-six (23%) of the 199 group-C fractures (p = 0.72). Wound-healing problems occurred in association with nineteen group-B fractures (9.5%) and eight group-C fractures (4%). This difference was significant (p = 0.03). Irrigation of open fracture wounds with antibiotic solution offers no advantages over the use of a nonsterile soap solution, and it may increase the risk of wound-healing problems.
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                Author and article information

                Journal
                geroko
                Gerokomos
                Gerokomos
                Sociedad Española de Enfermería Geriátrica y gerontológica (Barcelona, Barcelona, Spain )
                1134-928X
                2020
                : 31
                : 4
                : 248-255
                Affiliations
                [1] Toledo orgnameComplejo Hospitalario de Toledo orgdiv1Hospital Provincial orgdiv2Unidad de Cuidados Paliativos Domiciliarios España
                [2] Toledo orgnameFundación La Caixa orgdiv1Equipo de Atención Psicosocial España
                [3] Toledo orgnameComplejo Hospitalario de Toledo orgdiv1Área quirúrgica España
                Article
                S1134-928X2020000500248 S1134-928X(20)03100400248
                a4afba5e-ed14-45a9-9015-22aa281b20e9

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 24 April 2019
                : 29 November 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 40, Pages: 8
                Product

                SciELO Spain

                Categories
                Helcos

                enfermería,encuestas y cuestionarios,Wounds,soaps,surveys and questionnaires,nursing,Heridas,jabones

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