Characterization of patients with chronic skinulcers and their acute phase reactants levels

Caracterización de pacientes con úlceras cutáneas y sus niveles de reactantes de fase aguda

Objective: To characterize patients with skin and soft tissue lesions and their levels of acute phase reactants in a high complexity institution in the city of Medellin. A retrospective observational study was carried out including patients with skin ulcers of different etiology with acute phase reactants measurement. The eligibility criteria were: over 18 years of age, with the presence of skin lesions, measurement of acute phase reactants before and after the exacerbation of the lesion, and who had been treated at the participating institution. Methodology: a non-probabilistic sampling of consecutive cases was performed. Data analysis was performed in the jamovi program; quantitative variables that did not have normal distribution were calculated as median and interquartile range; quantitative variables with normal distribution are presented as mean and standard deviation. Qualitative variables were measured with absolute and relative frequencies. Results: 56 patients were included, as for the etiology of skin ulcers the main ones were caused by immobility and venous insufficiency with 26.78% and 25% respectively. The main locations of the lesions were on the foot, sacral and gluteal region, both with 21.42%. The size of most of the lesions was less than 10 cm2 (41.07%). In relation to the paraclinical results, for hemoglobin, a median of 11.7 was obtained and C-reactive protein (CRP) had a median value of 4.86. Conclusions: Knowledge of the clinical and sociodemographic characteristics of patients with chronic skin lesions allows health personnel to provide individualized care that enables an integral approach to the pathology and application of actions oriented to the management and improvement of the quality of life of this group of patients.

1. Sánchez N, Hermosa G, Gómez L, Vaño S. Protocolo diagnóstico de las úlceras cutáneas. Medicine. 2014;11(47):2800-5.
2. Ruiz E, Peral M, Rodríguez M, Moreno A. Protocolo de tratamiento de úlceras cutáneas y pie diabético. Medicine. 2014;11(55):3296-9.
3. Hernández N, Bulla A, Mancilla E, Peña L. Prevalencia de lesiones de piel asociadas a la dependencia física en geriátricos e instituciones de salud de Tunja. Gerokomos. 2021;32(1): 51-6. doi: https://dx.doi.org/10.4321/s1134-928x2021000100011.
4. González R, López W, Roa K. Epidemiología de lesiones de piel relacionadas con el cuidado: estudio de la prevalencia en Colombia. Revista de Enfermagem Referência. 2017;4(15):65-72. doi: https://doi.org/10.12707/RIV17038.
5. Bluestein D, Javaheri A. Pressure Ulcers: Prevention, Evaluation, and Management. American Family Physician. 2008;78(10): 1186-94.
6. Kottnera J, Cuddiganc J, Carvilled K, BalzereK, Berlowitzf D, Lawg S, Litchfordh M. et al. Pressure ulcer/injury classification today: An international perspective. Journal of Tissue Viability. 2020;29:197-203. doi: 10.1016/j.jtv.2020.04.003.
7. Mervis J, Phillips T. Pressure ulcers: Pathophysiology, epidemiology, risk factors, and presentation. J Am Acad Dermatol. 2019; 81:881-90. doi: 10.1016/j.jaad.2018.12.069.
8. Ojeda-Méndez C, Palomino-Pacichana D, Bejarano-Barragán L, Ocampo-Chaparro J. Factores asociados con estancia hospitalaria prolongada en una unidad geriátrica de agudos. Acta Med Colomb. 2021;46(1):1-7. doi: 10.36104/amc.2021.1844.
9. Domingo-Triadó V, López-Alarcón D, Villegas-Estévez F, Alba-Moratilla C, Massa-Domínguez B, Alepuz L et al . Manejo del dolor irruptivo asociado a la cura de úlceras cutáneas. Rev. Soc. Esp. Dolor. 2020;27(2):113-26. doi: 10.20986/resed.2020.3755/2019.
10. Kim J, Wilkie DJ, Weaver M, Lyon D, Kelly DL, Millan SB, Et. Al. Multidimensional Pain Characteristics in Older Adults with Chronic Venous Leg Ulcers. Adv Wound Care (New Rochelle). 2021;10(10):544-56. doi: 10.1089/wound.2020.1355.
11. Guarro G, Cozzani F, Rossini M, Bonati E, Del Rio P. Wounds morphologic assessment: application and reproducibility of a virtual measuring system, pilot study. Acta Biomed. 2021. 3;92(5):2021-27. doi: 10.23750/abm.v92i5.11179.
12. Garcia S, Alòs J, Guallar J, Viu M, Serra-Prat M. Prevalence, incidence and risk factors for foot pressure ulcers in hospitalized elderly patients. An observational and prospective study. J Healthc Qual Res. 2021;36(1):27-33. doi: 10.1016/j.jhqr.2019.12.005.
13. Otero G, Agorio C, Martínez M. Úlceras de miembros inferiores características clínico-epidemiológicas de los pacientes asistidos en la unidad de heridas crónicas del Hospital de Clínicas. Rev Med Urug. 2012; 28(3):182-89.
14. Nag F, Chatterjee G, Ghosh A, De A. Clinico-Etiological Evaluation of Chronic Leg Ulcer in a Tertiary Care Center of Eastern India. Indian J Dermatol. 2020;65(6):495-99. doi: 10.4103/ijd.IJD_62_20.