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Acta Vulnologica 2007 June;5(2):45-9


language: Italian

Normothermic treatment of pressure ulcers: preliminary results of the first Italian multicenter randomized trial

Romanelli M. 1, Brilli C. 2, Panizzi R. 3, Ricci E. 4, Scalise A. 5, Bovone U. 6, Richetta A. 7, Fabbri C. 8, Hanna D. 9

1 Ospedale Santa Chiara, Pisa 2 Centro Sais, Livorno 3 Ospedale Cisanello, Pisa 4 Ospedale San Luca, Torino 5 Clinica di Chirurgia Plastica e Ricostruttiva Università Politecnica delle Marche, Ancona 6 Istituto Don Orione, Genova 7 Policlinico Umberto I, Roma 8 Ospedale Careggi, Firenze 9 Ospedale Sant Maria Nuova, Firenze


Treatment of decubitus ulcers remains problematic. Wound treatment modalities are numerous, ranging from adjunct techniques to surgery. Early approaches included topical agents (disinfectants, antimicrobials and phytotherapeutic products) and surgery (skin grafts and flaps). Beginning in the mid-1990s, the approach to managing difficult-to-treat wounds changed with the clinical application of technological and scientific research. Building on the work of George Winter, who laid the foundation for the concept of moist wound healing in 1962, new advanced dressings were developed that improved treatment and shortened healing time considerably. Tissue engineering and vacuum-assisted closure (VAC)® led to a drastic reduction in the number of operations, particularly in patients whose precarious condition precluded surgical intervention. These techniques provided a much needed solution to two basic problems in wound care: lack of tissue and slow or absent wound healing. Both problems may be viewed as the main reason for retarded healing: bacterial contamination and infection. A recent development is the combined use of a heat dressing and moist wound healing to promote tissue repair and counteract bacterial growth. The promising preliminary results with this new method show that normothermic treatment is efficacious and devoid of contraindications in the management of pressure sores and ulcers.

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