Perspective, Non-Interventional, Clinical Study of Follow-up of Ulcer Healing and Investigation of its Correlation with Oxidative Stress.

Postgraduate Thesis uoadl:2878740 287 Read counter

Unit:
Κατεύθυνση Κοσμητολογία - Δερματοφαρμακολογία
Library of the School of Science
Deposit date:
2019-07-13
Year:
2019
Author:
Kostaki Maria
Supervisors info:
Ευάγγελος Καραλής , Επίκουρος καθηγητής, Τομέας Φαρμακευτικής Τεχνολογίας, Τμήμα Φαρμακευτικής, Σχολή Επιστημών Υγείας, Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών
Original Title:
Προοπτική, Μη Παρεμβατική, Κλινική Μελέτη Παρακολούθησης της Επούλωσης Ελκών και Διερεύνηση της Συσχέτισής της με το Οξειδωτικό Στρες.
Languages:
Greek
Translated title:
Perspective, Non-Interventional, Clinical Study of Follow-up of Ulcer Healing and Investigation of its Correlation with Oxidative Stress.
Summary:
Introduction: Chronic ulcers are an important health issue that affects a large part of the population. It is estimated that 1 to 2% of the population of developed countries will experience a chronic ulcer in their lifetime. As life expectancy increases, the number of patients with chronic ulcers increases as well, due to the fact that the rate of healing slows down significantly over time. Complications of chronic ulcers include infection, often mutilation, poor quality of life and may lead to impotence, disability, even death. Until today, no formulation has been found with excellent healing ability, applicable in all cases. Concerning chronic ulcers, there are no acceptable indicators to allow an assessment of the condition of the ulcers. In addition, there are no effective diagnostic tools to identify biological activity in the wound area, which makes it difficult to develop strategies for managing and selecting appropriate and effective therapies.
Methods: For the purpose of this study, data from 80 patients with chronic wounds of all causes were collected and used, and a three month follow-up of the course of the healing process was conducted for 40 of those patients (the patients visited the hospital once per month,on day: 0, 30, 60 and 90).The data collected include demographic characteristics (age, height, weight, BMI), features concerning ulcer, biochemical tests, blood tests, co-morbidities, treatment and skin antioxidants. An extensive statistical analysis was then carried out to find statistically important parameters and correlations concerning chronic ulcers with the aim of finding indicators that would act as prognostic factors in the future for patients suffering from ulcers. The study was conducted in the Ulcers Unit of Andreas Syggros Hospital of Cutaneous & Venereal Diseases.
Results/Conclusions: This study resulted that the degree of hydration around the ulcer is related to the location of the ulcer and to the degree of ulcer pain, where severe pains showed more hydration. Also, the degree of hydration around the ulcer was found to be positively correlated with the PUSH index of patients with chronic ulcers, meaning the increase of hydration leads to greater PUSH index. However this correlation was not found for the hydration of the symmetrical healthy point.
The body temperature of patients with chronic ulcers was found to be related to whether the patient suffered from serious cardiovascular diseases where in particular the temperature of patients without cardiac co-morbidities was higher. The ulcer site appeared to play an important role and to significantly affect the characteristics of the ulcer since it was found to be correlated with the temperature of the ulcer, with the transepidermal water loss in the ulcer and with the melanin of the symmetrical healthy point.
Pain in the area of the ulcer was found to be associated with both the PUSH index and the duration of the ulcer. Particularly, patients with severe pain exhibit a higher PUSH score, meaning worse general clinical picture of ulcers while patients with mild pain exhibit delayed healing process.
The age of the patient showed a negative correlation with body temperature, the ABPI index, the transepidermal water loss and the erythema of healthy skin. More particularly, while age increases, it was found that the biophysical parameters of the skin as well as the blood flow are modified. The patient's weight tended to be positively correlated with the PUSH index where patients with a greater weight showed the worst clinical picture in the ulcer area.
An indication for the hydrophilic antioxidants of the skin resulting from this study is that ascorbic acid is found at much higher concentrations on the surface of healthy skin than the pathological skin around the ulcer while uric acid is detected in small concentrations only on healthy skin and not at all in the pathological area around the ulcer.
Main subject category:
Science
Other subject categories:
Health Sciences
Keywords:
wound healing, chronic ulcers, clinical study, ulcer microclimate
Index:
Yes
Number of index pages:
4
Contains images:
Yes
Number of references:
236
Number of pages:
165
Προοπτική, μη παρεμβατική, κλινική μελέτη παρακολούθησης της επούλωσης ελκών και διερεύνηση της συσχέτισής της με το οξειδωτικό στρες. ΜΑΡΙΑ ΚΩΣΤΑΚΗ.pdf (4 MB) Open in new window