EUROPEAN TISSUE REPAIR SOCIETY
NEWS FROM SPAIN |
EUROPEAN TISSUE REPAIR SOCIETY NEWS FROM SPAIN |
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WOUND HEALING
IN SPAIN The field of wound healing has shown an exponential growth in Spain in the last years. There are different facts that underline the importance of wound healing in our country:
Some autonomous regions with responsibilities in health care like Catalonia have included specific targets about chronic wounds (pressure ulcers and diabetic feet) in their health maps. These health maps are a basic tool for establishing medium-long term policies and targets for the National Health Service. The Spanish Health Care System is closely influenced by the improvement of the Primary Health Care Network which has changed the roles of the different types of institutions focussing in the contribution of the Primary Health Care Centres as the first level of wound healing treatment. According to recent epidemiological data, a survey covering the whole region of La Rioja (260,000 habitants), 50% of patients with pressure ulcers were treated in the community, 35% in the socio-sanitary network and only 15% in acute hospitals. The prevalence observed was 12.26% in acute hospitals, 12.84% in socio-sanitary facilities and 0.27% of the people older than 65 years in the community. All Primary Health Care Teams offer home care, with a great involvement of community nurses, and a great weight of the prevention and treatment activities for the management of pressure ulcers problem. In the case of leg ulcers, a survey done in a population of 161,282 persons in five Primary Health Care Centres showed us that a 67.7% of them were venous ulcers, 10.8% arterial ulcers, 10.8% diabetic foot, 5.4% mixed ulcers and 4.31% were post-traumatic wounds. The prevalence rates were, 0.03% for venous ulcers, 0.005% for arterial ulcers and 0.004% for arterial ulcers. 73% of patients with leg ulcers were treated in community. Leg ulcers are also a problem in which Primary Health Care is becoming more involved in its first level approach. In the case of diabetic foot, the diabetes programme (available in all Primary Health Care Centres) focuses in prevention and early detection of problems. The second level of treatment of chronic wounds can be found in different types of institutions involving different types of medical specialities like general surgery, plastic surgery, vascular surgery, dermatology and endocrin-ology according to the availability of resources in each local context. Other than plastic surgery units, a few specific chronic wound units like the ‘Pressure Ulcers Unit’ at the Hospital Clínico de San Carlos de Madrid, the ‘Interdisciplinary Chronic Wounds Unit’ at the Consorci Sanitari de Terrassa or the Interdisciplinary Diabetic Foot at the Hospital Mutua de Terrassa, both in the town of Terrassa, Barcelona, have been established. In 1995 the ‘Grupo Nacional para el Estudio y Ases-oramiento en Ulceras por Presión y Heridas Crónicas – GNEAUPP’ (Spanish Pressure Ulcers and Chronic Wounds Advisory Panel) was created. This is an interdisciplinary society which joins about 1500 healthcare professionals, most of them nurses. The GNEAUPP has published several guidelines in areas such as staging, prevention and treatment of pressure ulcers, obtaining samples for culture and calculating epidemiological data. It is also involved in other European groups like the European Pressure Ulcer Advisory Panel (EPUAP). The aims of the GNEAUPP are focused on the promotion of evidence based comprehesive approaches for the prevention and treatment of chronic wounds involving different types of disciplines. The GNEAUPP has its own website: http://www.readysoft.es/gneaupp/ It produces a newsletter and publishes Gerokomos-Helcos. It also organizes a scientific meeting every two years (1996 Logrono, 1997 Barcelona and 2000 in Logrono) as well as large number of educational activities in wound care. The evolution of wound healing in Spain has produced an increase of research activities – in fields like clinical, epidemiology and basic sciences – and, as a result, the forthcoming GNEAUPP Conference (in April 2000) will include about 100 oral presentations and posters. Major Nursing Journals, as well as Gerokomos-Helcos (Gneaupp’s own publication), are including papers about research in wound healing. In Spain there is not a speciality of wound healing, but some educational activities, most of them in the framework of post-graduated nursing educational activities in geriatric and surgical nursing, are drawing the basis of a future post-graduate university wound healing course. There are lot of short term educational activities supported by wound care companies that are collaborating in the education and support for all health-care professionals interested in wound healing. In conclusion, the new millennium is opening many new opportunities in wound care in Spain, and a lot of health-care professionals, like nurses and physicians, are being involved in the challenge of providing the best care for their patients with wounds. Further information may be obtained from: Joan-Enric Torra i Bou (RN) |
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