WCET Journal - Spanish Edition

Background The creation of an intestinal and/or urinary ostomy is often associated with a wide variety of complications, whose incidence and risk factors reported in the literature are often discordant.

Aims A prospective longitudinal repeated-measures observational study was conducted aimed at investigating the incidence of complex stomal complications and ascertaining the determinants of their occurrence. The ultimate goal is to improve the available data for the development of new knowledge in this area.

Methods A total of 181 adult subjects were recruited and followed  for a period of three months at set intervals (T0 to T5), surveying the occurrence of any complications. Fisher’s Test and Chi-square Test were used to study the relationship between the various variables and the occurrence of complications.

Results Complications occur most frequently in the immediate postoperative period (iT0= 54.14%). The incidence rate of stomal and peristomal complications demonstrated a different distribution in the various follow-ups. Complications show a different character depending on the type of ostomy, with a higher incidence in intestinal ostomies; they also appear to be statistically correlated with the presence of general preoperative comorbidities.

Conclusions The purpose of this study was to implement the available data regarding complex stomal complications for the future development of new knowledge through two objectives: 1) to determine the incidence of complex stomal complications in new ostomate patients residing in the Empolese-Val d’Elsa and Lower Valdarno area of Italy,
2) to verify what the factors determining the occurrence of these complications are.

Significance Diabetic foot ulcers are a major complication of diabetes and a significant public health issue, greatly impacting healthcare costs. These ulcers are commonly treated with conventional methods such as saline cleaning, debridement, antibiotics, and topical dressings. However, the rise in non-traumatic lower limb amputations related to diabetes, along with growing antimicrobial resistance, highlights the insufficiency of these standard treatments in achieving timely healing.

Recent advances New light source adjuvant therapies, such as antimicrobial photodynamic therapy, are being tested to aid the healing of foot ulcers. This therapy involves using light (LASER or LED) to irradiate the lesion in combination with a photosensitising agent and tissue oxygen. This process promotes oxidative stress and reduces the microorganisms present in the ulcer.

Critical issues A significant challenge in applying photodynamic therapy is the lack of comprehensive clinical studies and complete treatment protocols. Although there is growing evidence supporting this therapy’s effectiveness in various conditions, the scarcity of well-documented clinical trials, and reliable replication of these studies, represents a major obstacle for other researchers seeking to replicate the results.

Future directions This article provides a detailed and transparent protocol, which can be easily reproduced by other researchers, making significant step towards consolidating and expanding the use of photodynamic therapy in the treatment of diabetic ulcers. It is hoped that this study and the presented protocol will serve as a foundation for future research and innovations in photodynamic therapy, opening up new therapeutic possibilities and contributing to improving quality of clinical practice.

Delegates at the WCET^® Congress, in Glasgow, UK in September, were treated to a very successful scientific programme with diverse, stimulating and high-quality content.

For the benefit of the many members who were unable to attend, here is a sample of what was presented by speakers from around the world.