HIDRADENITIS SUPPURATIVA (HS) IS A PAINFUL, CHRONIC AND RECURRENT INFLAMMATORY SKIN DISORDER AFFECTS PATIENT IN THEIR MOST PRODUCTIVE TIME OF LIFE. IT IMPOSES DIRECT AND INDIRECT COSTS TO HEALTHCARE SYSTEM (MEHDIZADEH, 2015). THE PREVALENCE OF HS RANG FROM<1% TO 4% IN DIFFERENT POPULATIONS (JEMEC, 2012). THE IMPACT OF HS ON PATIENT’S QUALITY OF LIFE AND WORK PRODUCTIVITY IS EXTENSIVE AND YET REMAINS UNDERSTUDIED AND UNDERESTIMATED (ALAVI, 2015)...

NEW TREATMENTS FOR CHRONIC WOUNDS HAVE LED TO IMPROVEMENTS IN LESION MANAGEMENT AND IN THE QUALITY OF ASSISTANCE PROVIDED BY MEDICAL AND PARAMEDICAL STAFF, BUT LESION MONITORING METHODOLOGIES HAVE NOT KEPT PACE WITH THIS PROGRESS.THE CONSTANT IMPROVEMENT OF DIAGNOSTIC AND THERAPEUTIC PROCEDURES, TOGETHER WITH THE INCREASE OF LIFE LASTING, RESULTS IN A HIGHER FREQUENCY OF PATIENTS SUFFERING FROM CHRONIC CUTANEOUS ULCERS.DUE TO THE HIGH COSTS THESE PATHOLOGIES IMPLY FOR TREATMENTS AND OFTEN POOR OUTCOMES IN TERMS OF QUALITY OF LIFE, A DECREASE IN PATIENTS ’HOSPITALIZATION, WITHOUT A CORRESPONDING WORSENING OF THE QUALITY OF THERAPY, WOULD PROVIDE IMPORTANT BENEFIT.MOREOVER, SINCE THE HEALING PROCESS IS REMARKABLY SLOW, THE CLINICAL PERCEPTION OF THE PHASES THAT LEAD A CHRONIC WOUND TO COMPLETE RESTORATION IS OFTEN PENALIZED: THIS EFFECT IS DRAMATICALLY AMPLIFIED IN THOSE CASES IN WHICH THE PATIENT IS FOLLOWED BY MORE THAN ONE OPERATOR.THEREFORE, THE STUDY OF WOUND HEALING PATHOPHYSIOLOGY AND THE DEVELOPMENT OF NEW TOOLS FOR THE MONITORING OF THE HEALING PROCESS MAY REPRESENT A POSSIBLE OPTIMIZATION OF THE TREATMENT EFFICACY FOR THESE LESIONS.THE MORPHOLOGIC FEATURES OF AN ULCERATIVE CUTANEOUS LESION CAN BE SUBSTANTIALLY ANALYZED ACCORDING TO TWO DISTINGUISHED MODALITIES: THE QUANTIFICATION OF THE LOSS OF SUBSTANCE SUCH AS THE EXTENSION AND DEPTH OF THE LESION, CHARACTERISTICS OF THE EDGES, AND THE QUALITATIVE DISCRIMINATION OF THE SEVERAL AREAS OF THE WOUND BED LIKE THE PRESENCE OF NECROSIS, FIBRIN, FLUID, EXTENSION OF THE SURROUNDING SKIN INFLAMMATION. MOLECULAR AND HISTOLOGIC ANALYSIS OF CHRONIC WOUNDS HAS BEEN SUGGESTED AS A METHOD TO VALIDATE THE USE OF DEBRIDEMENT. THE NON-HEALING EDGE CONTAINS CELLS WITH MOLECULAR MARKERS INDICATIVE OF HEALING IMPAIRMENT. THE USE OF WOUND AND SKIN BIOMARKERS WILL PROVIDE SUBSTANTIAL INFORMATION IN THE NEAR FUTURE TO BETTER UNDERSTAND THE NON-HEALING WOUNDS PROCESS.

BACKGROUND AND AIM: INFECTION IS A MAJOR COMPLICATION IN PATIENTS WITHIN COMPLETE REMOVAL OF FOREIGN BODIES. STAPHYLOCOCCUS AUREUS (S. AUREUS) IS THE DOMINANT PATHOGEN IN EARLY-ONSET INFECTIONS. THIS ORGANISM IS OFTEN FOUND AS A PART OF THE NORMAL CUTANEOUS FLORA AND CAN BE TRANSMITTED FROM THE SKIN INTO TRAUMATIZED BONEOR SOFT TISSUE DURING THE TRAUMA.METHODS: RESULTS: INFECTIONS OF PROSTHETIC DEVICES OR FOREIGN BODIES MAY BE ACQUIRED BY THREE ROUTES: S. AUREUS IS GENERALLY THE DOMINANT PATHOGEN IN EARLY-ONSET INFECTIONS...

NON- HEALING ARE A SIGNIFICANT PROBLEM FOR HEALTH CARE SYSTEM AND PATIENTS ALL OVER THE WORLD.1-1.5 % OF THE POPULATION IN INDUSTRIALIZED COUNTRIES HAVE A WOUND.WOUND TREATMENT COST BETWEEN 2-4 % OF HEALTH CARE BUDGET AND DUE TO DEMOGRAPHIC CHANGES AND RISE IN DIABETES, CHRONIC WOUNDS WILL INCREASE...

THE ROLE PLAYED BY BACTERIAL BIOFILM IN CHRONIC WOUNDS HAS BEEN EMPHASIZED, AS A MAJOR DETRIMENT TO WOUND HEALING IN RECENT YEARS. BIOFILMS ARE STRUCTURED COMMUNITIES OF BACTERIAL OR FUNGAL CELLS ENCLOSED IN A SELF-PRODUCED POLYMERIC MATRIX THAT ADHERES TO BOTH INERT AND LIVING SURFACES. THEY PROVIDE A PROTECTIVE SHIELD FOR BACTERIA TO THRIVE AND RESIST DAMAGE FROM MANY EXTREME ENVIRONMENTAL CONDITIONS.

BACKGROUND: CHRONIC WOUNDS ARE OFTEN RESISTANT TO TREATMENT AND A GREAT CHALLENGE TO THE DEVELOPMENT OF INFECTIONS. DEBRIDEMENT IS DEFINED AS THE REMOVAL OF FOREIGN MATERIAL AND NECROTIC TISSUE FROM A WOUND AND IT CAN ALSO HELP TO STIMULATE WOUND HEALING. HOWEVER, NOT ALL METHODS OF DEBRIDEMENT ARE THE SAME. EACH METHOD HAS ADVANTAGES AND DISADVANTAGES THAT MUST BE CLEARLY UNDERSTOOD...