Person:
García Álvarez, Yolanda

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First Name
Yolanda
Last Name
García Álvarez
Affiliation
Universidad Complutense de Madrid
Faculty / Institute
Enfermería, Fisioterapia y Podología
Department
Enfermería
Area
Enfermería
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Now showing 1 - 2 of 2
  • Publication
    Microcirculation Improvement in Diabetic Foot Patients after Treatment with Sucrose Octasulfate-Impregnated Dressings
    (MDPI, 2023) Lázaro-Martínez, José Luis; García-Madrid, Marta; Bohbot, Serge; López Moral, Mateo; Álvaro Afonso, Francisco Javier; García Álvarez, Yolanda
    To assess the patients’ microcirculation evolution during the treatment with a sucrose octasulfate-impregnated dressing, fifty patients with neuroischaemic DFU treated with TLC-NOSF dressing were included in a prospective study between November 2020 and February 2022. TcpO2 values were measured on the dorsalis pedis or tibial posterior arteries’ angiosome according to the ulcer location. TcpO2 values were assessed at day 0 and every 4 weeks during 20 weeks of the follow-up or until the wound healed. A cut-off point of tcpO2 < 30 mmHg was defined for patients with impaired microcirculation. The TcpO2 values showed an increase between day 0 and the end of the study, 33.04 � 12.27 mmHg and 40.89 � 13.06 mmHg, respectively, p < 0.001. Patients with impaired microcirculation showed an increase in the tcpO2 values from day 0 to the end of the study (p = 0.023). Furthermore, we observed a significant increase in the TcpO2 values in the forefoot DFU (p = 0.002) and in the rearfoot DFU (p = 0.071), with no difference between the ulcer locations (p = 0.694). The local treatment with TLC-NOSF dressing improved the microcirculation in patients with neuroischaemic DFU, regardless of microcirculation status at the baseline, and in the forefoot, regardless of the location.
  • Publication
    Bacterial Diversity and Antibiotic Resistance in Patients with Diabetic Foot Osteomyelitis
    (MDPI, 2023-01-19) Álvaro Afonso, Francisco Javier; García Álvarez, Yolanda; Tardaguila García, Aroa; García Madrid, Marta; López Moral, Mateo; Lázaro Martínez, José Luis
    This study analysed the bacterial diversity, antibiotic susceptibility, and resistance in patients with complications of diabetic foot osteomyelitis (DFO). A retrospective observational study was carried out between September 2019 and September 2022 and involved 215 outpatients with a diagnosis of DFO at a specialized diabetic foot unit. A total of 204 positive bone cultures were isolated, including 62.7% monomicrobial cultures, and 37.3% were formed with at least two microorganisms. We observed that Proteus spp., Coagulase-negative staphylococci (CoNS), Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and Corynebacterium were the most frequently isolated microorganisms and accounted for more than 10% of the DFO cases. With stratification by Grampositive (GP) and Gram-negative (GN) bacteria, we observed that 91.6% of cultures presented at least one GP bacteria species, and 50.4% presented at least one GN bacteria species. The most common GP species were CoNS (29%), S. aureus (25.8%), and Corynebacterium spp. (14%). The most frequent GN species consisted of Proteus spp. (32%), P. aeruginosa (23.3%), and E. coli (17.5%). The main antibiotics with resistance to GP-dominated infections were penicillins without �-lactamase inhibitor, and those in GN-dominated infections were sulfonamides and penicillins without �-lactamase. Significant differences were not observed in mean healing time in DFU with acute osteomyelitis (12.76 weeks (4.50;18)) compared to chronic osteomyelitis (15.31 weeks (7;18.25); p = 0.101) and when comparing cases with soft tissue infection (15.95 (6;20)) and those without such an infection (16.59 (7.25;19.75), p = 0.618). This study shows that when treatment of DFO is based on early surgical treatment, the type of DFO and the presence of soft infection are not associated with different or worse prognoses.