Person: Sevillano Fernández, David
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First Name
David
Last Name
Sevillano Fernández
Affiliation
Universidad Complutense de Madrid
Faculty / Institute
Medicina
Department
Medicina
Area
Microbiología
Identifiers
7 results
Search Results
Now showing 1 - 7 of 7
Item A deeper look at low‐frequency contact ultrasonic debridement in the clinical management of patients with diabetic foot ulcers(Wound Repair and Regeneration: The International Journal of Tissue Repair and Regeneration, 2023) Álvaro Afonso, Francisco Javier; Flores Escobar, Sebastián; Sevillano Fernández, David; García Álvarez, Yolanda; García-Madrid Martín De Almagro, Marta; Lázaro Martínez, José LuisThe current study aimed to evaluate the dispersal of solution and microbes (aerosol) in the clinical environment during treatment with Low-frequency contact ultrasonic debridement (LFCUD) with or without suction attachment in patients with diabetic foot ulcers (DFUs). We performed 20 treatments in 10 patients divided into two groups to receive the proposed LFCUD modalities. We measured the microbial load of the environment pre-treatment (sample M1), during treatment with each LFCUD modality (sample M2) and post-treatment (sample M3). The use of LFCUD debridement without a suction attachment results in significantly higher immediate contamination of the clinic environment than the suction attachment, particularly during the procedure (1.70 ± 0.98 log 10 CFU/mL versus 0.77 ± 0.85 log 10 CFU/mL, p = 0.035). When suction is not applied, there are statistically significant differences depending on whether the DFUs are neuropathic or neuroischemic, finding a greater number of microorganisms with high loads in neuropathic DFUs. We found a statistically significant positive correlation between wound area (r = 0.450, p = 0.047) and TBI (r = 0.651, p = 0.006) with the bacterial load during the LFCUD. Based on our results, we recommend using the personal protective equipment required to protect staff members and patients during treatment with LFCUD and using a suction attachment where clinically possible to reduce clinic environmental pollution, especially in neuropathic DFUs and those with larger areas.Item Efficacy of Preoperative and Intraoperative Skin and Nail Surgical Preparation of the Foot in Reducing Bacterial Load(Dermatologic Surgery, 2010) Becerro De Bengoa Vallejo, Ricardo; Losa Iglesias, Marta Elena; Alou Cervera, Luis; Sevillano Fernández, David; Prieto Prieto, JoséBackground: A common problem associated with toenail removal surgery is the accompanying bacterial infection that often ensues. The foot has a particularly difficult anatomy to prepare antiseptically for surgery, which contributes to this wide-spread problem. Objective: To compare the antiseptic efficacy of two skin pretreatment methods before toenail avulsion surgery. Methods: Two presurgical methods were performed on 24 patients each (48 patients total). Swab samples were taken from each patient at five distinct stages (pretreatment, post-treatment, after surgery, after saline solution irrigation of the nail bed, and after phenol application) throughout the surgical procedure, and bacterial culture analysis was performed (total inocula count and identification of specific microorganisms). Results: We found both methods to be effective at reducing the initial bacterial load when used at pretreatment, but the reduction in bacterial load was lost after the nail avulsion surgery, achieving values similar to the initial bacterial load before the presurgical scrub, from 5.17 and 5.04 log(10) colony-forming units (CFU)/cm(2) to 4.86 and 5.07 log(10) CFU/cm(2), respectively. An interoperative irrigation step was effective in reducing the bacterial load by 95.2% and 95.3%, respectively. Study limitations: Our patients underwent phenol-based nail avulsion, resulting in no bacterial load after complete nail removal because of the intrinsic antiseptic nature of the phenol. Conclusions: Incorporation of intraoperative irrigation of sterile saline solution after nail avulsion surgery reduces potential bacterial load. Every effort should be made to lower the risk of contamination after nail plate avulsion.Item Efficacy of intraoperative antiseptic scrub after nail removal surgery(Journal of the European Academy of Dermatology and Venereology, 2012) Becerro De Bengoa Vallejo, Ricardo; Losa Iglesias, Marta; Alou Cervera, Luis; Sevillano Fernández, David; Prieto Prieto, JoséItem Preoperative skin and nail preparation of the foot: Comparison of the efficacy of 4 different methods in reducing bacterial load(Journal of the American Academy of Dermatology, 2009) Becerro De Bengoa Vallejo, Ricardo; Losa Iglesias, Marta Elena; Alou Cervera, Luis; Sevillano Fernández, David; Prieto Prieto, JoséBackground: Orthopedic surgical procedures involving the foot and ankle are associated with high rates of infection. The optimal method of preparing the skin and nails for foot and ankle surgery remains unknown. Objective: This study was conducted to compare the efficacy of 4 different methods of skin and nail preparation of the foot using various antiseptic solutions. Methods: In this prospective, randomized study, 4 methods of skin and nail preparation were compared in terms of their efficacy in eliminating bacteria from the hallux nailfold and first web space of the normal foot in 28 healthy adult volunteers. Efficacy was determined by evaluating the difference in the total bacterial load before and after skin preparation. The foot-preparation solutions evaluated were 4% chlorhexidine gluconate, 70% isopropyl alcohol, and 7.5% to 10% povidone-iodine. Results: The addition of alcohol to povidone-iodine was found to increase the efficacy of the preparation method. The nailfold remained contaminated after any of the preoperative skin- and nail-preparation methods studied. Limitations: This study did not measure clinically relevant infections, and the results may not correlate with decreased rates of infection after surgery. Conclusion: Incorporation of alcohol and povidone-iodine into the preoperative skin- and nail-preparation process may help reduce the bacterial load. Every effort should be made to lower the risk of contamination from the nail.Item Efficacy of intraoperative surgical irrigation with polihexanide and nitrofurazone in reducing bacterial load after nail removal surgery(Journal of the American Academy of Dermatology, 2011) Becerro De Bengoa Vallejo, Ricardo; Losa Iglesias, Marta Elena; Alou Cervera, Luis; Sevillano Fernández, David; Prieto Prieto, JoséBackground: A common challenge of nail avulsion surgery is the associated bacterial contamination and infection that can manifest. The toe has a difficult anatomy to antiseptically prepare and properly maintain throughout the surgical procedure, lending to this widespread problem. Objective: We conducted a controlled, prospective randomized study to examine the antiseptic efficacy of 3 intraoperative irrigation methods during nail avulsion surgery. Methods: We compared intraoperative antiseptic irrigation using 0.9% saline solution (24 patients), 0.2% nitrofurazone (22 patients), and 0.1% polihexanide (25 patients). Swab samples were taken from each patient at 5 distinct stages throughout the surgical procedure, and bacterial culture analysis was performed (positive culture rate, total inocula count, reduction of bacterial load, and identification of specific micro-organisms). Results: All 3 intraoperative irrigation methods reduced the total bacterial load, but polihexanide was significantly more effective. Furthermore, no patient from the polihexanide group developed postoperative infection. The reduction in bacterial load was lost for all 3 methods after partial nail avulsion surgery, returning to similar values as the initial presurgical bacterial load. An intraoperative irrigation step after partial nail avulsion with saline, nitrofurazone, and polihexanide was effective in reducing the bacterial load by 95.2%, 96.6%, and 99.5%, respectively. Limitations: Our patients underwent phenol-based nail avulsion, resulting in no bacterial load after complete nail removal because of the intrinsic antiseptic nature of the phenol. Conclusions: Intraoperative irrigation with 0.1% polihexanide substantially reduced the bacterial load and subsequent infections, highlighting the importance of an irrigation step in nail avulsion surgery.Item Total nail ablation for onychodystrophy with optimized gauze–phenol application(Journal of the European Academy of Dermatology and Venereology, 2010) Becerro De Bengoa Vallejo, Ricardo; Losa Iglesias, Marta Elena; Alou Cervera, Luis; Sevillano Fernández, David; Prieto Prieto, JoséBackground Nail disorders are frequent among the geriatric population and unfortunately, repeat avulsionprocedures often result in complications.Objective To utilize a phenol-based total matricectomy technique for permanent nail ablation and evaluate itseffectiveness.Methods We performed total nail ablation on 34 toenails of the hallux (30 patients) with a gauze–phenolapplication technique and evaluated the degree of pain reported by the patient 12 months postoperatively comparedwith the preoperative stage. Furthermore, we evaluated the patients’ satisfaction with the final cosmetic appearanceas well as their satisfaction with the overall procedure.Results All patients reported ‘too much’ or ‘severe’ pain prior to surgery and 94.11% reported ‘no pain’ 12 monthspost-surgery. A vast majority of the patients (82.35%) felt pleased with the cosmetic results and all patients reportedthat they were ‘very satisfied’ or ‘strongly satisfied’ with the procedure when interviewed at their 12 month follow-upexamination.Limitations There were a limited number of participants in this study across an extensive timeframe.Conclusion Phenol-based total nail ablation with specific gauze application is safe, inexpensive and has a highrate of patient satisfaction.Item Complicaciones infecciosas en cirugía digital(Revista Internacional en Ciencias Podológicas, 2007) Alou Cervera, Luis; Maestre Vera, Juan Ramón; Sevillano Fernández, David; Prieto Prieto, JoséLos autores exponen las complicaciones infecciosas que con más frecuencia se instauran tras la realización de técnicas quirúrgicas en el pie así como el tratamiento antimicrobiano de elección.