1. USE OF A NEW ULCER CLEANSING SYSTEM AND OF PLATELET GEL IN THE MANAGEMENT OF “NON HEALING” LEG ULCERS IN ELDERLY PALUMBO F.P. 1 – SERANTONI S. 2 – ABBRITTI F. 3 – MAZZOLA G. 4 - FAILLA G. 5 - DI SALVO M.M. 5 1 – LABORATORIO DI VULNOLOGIA – PALERMO 2 – CASA DI CURA “VILLA FIORITA” – PRATO 3 – U.O. CHIRURGIA VASCOLARE – A.O. G. SALVINI, GARBAGNATE MILANESE 4 – U.O. MEDICINA TRASFUSIONALE – A.O.U. POLICLINICO, PALERMO 5 - U.O. ANGIOLOGIA – A.O.U. VITTORIO EMANUELE – “FERRAROTTO”, CATANIA

2. USE OF A NEW ULCER CLEANSING SYSTEM AND OF PLATELET GEL IN THE MANAGEMENT OF “NON HEALING” LEG ULCERS IN ELDERLY Age: 74 - 92 years Average age 81,6 yy AETIOLOGY Venous 5 Arterial 2 Mixed 3 Vasculitis 3 Diabetic 3 A new technological advanced device was tested on 27 lesions selected in 16 patients in a multicentric observational study. PALUMBO F.P. – SERANTONI S. – ABBRITTI F.– MAZZOLA G.- FAILLA G.- DI SALVO M.M.

3. METHODS All patients underwent to an anamnestic and clinical and instrumental evaluation (when required). Data were collected using a schedule to detect wound characteristics. QL index was administred to all patients. In selected patients, a multilayer, multicomponent, inelastic bandage was applied. Ulcer Cleansing System Device was administred before platelet gel application. Autologous PLT Gel was administred in 14 patients. Only in 2 patients homologous PLT Gel was administred. Patients were selected according to conditions of the injury at time T0, regardless of time of onset and treatment prior to enrollment date. Criteria exclusion: severe infected lesions. PALUMBO F.P. – SERANTONI S. – ABBRITTI F.– MAZZOLA G.- FAILLA G.- DI SALVO M.M. USE OF A NEW ULCER CLEANSING SYSTEM AND OF PLATELET GEL IN THE MANAGEMENT OF “NON HEALING” LEG ULCERS IN ELDERLY

4. USE OF A NEW SURFACTANT GEL WITH SILVER SULPHADIAZINE IN THE TREATMENT OF CHRONIC LEG ULCERS AND DIABETIC FOOT: ITALIAN MULTICENTRIC EXPERIENCE ULCERS AREAPLANIMETRIC METHOD PAINVISUAL SCALE EXUDATEN. DRESSING CHANGE/WEEK QUALITY OF LIFE INDEX (QL) ACTIVITY, DAILY LIVING, HEALTH, SUPPORT, OUTLOOK PALUMBO F.P. – SERANTONI S. – ABBRITTI F.– MAZZOLA G.- FAILLA G.- DI SALVO M.M. USE OF A NEW ULCER CLEANSING SYSTEM AND OF PLATELET GEL IN THE MANAGEMENT OF “NON HEALING” LEG ULCERS IN ELDERLY

5. USE OF A NEW SURFACTANT GEL WITH SILVER SULPHADIAZINE IN THE TREATMENT OF CHRONIC LEG ULCERS AND DIABETC FOOT: ITALIAN MULTICENTRIC EXPERIENCE RESULTS In all almost patients an improvement of obiective data was observed. Reduction of exudation and of inflamation in the skin around the ulcers were observed since the first week of gel application. These were accompanished by reduction of average wound areas and of pain. Also malodour decreased since the first week. Some patients have reported the occurrence of burning in the first two days of application of platelet gel. PALUMBO F.P. – SERANTONI S. – ABBRITTI F.– MAZZOLA G.- FAILLA G.- DI SALVO M.M. USE OF A NEW ULCER CLEANSING SYSTEM AND OF PLATELET GEL IN THE MANAGEMENT OF “NON HEALING” LEG ULCERS IN ELDERLY

6. USE OF A NEW SURFACTANT GEL WITH SILVER SULPHADIAZINE IN THE TREATMENT OF CHRONIC LEG ULCERS AND DIABETIC FOOT: ITALIAN MULTICENTRIC EXPERIENCE PAIN WOUND AREAS PALUMBO F.P. – SERANTONI S. – ABBRITTI F.– MAZZOLA G.- FAILLA G.- DI SALVO M.M. USE OF A NEW ULCER CLEANSING SYSTEM AND OF PLATELET GEL IN THE MANAGEMENT OF “NON HEALING” LEG ULCERS IN ELDERLY - 59,9 % - 31,1 %

7. USE OF A NEW SURFACTANT GEL WITH SILVER SULPHADIAZINE IN THE TREATMENT OF CHRONIC LEG ULCERS AND DIABETIC FOOT: ITALIAN MULTICENTRIC EXPERIENCE QL-INDEXEXUDATE PALUMBO F.P. – SERANTONI S. – ABBRITTI F.– MAZZOLA G.- FAILLA G.- DI SALVO M.M. USE OF A NEW ULCER CLEANSING SYSTEM AND OF PLATELET GEL IN THE MANAGEMENT OF “NON HEALING” LEG ULCERS IN ELDERLY -61,7% 10,2%

8. USE OF A NEW SURFACTANT GEL WITH SILVER SULPHADIAZINE IN THE TREATMENT OF CHRONIC LEG ULCERS AND DIABETIC FOOT: ITALIAN MULTICENTRIC EXPERIENCE PALUMBO F.P. – SERANTONI S. – ABBRITTI F.– MAZZOLA G.- FAILLA G.- DI SALVO M.M. USE OF A NEW ULCER CLEANSING SYSTEM AND OF PLATELET GEL IN THE MANAGEMENT OF “NON HEALING” LEG ULCERS IN ELDERLY Cleansing of a pressure ulcer in a patient affected of PAD by device and application of PLT Gel. After 2 weeks growth of proliferative tissue. Cleansing of an ulcer occurring in a woman affected of thrombocytemia and application of PLT Gel.

9. USE OF A NEW SURFACTANT GEL WITH SILVER SULPHADIAZINE IN THE TREATMENT OF CHRONIC LEG ULCERS AND DIABETIC FOOT: ITALIAN MULTICENTRIC EXPERIENCE DISCUSSION The aim of the study was to verify the effectiveness a new system of debridment using a solution based on poloxamer and moisturisers like aloe vera. Cleansing and debridment, obtained with a tovel soaked in this liquid, was followed immediately by a feeling of freshness even on very exuding and inflamed ulcers. The application of platelet gel in some patient was followed by the onset of burning of vatiable duration from a few hours up to two days. Since the first two applications it was observed a decrease of exudate and dressing changes to the reduction of inflamation of the tissue surrounding the wound. Also the bad odor was reduced until the disappareance and this has improved the social life of the elderly subjects. The handling and ease of use of the new debridment system has considerably shortened time of PLT gel application. PALUMBO F.P. – SERANTONI S. – ABBRITTI F.– MAZZOLA G.- FAILLA G.- DI SALVO M.M. USE OF A NEW ULCER CLEANSING SYSTEM AND OF PLATELET GEL IN THE MANAGEMENT OF “NON HEALING” LEG ULCERS IN ELDERLY

10. USE OF A NEW SURFACTANT GEL WITH SILVER SULPHADIAZINE IN THE TREATMENT OF CHRONIC LEG ULCERS AND DIABETIC FOOT: ITALIAN MULTICENTRIC EXPERIENCE AKNOWLEDGEMENTS A SPECIAL THANKS TO DR. ELSA LO IACONO AND DR. ELENA PATORNO FOR THE PREPARATION OF DATA ON PATIENTS. PALUMBO F.P. – SERANTONI S. – ABBRITTI F.– MAZZOLA G.- FAILLA G.- DI SALVO M.M. USE OF A NEW ULCER CLEANSING SYSTEM AND OF PLATELET GEL IN THE MANAGEMENT OF “NON HEALING” LEG ULCERS IN ELDERLY CONCLUSIONS In almost all cases we observed an improvement in the wounds, indicated by:  Regression of signs of inflamation;  Reduction of exudate and fibrin;  Reduction of pain assessed by the patients;  Good compliance at dressing change;  Reduction of malodour;  Improving QL-Index rate. These result suggest that a good bed wound preparation is important to the next PLT gel action, No collateral effects and complications were reported in all patients: