Background and objectives: This study aimed to determine the frailty, prognosis, complexity, and palliative care complexity of nursing home residents with palliative care needs and define the characteristics of the cases eligible for receiving advanced palliative care according to the resources available at each nursing home. Materials and Methods: In this multi-centre, descriptive, and cross-sectional study, trained nurses from eight nursing homes in southern Spain selected 149 residents with palliative care needs. The following instruments were used: the Frail-VIG index, the case complexity index (CCI), the Diagnostic Instrument of Complexity in Palliative Care (IDC-Pal), the palliative prognosis index, the Barthel index (dependency), Pfeiffer’s test (cognitive impairment), and the Charlson comorbidity index. A consensus was reached on the complexity criteria of the Diagnostic Instrument of Complexity in Palliative Care that could be addressed in the nursing home (no priority) and those that required a one-off (priority 2) or full (priority 1) intervention of advanced palliative care resources. Non-parametric tests were used to compare non-priority patients and patients with some kind of priority. Results: A high percentage of residents presented frailty (80.6%), clinical complexity (80.5%), and palliative care complexity (65.8%). A lower percentage of residents had a poor prognosis (10.1%) and an extremely poor prognosis (2%). Twelve priority 1 and 14 priority 2 elements were identified as not matching the palliative care complexity elements that had been previously identified. Of the studied cases, 20.1% had priority 1 status and 38.3% had priority 2 status. Residents with some kind of priority had greater levels of dependency (p < 0.001), cognitive impairment (p < 0.001), and poorer prognoses (p < 0.001). Priority 1 patients exhibited higher rates of refractory delirium (p = 0.003), skin ulcers (p = 0.041), and dyspnoea (p = 0.020). Conclusions: The results indicate that there are high levels of frailty, clinical complexity, and palliative care complexity in nursing homes. The resources available at each nursing home must be considered to determine when advanced palliative care resources are required.

Introduction: Venous leg ulcers are the most severe manifestation of chronic venous insufficiency, and their treatment is based on compression therapy, whose effectiveness depends on the magnitude of the pressure and the biomechanical properties of the system. Doubts persist about the actual correlation between interface pressure, bandage stiffness and clinical outcomes in real-world practice. Objective: To compare the clinical efficacy and biomechanical behavior of different multicomponent compression systems in venous leg ulcers, analyzing the relationship between interface pressure, static stiffness, edema reduction and variation in the wound area. Methodology: This is a prospective, observational and multicenter study in six districts/health areas of Andalusia, in adults with active venous ulcers attended by Advanced Practice Nurses in Complex Chronic Wounds. Several multi-component compression systems were applied, and interface pressure was monitored using Tight Alright^® at three points on the leg for 96 h, recording final pressure, static stiffness, perimeters and ulcer area. Results: All systems achieved a reduction in leg circumference, more marked at the proximal points, evidencing an overall decongestant effect. The correlation between final pressure and edema reduction was weak, and relevant differences were observed in the reduction in ulcer area, with Urgo K2 and CPK Compress 2 standing out with decreases of more than 50% compared to medium or low yields of other systems with comparable pressures. The static stiffness analysis showed specific patterns according to system and leg size, as well as a heterogeneous longitudinal distribution of pressure. Conclusions: The efficacy of compression in venous ulcers depends on both the interface pressure and the design and biomechanical behavior of the system, with clinically relevant differences between multicomponent dressings. Multipoint pressure and stiffness monitoring provides useful information to optimize system selection and support decisions based on biomechanical parameters and standardized clinical outcomes.

Objectives: To evaluate the effectiveness of zinc oxide (ZnO) ointments versus non-irritant barrier films (NIBFs) in the prevention of Incontinence-Associated Dermatitis (IAD). Specific objectives included analyzing the effects of treatment over time, establishing when IAD appears in each group, and determining the safety and cost-effectiveness of both treatments. Methodology: A multicenter prospective cohort study was carried out in 10 social health centers in Spain. The final sample included 164 older institutionalized patients with urinary and/or mixed incontinence, divided into two cohorts (79 with ZnO and 85 with NIBF). Follow-up lasted for six weeks. Validated scales were used for data collection, such as the Categorization of Moisture-Associated Skin Damage (MASD) of the GNEAUPP (National [Spain] group for the assessment of pressure ulcers and chronic wounds) and the Visual Erythema Scale (VES). Results: The overall incidence of IAD was 20.7% in the sample during follow-up. No statistically significant difference in effectiveness was found between ZnO (27.8% incidence of IAD) and NIBF (32.9% incidence of IAD) in preventing IAD (p = 0.479). However, survival analysis suggested that the onset of IAD is delayed more in the NIBF group. No adverse events or side effects were reported attributable solely to the use of the products. When considering the total cost per process (including staff application time), ZnO ointment was EUR 0.02 more expensive per patient per day than NIBFs. Conclusions: Although both products have similar efficacy and safety, NIBFs delay the onset of IAD more than ZnO. In addition, despite a higher unit price, NIBFs are more cost-effective per procedure because of savings in nursing time during application and removal.

Objectives: To evaluate the effectiveness of zinc oxide (ZnO) ointments versus non-irritant barrier films (NIBFs) in the prevention of Incontinence-Associated Dermatitis (IAD). Specific objectives included analyzing the effects of treatment over time, establishing when IAD appears in each group, and determining the safety and cost-effectiveness of both treatments. Methodology: A multicenter prospective cohort study was carried out in 10 social health centers in Spain. The final sample included 164 older institutionalized patients with urinary and/or mixed incontinence, divided into two cohorts (79 with ZnO and 85 with NIBF). Follow-up lasted for six weeks. Validated scales were used for data collection, such as the Categorization of Moisture-Associated Skin Damage (MASD) of the GNEAUPP (National [Spain] group for the assessment of pressure ulcers and chronic wounds) and the Visual Erythema Scale (VES). Results: The overall incidence of IAD was 20.7% in the sample during follow-up. No statistically significant difference in effectiveness was found between ZnO (27.8% incidence of IAD) and NIBF (32.9% incidence of IAD) in preventing IAD (p=0.479). However, survival analysis suggested that the onset of IAD is delayed more in the NIBF group. No adverse events or side effects were reported attributable solely to the use of the products. When considering the total cost per process (including staff application time), ZnO ointment was €0.06 more expensive per patient per day than NIBFs. Conclusions: Although both products have similar efficacy and safety, NIBFs delay the onset of IAD more than ZnO. In addition, despite a higher unit price, NIBFs are more cost-effective per procedure because of savings in nursing time during application and removal.

Objective: To evaluate the effectiveness of different compression therapy (CT) systems for providing edema reduction, wound healing, and patient comfort during the treatment of venous leg ulcers (VLUs). Methodology: A multicenter study was carried out in four Andalusian provinces with 140 patients with active VLUs. The target population consisted of patients with active VLUs referred to the Advanced Practice Nurses in Complex Chronic Wounds APN-CCW during the study period, which ran from January 2024 to July 2025. The inclusion criteria were: VLU patients over 18 years of age, with an Ankle-Brachial Index between 0.9 and 1.3, and with exudate and scarring that would allow twice weekly dressing changes. The exclusion criteria were: Patients with wound types other than VLUs, with an inability to give informed consent, or with less than one year expected mortality. Patients were treated with 6 different types of compression therapy for 4 days, in accordance with manufacturers’ instructions. The pressures were monitored daily using a wearable pressure sensing device and connected digital platform. Leg circumference, RESVECH 2.0 score, mean improvement in wound condition, mean improvement in wound surface area average, and patient comfort level were analyzed. Results: CT significantly reduced edema, with a mean leg circumference reduction between 0.9 to 1.4 cm in four days. No differences were observed when grouping the participants by sex, age, or BMI. At the end of the study period, 21.4% of participants had achieved complete ulcer healing, and non-healed participants achieved a mean reduction of 2.6 points in the RESVECH scale. Although no statistically significant differences were found between the different compression systems, CPK Compress 2 and Urgo K2 showed the highest rates of healing, while Urgo K1 and Jobst Compri2 showed the lowest. This suggests possible variations in initial efficacy that merit further investigation. Patient comfort was highly satisfactory, with 93.8% of participants rating the compression as comfortable. The absence of significant differences in comfort across sex, age, obesity, or type of compression system, combined with the low number of bandage removals, reinforces the idea that CT is well tolerated and provides clear therapeutic benefits. Conclusions: The CT reduced edema and promoted healing in VLU patients, regardless of the compression system used. No significant differences were observed between compression systems in reduction of edema or healing outcomes. Patients reported high levels of comfort with all compression systems.

We present the clinical case of a 64-year-old multi-pathological patient who presents numerous skin tears in the upper extremities. The aim is to restore skin integrity in a patient with numerous skin tears (ST) on both forearms using a new class I medical device composed of elastic and adjustable medical grade encapsulated gel. Once the NANDA International diagnostic labels were identified using the NNNConsult online tool, the expected results were planned along with the nursing interventions. The care plan and cure guidelines are detailed based on the consensus evidence of the International Skin Tear Advisory Panel, also including preventive activities in risk areas (General Health, Mobility and Skin), in addition to the implementation of a new class I medical device. Finally, skin integrity is restored. This work shows the positive preventive and therapeutic results in fragile skin and ST when carrying out a multiple care strategy with a new medical device.