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infected venous ulcer

Stefan Walzer, Daniel Dröschel, Lutz Vollmer, Leanne Atkin, Karen Ousey
OBJECTIVE: Venous leg ulcers (VLUs) cause significant pain and suffering for patients. Additionally, they place considerable financial and service burden on the National Health Service (NHS). A large proportion of VLUs do not heal within the standard time frame of 16-24 weeks, resulting in static wounds which commonly have issues with increasing exudate production. As the NHS continues to face times of austerity, services need to find solutions to be able to reduce costs and release nursing time while maintaining standards of care...
March 2, 2018: Journal of Wound Care
Leelavathy Budamakuntla, Eswari Loganathan, Sacchidananda A Sarvajnamurthy, H V Nataraj
Introduction and Objectives: The restoration of the epithelium after injury takes place by migration of epithelial cells adjoining a wound or by centrifugal migration from hair follicles. To evaluate the feasibility and potential healing capacity of scalp follicular unit grafts transplanted into the wound bed of chronic leg ulcers. Materials and Methods: Patients with chronic nonhealing ulcers of more than 6 weeks duration were selected for the study. Those with infected ulcers and uncontrolled diabetes were excluded from the study...
October 2017: Journal of Cutaneous and Aesthetic Surgery
Stefano Mancini, Roberto Cuomo, Mauro Poggialini, Carlo D'Aniello, Giuseppe Botta
BACKGROUND: Debridement and control of bacterial load are key-points of wound care. The aim of this study is to evaluate the effectiveness of autolytic debridement and management of bacterial load (bioburden) of an occlusive hydro-active dressing impregnated with polyhexamethylene biguanide (PHMB). METHODS: We used an occlusive dressing of hydro-active for leg ulcers' treatment (TenderWet-plus® - Hartmann).  Inclusion criteria were: presence of a fibrinous ulcer with multiple etiopathogenesis, in absence of clinical infection, no hypersecretion and diameter within 5 cm...
January 16, 2018: Acta Bio-medica: Atenei Parmensis
Jacob Ruiter-Ligeti, Sophie Vincent, Nicholas Czuzoj-Shulman, Haim Arie Abenhaim
OBJECTIVE: To evaluate the risk factors, incidence, and morbidity associated with the diagnosis of obstetric Clostridium difficile infection. METHODS: We performed a retrospective cohort study on women admitted for delivery using the Healthcare Cost and Utilization Project Nationwide Inpatient Sample from the United States. The delivery admission records of pregnant women were reviewed between 1999 and 2013. After adjusting for demographic and clinical characteristics, we assessed risk factors for the diagnosis of C difficile infection using unconditional logistic regression...
January 9, 2018: Obstetrics and Gynecology
Samuel R Nussbaum, Marissa J Carter, Caroline E Fife, Joan DaVanzo, Randall Haught, Marcia Nusgart, Donna Cartwright
OBJECTIVE: The aim of this study was to determine the cost of chronic wound care for Medicare beneficiaries in aggregate, by wound type and by setting. METHODS: This retrospective analysis of the Medicare 5% Limited Data Set for calendar year 2014 included beneficiaries who experienced episodes of care for one or more of the following: arterial ulcers, chronic ulcers, diabetic foot ulcers, diabetic infections, pressure ulcers, skin disorders, skin infections, surgical wounds, surgical infections, traumatic wounds, venous ulcers, or venous infections...
January 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Julian F Guest, Graham W Fuller, Peter Vowden
The aim of this study was to estimate the patterns of care and annual levels of health care resource use attributable to managing venous leg ulcers (VLUs) in clinical practice by the UK's National Health Service (NHS) and the associated costs of patient management. This was a retrospective cohort analysis of the records of 505 patients in The Health Improvement Network (THIN) Database. Patients' characteristics, wound-related health outcomes and health care resource use were quantified, and the total NHS cost of patient management was estimated at 2015/2016 prices...
February 2018: International Wound Journal
Wu Pan, Josh Drost, Sara Roccabianca, Seungik Baek, Tamara Reid Bush
Venous ulcers are deep wounds that are located predominantly on the lower leg. They are prone to infection and once healed have a high probability of recurrence. Currently, there are no effective measures to predict and prevent venous ulcers from formation. Hence, the goal of this work was to develop a Windkessel-based model that can be used to identify hemodynamic parameters that change between healthy individuals and those with wounds. Once identified, these parameters have the potential to be used as indicators of when internal conditions change, putting the patient at higher risk for wound formation...
December 13, 2017: Journal of Biomechanical Engineering
Silvana de Lima Vieira Dos Santos, Marlene Andrade Martins, Marinésia Aparecida do Prado, José Verdú Soriano, Maria Márcia Bachion
The selection of topical and systemic therapies for the treatment of venous ulcers with signs of infection is challenging and should be accompanied by specific precautionary measures to protect against cross-contamination in the presence of multidrug-resistant microorganisms. However, there are still no clinical indicators for this situation, and confirmation of resistant strains occurs through culture and sensitivity, which can take up to 14 days. During this period, protective measures may no longer be taken, contributing to the spread of these pathogens...
December 2017: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
Agata Cieslik-Bielecka, Rafał Skowroński, Magdalena Jędrusik-Pawłowska, Marcin Pierchała
Nonhealing wounds or skin ulcerations are the result of insufficient repair and destruction of a local healing potential. Opportunistic infections which cause a lot of ulcer complications influence the worsening general condition of patients with AIDS, ultimately leading to death. The chronicity of the condition and poor results of conventional therapy have prompted the search for new methods of treatment. We have examined venous or arteriovenous insufficiency-related extensive crural ulcers in AIDS patients...
November 6, 2017: Advances in Medical Sciences
Priya H Dedhia, Yasmine White, Jonathan R Dillman, Jeremy Adler, Marcus D Jarboe, Daniel H Teitelbaum, Ronald B Hirschl, Samir K Gadepalli
BACKGROUND AND OBJECTIVES: Sarcopenia, defined as reduced muscle mass, is typically assessed by CT scans, which are infrequently performed in children. Using MRI to measure sarcopenia, we determined the association with postoperative complications after colectomy for ulcerative colitis (UC). METHODS: Clinical and preoperative MRI data for 13-18-year-old UC patients who underwent colectomy were retrospectively reviewed. Bilateral paraspinous muscle area (PSMA) and psoas muscle area (PMA) at L3 vertebra were measured and averaged...
September 14, 2017: Journal of Pediatric Surgery
M Klonizakis, G A Tew, A Gumber, H Crank, B King, G Middleton, J A Michaels
BACKGROUND: Almost 70% of all leg ulcers have a venous component. Venous leg ulcers (VLU's) are typically painful and heal slowly, resulting in an impaired quality of life (QoL), social isolation and reduced work productivity. Compression therapy offers high healing rates, however, improvements aren't usually sustained. Exercise is a low-cost, low-risk, and effective strategy for improving physical and mental health. However, little is currently known about the feasibility and efficacy of supervised exercise training used in combination with compression therapy in this patient group...
October 27, 2017: British Journal of Dermatology
Alberto Dal Molin, Claudia Gatta, Chiara Boggio Gilot, Rachele Ferrua, Tiziana Cena, Marie Manthey, Antonella Croso
AIMS AND OBJECTIVES: The aim of this study was to explore the effect of "Primary Nursing" on nursing-sensitive patient outcomes, staff-related outcomes, and organization-related outcomes. BACKGROUND: Primary Nursing is one example of a care pattern that has recently been implemented in many countries. DESIGN: Before-after study METHODS: This study was conducted in an Italian hospital. We observed patient-related outcomes (pressure ulcers, falls, urinary tract infection and venous catheter infection) in 2,857 inpatients before the implementation of Primary Nursing and in 3,169 inpatients after its implementation...
October 27, 2017: Journal of Clinical Nursing
Yong-Beom Lee, Dae-Hwan Kim, Jong-Ho Jung, Jae-Yong Park
BACKGROUND: Using a sinus tarsi rotational flap is an uncommon approach to treating chronic open infective lateral malleolus bursitis. METHODS: We treated eight patients, including six males, using this approach. First, we debrided all the infected tissues and used a negative pressure wound closure system where needed. After acute infection had been controlled, the local rotational flap was used for cases where the wound could not be closed by a simple suture or bone exposure...
2017: BioMed Research International
Nakyung Jeon, Ben Staley, Thomas Johns, Glori Pflugfelder Lipori, Babette Brumback, Richard Segal, Almut G Winterstein
PURPOSE: The approach and results for identifying and characterizing preventable adverse drug events (pADEs) that are key targets for pharmacist medication therapy management (MTM) are summarized. METHODS: This study was part of a larger effort aimed at developing an electronic health record-based prediction model (the complexity score, or C-score) that ranks hospitalized patients according to their risk for pADEs. An environmental scan of published epidemiologic pADE studies and national patient safety priority areas was conducted...
November 1, 2017: American Journal of Health-system Pharmacy: AJHP
Stephan A Schug, Bruce Parsons, Chunming Li, Feng Xia
BACKGROUND: Nonselective, nonsteroidal anti-inflammatory drugs (NSAIDs) and selective cyclooxygenase-2 (COX-2) inhibitors are associated with safety issues including cardiovascular, renal, and gastrointestinal (GI) events. OBJECTIVE: To examine the safety of parecoxib, a COX-2 inhibitor, for the management of postoperative pain. DESIGN: Pooled analysis of 28 placebo-controlled trials of parecoxib and review of postauthorization safety data...
2017: Journal of Pain Research
Frances Game, William Jeffcoate, Lise Tarnow, Florence Day, Deborah Fitzsimmons, Judith Jacobsen
BACKGROUND: Diabetic foot ulcers are a common and severe complication of diabetes mellitus. Standard treatment includes debridement, offloading, management of infection and revascularisation where appropriate, although healing times may be long. The LeucoPatch® device is used to generate an autologous platelet-rich fibrin and leucocyte wound dressing produced from the patient's own venous blood by centrifugation, but without the addition of any reagents. The final product comprises a thin, circular patch composed predominantly of fibrin together with living platelets and leucocytes...
October 10, 2017: Trials
Chang-Yi Chou, Hao-Yu Chiao, Chi-Yu Wang, Yu-Shan Sun, Chin-Ta Lin, Niann-Tzyy Dai, Shyi-Gen Chen, Shun-Cheng Chang
BACKGROUND: Loss of soft tissue in heel-calcaneal region is frequently caused by trauma, infection, or tumors. Limited availability of similar tissue becomes challenging, therefore, the use of free tissue transfer offers a solution. Our aim is to describe long term functional outcome of different free tissue transfers for these defects. PATIENTS AND METHODS: We retrospectively reviewed 24 consecutive cases of the heel-calcaneal defect between January 2009 and December 2014...
October 9, 2017: Microsurgery
Marion Burckhardt, Cristina Hoffmann, Brigitte Nink-Grebe, Sylvia Sänger
BACKGROUND: Clinical practice guidelines can change the practice in healthcare only if their recommendations are implemented in a comprehensive way. The German S3 guideline "Local Therapy of Chronic Wounds in Patients with Peripheral Vascular Disease, Chronic Venous Insufficiency, and Diabetes" will be updated in 2017. The emphasis here is on the guideline's validity, user-friendliness and implementation into practice. Therefore, the aim was to identify the improvements required in regard to the guideline's methods and content presentation...
September 25, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
Suzanne A V van Asten, Moez Mithani, Edgar J G Peters, Javier La Fontaine, Paul J Kim, Lawrence A Lavery
AIM: To identify complications of medical treatment in patients with diabetic foot osteomyelitis (DFO). METHODS: We reviewed 143 records of consecutive patients admitted with DFO, confirmed by bone histopathology or culture. Complications monitored included acute kidney injuries (AKI), development of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE), gastrointestinal complications, and venous catheter related complications during a 12months follow-up period...
January 2018: Diabetes Research and Clinical Practice
Sanjay Bhandari, Mubeen Khan Mohammed Abdul, Binod Dhakal, Lisa Baumann Kreuziger, Kia Saeian, Daniel Stein
BACKGROUND: Risk of venous thromboembolism (VTE) in patients with inflammatory bowel disease (IBD) is well established; however, there is paucity of data on the potential added risk of VTE in patients with IBD with Clostridium difficile infection (CDI). We sought to study the difference in VTE rates in hospitalized patients with IBD with CDI compared to those without CDI. METHODS: We queried Nationwide Inpatient Sample from year 2011 to identify patients ≥18 years of age with a discharge diagnosis of IBD (i...
October 2017: Inflammatory Bowel Diseases
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