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Device related pressure ulcer

Giovanni Fuoco, Paola Di Giulio
: . Economic impact of AFId management with modern management systems in Intensive Care patients: comparison between ICUs. INTRODUCTION: Acute fecal incontinence associated with diarrhea (AFId) affects up to 40% of intensive care unit (ICU) patients and may be responsible for pressure ulcers (PU). The FMS (Fecal Management System) though improving the management of these patients is not often provided due to its cost. AIM: To measure the costs of the use of FMS compared to routine care in three intensive care units (ICU) of Piedmont (Italy)...
October 2016: Assistenza Infermieristica e Ricerca: AIR
Z Ahmed, S M McHugh, A Elmallah, M P Colgan, A O'Callaghan, S M O'Neill, P Madhavan, Z Martin
Endovascular repair has revolutionised the emergency treatment of thoracic aortic disease. We report our 10 year experience using this treatment in emergency cases. A prospectively maintained vascular database was analysed. Patients' medical records and CT images stored on the hospital PACS system were also reviewed. Statistical analysis was done using IBM SPSS V21. There were a total of 59 thoracic aortic stenting procedures of which 33 (60% males with a mean age of 58 yrs) were performed for emergency thoracic pathologies: traumatic transection (n = 10), ruptured aneurysm (n = 6), non-traumatic dissection (n = 8) and penetrating aortic ulcer (n = 9)...
December 27, 2016: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
Farooq A Rathore, Faria Ahmad, Muhammad Umar U Zahoor
Non-invasive ventilation (NIV) is used in patients with respiratory failure, sleep apnoea, and dyspnoea related to pulmonary oedema. NIV is provided through a facial mask. Many complications of NIV facial masks have been reported, including the breakdown of facial skin. We report a case of an elderly male admitted with multiple co-morbidities. The facial mask was applied continuously for NIV, without any relief or formal monitoring of the underlying skin. It resulted in a Grade II pressure ulcer. We discuss the possible mechanism and offer advice for prevention of such device-related pressure ulcers...
October 3, 2016: Curēus
Peggy Kalowes, Valerie Messina, Melanie Li
BACKGROUND: In critically ill patients, prevention of pressure ulcers is a challenge because of the high risk for multiple comorbid conditions, immobility, hemodynamic instability, and increased use of medical devices. OBJECTIVES: To compare the difference in incidence rates of hospital-acquired pressure ulcers (HAPUs) in critically ill patients between those treated with usual preventive care and a 5-layered soft silicone foam dressing versus a control group receiving usual care...
November 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
Anna-Barbara Schlüer
While the problem of Pressure Ulcers (PU) in adults has received a great deal of attention, far less is known about PUs in neonates and children. The overall health status of children is generally better and multi-morbidity is limited to a small percentage of patients, like very low term neonates (born before 32 weeks of gestation age), newborns with congenital abnormalities, genetic disorders, perinatal distress syndrome or children with a limited immunity. Survival rates of both critically and chronically ill neonates, infants and children have improved dramatically in recent years, introducing new challenges for medical and nursing care...
October 8, 2016: Journal of Tissue Viability
Marino Ciliberti, Francesco De Lara, Gianfranco Serra, Felice Tafuro, Francesco Maria Iazzetta, Alessia Filosa, Rosa Scognamiglio, Giorgia Ciliberti, Maria Rosaria Veneri
OBJECTIVE: This study was designed to clinically evaluate the efficacy of a bacteria- and-fungi-binding mesh (BFBM) dressing to modify the bacterial load of pressure ulcers (PUs) of categories 3 and 4, when used as a wound contact layer (WCL) during negative pressure wound therapy (NPWT). METHODS: This was an observational single-centre study in patients with PUs of categories 3 or 4, who were treated with NPWT. Patients were observed for 7 days and received NPWT at -80 mm Hg with the BFBM dressing as the WCL...
November 2016: Wounds: a Compendium of Clinical Research and Practice
Lisa Heuch, Judith Streak Gomersall
BACKGROUND: The incidence of foot ulceration related to diabetes is increasing. Many foot care professionals recommend offloading measures as part of management strategies for modulating excess pressure to prevent development of diabetic foot ulcers (DFUs). These measures may include padding, insoles/orthotic devices and footwear. There is a lack of evidence-based guidance on the effectiveness of the different offloading options for preventing primary ulceration in those with diabetes...
July 2016: JBI Database of Systematic Reviews and Implementation Reports
Natalie Campbell
This article describes how an interprofessional project in a London NHS Foundation Trust was undertaken to develop an intranet-based medical device-related pressure ulcer prevention and management pathway for clinical staff working across an adult critical care directorate, where life-threatening events require interventions using medical devices. The aim of this project was to improve working policies and processes to define key prevention strategies and provide clinicians with a clear, standardised approach to risk and skin assessment, equipment use, documentation and reporting clinical data using the Trust's CareVue (electronic medical records), Datix (incident reporting and risk-management tool) and eTRACE (online clinical protocol ordering) systems...
August 11, 2016: British Journal of Nursing: BJN
Mireia Llaurado-Serra, Marta Ulldemolins, Joan Fernandez-Ballart, Rosa Guell-Baro, Teresa Valentí-Trulls, Neus Calpe-Damians, Angels Piñol-Tena, Mercedes Pi-Guerrero, Cristina Paños-Espinosa, Alberto Sandiumenge, María F Jimenez-Herrera
BACKGROUND: Semi-recumbent position is recommended to prevent ventilator-associated pneumonia. Its implementation, however, is below optimal. OBJECTIVES: We aimed to assess real semi-recumbent position compliance and the degree of head-of-bed elevation in Spanish intensive care units, along with factors determining compliance and head-of-bed elevation and their relationship with the development of pressure ulcers. Finally, we investigated the impact that might have the diagnosis of pressure ulcers in the attitude toward head-of-bed elevation...
September 2016: International Journal of Nursing Studies
Ruth S Kim, Kimberly Mullins
BACKGROUND: In patients with acute lung injury and/or severe acute respiratory distress syndrome (ARDS), prone positioning is a therapeutic intervention to improve oxygenation. Positioning a patient in a prone position increases the risk of medical device-related pressure ulcers in the facial area. CASE STUDIES: This article summarizes experience with 4 patients with ARDS. Two did not receive pressure ulcer preventive measures and subsequently developed multiple necrotic facial pressure ulcers related to prone positioning for treatment of ARDS...
July 2016: Journal of Wound, Ostomy, and Continence Nursing
H W Ham, L Schoonhoven, M J Schuurmans, L P H Leenen
Of all patients in a hospital environment, trauma patients may be particularly at risk for developing (device-related) pressure ulcers (PUs), because of their traumatic injuries, immobility, and exposure to immobilizing and medical devices. Studies on device-related PUs are scarce. With this study, the incidence and characteristics of PUs and the proportion of PUs that are related to devices in adult trauma patients with suspected spinal injury were described. From January-December 2013, 254 trauma patients were visited every 2 days for skin assessment...
2016: Nederlands Tijdschrift Voor Geneeskunde
Bernhard Partsch, Hugo Partsch
In this review article the mechanisms of action of compression therapy are summarized and a survey of materials is presented together with some practical advice how and when these different devices should be applied. Some new experimental findings regarding the optimal dosage (= compression pressure) concerning an improvement of venous hemodynamics and a reduction of oedema are discussed. It is shown, that stiff, non-yielding material applied with adequate pressure provides hemodynamically superior effects compared to elastic material and that relatively low pressures reduce oedema...
June 2016: Wiener Medizinische Wochenschrift
David A Daar, Garrett A Wirth, Gregory Rd Evans, Melissa Carmean, Ian L Gordon
Current embodiments of negative pressure wound therapy (NPWT) create a hermetically sealed chamber at the surface of the body using polyurethane foam connected to a vacuum pump, which is then covered by a flexible adhesive drape. Commercially available NPWT systems routinely use flexible polyethylene films that have a sticky side, coated with the same acrylate adhesives used in other medical devices such as ECG leads and grounding pads. Severe reactions to the acrylate adhesives in these other devices, although uncommon, have been reported...
May 22, 2016: International Wound Journal
T Kanazawa, G Nakagami, T Goto, H Noguchi, M Oe, T Miyagaki, A Hayashi, S Sasaki, H Sanada
OBJECTIVE: To verify the reliability and validity of FLIR ONE, a device connected to a smartphone, for the assessment of inflammation based on relative temperature increase compared with the thermography routinely used in pressure ulcer (PU) and diabetic foot assessment. METHOD: Participants in this pilot cross-sectional observational study were recruited from the patients in the PU team rounds and the diabetic foot outpatient clinic at the university hospital in January 2015...
April 2016: Journal of Wound Care
Joseph C Salamone, Ann Beal Salamone, Katelyn Swindle-Reilly, Kelly Xiaoyu-Chen Leung, Rebecca E McMahon
Providing improved health care for wound, burn and surgical patients is a major goal for enhancing patient well-being, in addition to reducing the high cost of current health care treatment. The introduction of new and novel biomaterials and biomedical devices is anticipated to have a profound effect on the future improvement of many deleterious health issues. This publication will discuss the development of novel non-stinging liquid adhesive bandages in healthcare applications developed by Rochal Industries...
June 2016: Regenerative Biomaterials
Ayelet Levy, Kara Kopplin, Amit Gefen
Pressure ulcers (PUs) in the pediatric population are inherently different from those in adults, in their risk factors and etiology, with more than 50% of the cases related to contact with medical equipment at the care setting. The aims of this study were to: (i) Determine the mechanical loads in the scalp of a newborn lying supine, near a wedged encephalogram electrode or wire, which is deforming the scalp at the occiput. (ii) Evaluate the effect of a doughnut-shaped headrest on the mechanical state of tissues at the same site...
February 17, 2016: Journal of Tissue Viability
Seval Hanonu, Ayise Karadag
Pressure ulcers do not develop only in areas with bony prominences; they can develop in any tissue under pressure, including pressure exerted by medical devices. A prospective, descriptive study was conducted from December 15, 2013 to March 25, 2014 to determine the prevalence, risk factors, and characteristics of medical device-related hospitalacquired pressure ulcers (MDR HAPUs) among all patients (N = 175) in 5 adult intensive care units (ICUs) in a university hospital in Turkey. The previously established point prevalence of hospital-acquired pressure ulcers (HAPUs) in these ICUs was 15%...
February 2016: Ostomy/wound Management
Laila Habiballah, Ahmad Tubaishat
BACKGROUND: A paucity of research related to the problem of pressure ulcers in paediatrics is found, with a variety of reported prevalence rates. OBJECTIVE: To record the prevalence, location and categories of PU in the inpatient paediatric wards, and to identify the characteristics of pressure ulcer patients. DESIGN: A descriptive point prevalence study. SETTING: All paediatric inpatient wards in two hospitals in Jordan...
May 2016: Journal of Tissue Viability
Susan R Kahn, Jean-Philippe Galanaud, Suresh Vedantham, Jeffrey S Ginsberg
The post-thrombotic syndrome (PTS) is a frequent, potentially disabling complication of deep vein thrombosis (DVT) that reduces quality of life and is costly. Clinical manifestations include symptoms and signs such as leg pain and heaviness, edema, redness, telangiectasia, new varicose veins, hyperpigmentation, skin thickening and in severe cases, leg ulcers. The best way to prevent PTS is to prevent DVT with pharmacologic or mechanical thromboprophylaxis used in high risk patients and settings. In patients whose DVT is treated with a vitamin K antagonist, subtherapeutic INRs should be avoided...
January 2016: Journal of Thrombosis and Thrombolysis
Susanne Coleman, Isabelle L Smith, Jane Nixon, Lyn Wilson, Sarah Brown
This is the second of a two related papers describing work undertaken to compare and contrast Pressure Ulcer (PU) monitoring systems across NHS in-patient facilities in England. The work comprised 1) a PU/Wound Audit (PUWA) and 2) a survey of PU monitoring systems. This second paper focusses on the survey which explores differences in the implementation of PU adverse event monitoring systems in 24 NHS hospital Trusts in England. The survey questionnaire comprised 41 items incorporating single and multiple response options and free-text items and was completed by the PUWA Trust lead in liaison with key people in the organisation...
February 2016: Journal of Tissue Viability
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