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Acute wound care

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https://www.readbyqxmd.com/read/28529812/diabetic-muscle-infarction-masquerading-as-necrotizing-fasciitis
#1
Kalyana C Janga, Ankur Sinha, Perry Wengrofsky, Phone Oo, Sheldon Greenberg, Regina Tarkovsky, Kavita Sharma
A 43-year-old male patient with past medical history of diabetes mellitus (DM), end stage renal disease (ESRD) on hemodialysis (HD), congestive heart failure (CHF), obstructive sleep apnea (OSA), and chronic anemia presented with complaints of left thigh pain. A computerized tomogram (CT) of the thigh revealed evidence of edema with no evidence of a focal collection or gas formation noted. The patient's clinical symptoms persisted and he underwent magnetic resonance imaging (MRI) of his thigh which was reported to show small areas of muscle necrosis with fluid collection...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/28486324/case-report-and-review-of-management-of-penetrating-trauma-and-cardiac-pericarditis
#2
Elizabeth Thomas, Pamela Golden, Vicki Moran
Acute pericarditis is the most common form of pericardial disease worldwide and it has many potential etiologies. This case study examines a patient admitted for multiple gunshot wounds who developed acute pericarditis postpericardial drain removal. The initial penetrating abdominal trauma, along with facial injuries and a suspected myocardial infarction, led to confusion in which the initial etiology of pericarditis was missed, creating a delay in overall patient care and extended length of stay.
May 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28482805/management-of-potentially-life-threatening-emergencies-at-74-primary-level-hospitals-in-mongolia-results-of-a-prospective-observational-multicenter-study
#3
Naranpurev Mendsaikhan, Davaa Gombo, Ganbold Lundeg, Christian Schmittinger, Martin W Dünser
BACKGROUND: While the capacities to care for and epidemiology of emergency and critically ill patients have been reported for secondary and tertiary level hospitals in Mongolia, no data exist for Mongolian primary level hospitals. METHODS: In this prospective, observational multicenter study, 74 primary level hospitals of Mongolia were included. We determined the capacities of these hospitals to manage medical emergencies. Furthermore, characteristics of patients presenting with potentially life-threatening emergencies to these hospitals were evaluated during a 6 month period...
May 8, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28456441/surgical-treatment-and-management-of-the-severely-burn-patient-review-and-update
#4
P Gacto-Sanchez
Since one of the main challenges in treating acute burn injuries is preventing infection, early excising of the eschar and covering of the wound becomes critical. Non-viable tissue is removed by initial aggressive surgical debridement. Many surgical options for covering the wound bed have been described, although split-thickness skin grafts remain the standard for the rapid and permanent closure of full-thickness burns. Significant advances made in the past decades have greatly improved burns patient care, as such that major future improvements in survival rates seem to be more difficult...
April 26, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28445858/the-impact-of-minor-blood-transfusion-on-the-outcome-after-coronary-artery-bypass-grafting
#5
Eeva-Maija Kinnunen, Marco Zanobini, Francesco Onorati, Debora Brascia, Giovanni Mariscalco, Ilaria Franzese, Vito G Ruggieri, Karl Bounader, Andrea Perrotti, Francesco Musumeci, Giuseppe Santarpino, Daniele Maselli, Saverio Nardella, Helmut Gulbins, Riccardo Gherli, Antonino S Rubino, Carmelo Mignosa, Marisa De Feo, Giuseppe Gatti, Francesco Santini, Antonio Salsano, Magnus Dalén, Matteo Saccocci, Daniel Reichart, Giuseppe Faggian, Tiziano Gherli, Francesco Nicolini, Fausto Biancari
PURPOSE: To investigate the impact of minor perioperative bleeding requiring transfusion of 1-2 red blood cell (RBC) units on the outcome after coronary artery bypass grafting (CABG). METHODS: Sixteen cardiac surgical centers contributed to the prospective European CABG registry (E-CABG). 1014 patients receiving 1-2 RBC units during or after isolated CABG were compared to 2264 patients not receiving RBCs. RESULTS: In 827 propensity score matched pairs, transfusion of 1-2 RBC units did not affect the risk of in-hospital/30-day death (p=0...
April 19, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28438078/ten-year-follow-up-of-a-case-of-necrotizing-fasciitis-successfully-treated-with-negative-pressure-wound-therapy-dermal-regeneration-template-application-and-split-thickness-skin-autograft
#6
Sagi Martinov, Soccoro Ortiz
INTRODUCTION: Necrotizing fasciitis is a rapidly progressive and often fatal infection of the fasciae and subcutaneous tissues. PATIENT AND METHODS: In this case report, we present the treatment of a 63-year-old patient suffering from diabetes mellitus, who was admitted to the emergency unit for severe right gluteal pain, which had begun 24 hours before admission. Cutaneous symptoms, oliguria, metabolic acidosis, acute renal failure, severe hypotension, and tachycardia occurred, and the patient was admitted to Intensive Care a few hours after initial admission...
April 25, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28383472/battlefield-pain-management-a-view-of-17-years-in-israel-defense-forces
#7
Avi Benov, Margaux M Salas, Helit Nakar, Ben Antebi, Bader Tarif, Avraham Yitzhak, Elon Glassberg
INTRODUCTION: Pain control in trauma is an integral part of treatment in combat casualty care (CCC). More soldiers injured on the battlefield will need analgesics for pain than those who will need life-saving interventions (LSI). It has been shown that early treatment of pain improves outcomes after traumatic injury, while inadequate treatment leads to higher rates of PTSD. The purpose of this article is to report the Israel Defense Forces Medical Corps (IDF-MC) experience with point of injury (POI) use of analgesia...
April 5, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28380006/rapid-tissue-regeneration-induced-by-intracellular-atp-delivery-a-preliminary-mechanistic-study
#8
Harshini Sarojini, Adrian T Billeter, Sarah Eichenberger, Devin Druen, Rebecca Barnett, Sarah A Gardner, Norman J Galbraith, Hiram C Polk, Sufan Chien
We have reported a new phenomenon in acute wound healing following the use of intracellular ATP delivery-extremely rapid tissue regeneration, which starts less than 24 h after surgery, and is accompanied by massive macrophage trafficking, in situ proliferation, and direct collagen production. This unusual process bypasses the formation of the traditional provisional extracellular matrix and significantly shortens the wound healing process. Although macrophages/monocytes are known to play a critical role in the initiation and progression of wound healing, their in situ proliferation and direct collagen production in wound healing have never been reported previously...
2017: PloS One
https://www.readbyqxmd.com/read/28374708/-laparoscopic-cholecystectomy-in-patients-with-liver-cirrhosis
#9
S I Gadiev, K G Sarieva, E A Abdinov
AIM: To assess efficacy and safety of laparoscopic cholecystectomy in patients with liver cirrhosis. MATERIAL AND METHODS: 46 patients with liver cirrhosis Child-Pugh class A and B underwent laparoscopic cholecystectomy for the period from August 2001 to December 2015. Indications for surgery were acute calculous cholecystitis in 21 (45.6%) patients and chronic calculous cholecystitis in 25 (54.4%) patients. RESULTS: Mean surgery time was 75 minutes...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28363290/acute-management-of-hand-burns
#10
REVIEW
Ashwin Soni, Tam N Pham, Jason H Ko
The hand is extremely susceptible to burn injuries, and hand burns can occur in up to 90% of all major burns. A thorough neurovascular examination of the hand should be performed in the acute setting. Escharotomies are required in patients with full-thickness or circumferential burns, when perfusion of the upper extremity is compromised. The decision for excision and grafting is based on whether the wound will heal in the first 2 to 3 weeks after the burn injury. Acute care and resuscitation are always importance in this patient population; subsequent care leads to optimal hand functionality and cosmetic long-term outcomes...
May 2017: Hand Clinics
https://www.readbyqxmd.com/read/28355136/pharmacologic-impact-aka-breaking-bad-of-medications-on-wound-healing-and-wound-development-a-literature-based-overview
#11
Janice M Beitz
Patients with wounds often are provided pharmacologic interventions for their wounds as well as for their acute or chronic illnesses. Drugs can promote wound healing or substantively hinder it; some medications cause wound or skin reactions. A comprehensive review of extant literature was conducted to examine the impact of drug therapy on wound healing and skin health. MEDLINE and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched for English-language articles published between 2000 and 2016 using the terms drugs, medications, drug skin eruptions, adverse skin reactions, wound healing, delayed wound healing, nonhealing wound, herbals, and herbal supplements...
March 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/28353488/management-of-central-venous-access-device-associated-skin-impairment-an-evidence-based-algorithm
#12
Daphne Broadhurst, Nancy Moureau, Amanda J Ullman
Patients relying on central venous access devices (CVADs) for treatment are frequently complex. Many have multiple comorbid conditions, including renal impairment, nutritional deficiencies, hematologic disorders, or cancer. These conditions can impair the skin surrounding the CVAD insertion site, resulting in an increased likelihood of skin damage when standard CVAD management practices are employed. Supported by the World Congress of Vascular Access (WoCoVA), developed an evidence- and consensus-based algorithm to improve CVAD-associated skin impairment (CASI) identification and diagnosis, guide clinical decision-making, and improve clinician confidence in managing CASI...
May 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28345371/ewma-document-negative-pressure-wound-therapy
#13
Jan Apelqvist, Christian Willy, Ann-Mari Fagerdahl, Marco Fraccalvieri, Malin Malmsjö, Alberto Piaggesi, Astrid Probst, Peter Vowden
1. Introduction Since its introduction in clinical practice in the early 1990's negative pressure wounds therapy (NPWT) has become widely used in the management of complex wounds in both inpatient and outpatient care.(1) NPWT has been described as a effective treatment for wounds of many different aetiologies(2,3) and suggested as a gold standard for treatment of wounds such as open abdominal wounds,(4-6) dehisced sternal wounds following cardiac surgery(7,8) and as a valuable agent in complex non-healing wounds...
March 1, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28329287/outcome-after-procedures-for-retained-blood-syndrome-in-coronary-surgery
#14
Tuomas Tauriainen, Eeva-Maija Kinnunen, Joni Koski-Vähälä, Matti-Aleksi Mosorin, Juhani Airaksinen, Fausto Biancari
OBJECTIVES: Incomplete drainage of blood from around the heart and lungs can lead to retained blood syndrome (RBS) after cardiac surgery. The aim of this study was to assess the incidence of and the outcome after procedures for RBS in patients undergoing isolated coronary artery bypass grafting (CABG). METHODS: A total of 2764 consecutive patients who underwent isolated CABG from 2006 to 2013 were investigated retrospectively. Patients undergoing any procedure for RBS were compared with patients who did not undergo any procedure for RBS...
June 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28328647/pressure-injury-in-a-community-population-a-descriptive-study
#15
Lisa Q Corbett, Marjorie Funk, Gilbert Fortunato, David M OʼSullivan
PURPOSE: The purpose of this study was to describe present-on-admission pressure injuries (POA-PIs) in community-dwelling adults admitted to acute care. The specific aims of the study were to (1) measure the prevalence of POA-PIs during a 1-year period; (2) determine prehospital location of patients with POA-PIs; and (3) describe demographics, pressure injury (PI) characteristics, risk factors, and posthospital outcome of community-dwelling adults with PIs admitted to hospital. DESIGN: Retrospective descriptive study...
May 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28328645/relationship-of-wound-ostomy-and-continence-certified-nurses-and-healthcare-acquired-conditions-in-acute-care-hospitals
#16
Diane K Boyle, Sandra Bergquist-Beringer, Emily Cramer
PURPOSE: The purpose of this study was to describe the (a) number and types of employed WOC certified nurses in acute care hospitals, (b) rates of hospital-acquired pressure injury (HAPI) and catheter-associated urinary tract infection (CAUTI), and (c) effectiveness of WOC certified nurses with respect to lowering HAPI and CAUTI occurrences. DESIGN: Retrospective analysis of data from National Database of Nursing Quality Indicators. SUBJECTS AND SETTINGS: The sample comprised 928 National Database of Nursing Quality Indicators (NDNQI) hospitals that participated in the 2012 NDNQI RN Survey (source of specialty certification data) and collected HAPI, CAUTI, and nurse staffing data during the years 2012 to 2013...
May 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28284096/prevalence-of-graduated-compression-stocking-associated-pressure-injuries-in-surgical-intensive-care-units
#17
Deborah B Hobson, Tracy Y Chang, Jonathan K Aboagye, Brandyn D Lau, Hasan M Shihab, Betsy Fisher, Samantha Young, Nancy Sujeta, Dauryne L Shaffer, Victor O Popoola, Peggy S Kraus, Gina Knorr, Norma E Farrow, Michael B Streiff, Elliott R Haut
PURPOSE: This study aimed to determine the prevalence of static graduated compression stocking (sGCS)-associated pressure injury among patients in surgical intensive care units (ICUs). METHODS: We retrospectively reviewed data from wound care rounds between April 2011 and June 2012 at 3 surgical ICUs at an urban, tertiary care hospital. Patients with sGCS-associated pressure injury were identified and descriptive analysis was performed on their demographic, perioperative, and postoperative characteristics...
February 27, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28277989/dialkylcarbamoyl-chloride-dacc-coated-dressings-in-the-management-and-prevention-of-wound-infection-a-systematic-review
#18
J P Totty, N Bua, G E Smith, A E Harwood, D Carradice, T Wallace, I C Chetter
OBJECTIVE: Dialkylcarbomoyl chloride (DACC)-coated dressings (Leukomed Sorbact and Cutimed Sorbact) irreversibly bind bacteria at the wound surface that are then removed when the dressing is changed. They are a recent addition to the wound care professional's armamentarium and have been used in a variety of acute and chronic wounds. This systematic review aims to assess the evidence supporting the use of DACC-coated dressings in the clinical environment. METHOD: We included all reports of the clinical use of DACC-coated dressings in relation to wound infection...
March 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28272857/management-of-acute-complex-traumatic-wound-with-a-dermal-regeneration-template-case-report
#19
R R V Patel, M Giaquinto-Cillers, J Kotze, R S Hartnick, L W van der Merwe, E B Holford
BACKGROUND: Acute complex traumatic wounds of the lower limbs are usually managed by a combination of multiple debridements, dressing changes, and specialized surgical procedures which may include tissue transfers for the reconstruction of the soft tissue injury. The recovery is lengthy, and the outcome dependent on the initial injury, the surgical procedures undertaken and rehabilitation programs with a multidisciplinary team. METHOD: A nine-year-old male patient presented to Kimberly Hospital with an extensive soft tissue injury of the leg associated with a tibia fracture caused by a high velocity pedestrian vehicle accident...
November 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28261962/an-overview-of-the-therapeutic-potential-of-regenerative-medicine-in-cutaneous-wound-healing
#20
REVIEW
Calver Pang, Amel Ibrahim, Neil W Bulstrode, Patrizia Ferretti
The global burden of disease associated with wounds is an increasingly significant public health concern. Current treatments are often expensive, time-consuming and limited in their efficacy in chronic wounds. The challenge of overcoming current barriers associated with wound care requires innovative management techniques. Regenerative medicine is an emerging field of research that focuses on the repair, replacement or regeneration of cells, tissues or organs to restore impaired function. This article provides an overview of the pathophysiology of wound healing and reviews the latest evidence on the application of the principal components of regenerative medicine (growth factors, stem cell transplantation, biomaterials and tissue engineering) as therapeutic targets...
June 2017: International Wound Journal
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