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Acute wound care

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https://www.readbyqxmd.com/read/28722595/multidrug-resistant-microorganisms-colonizing-lower-extremity-wounds-in-patients-in-a-tertiary-care-hospital-lima-peru
#1
Rafael Mendo-Lopez, Luis Jasso, Ximena Guevara, Aurora Lizeth Astocondor, Saul Alejos, Ana C Bardossy, Tyler Prentiss, Marcus J Zervos, Jan Jacobs, Coralith García
Multidrug-resistant organism (MDRO) infections cause high morbidity and mortality, and high costs to patients and hospitals. The study aims were to determine the frequency of MDRO colonization and associated factors in patients with lower-extremity wounds with colonization. A cross-sectional study was designed during November 2015 to July 2016 in a tertiary care hospital in Lima, Peru. A wound swab was obtained for culture and susceptibility testing. MDRO colonization was defined if the culture grew with methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and/or extended spectrum beta-lactamase (ESBL) microorganisms...
June 19, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28720187/experiences-with-regional-anesthesia-for-analgesia-during-prolonged-aeromedical-evacuation
#2
Jeffrey M Carness, Melissa A Wilson, Mark J Lenart, Danny E Smith, Susan F Dukes
INTRODUCTION: There is much debate regarding the appropriate analgesic management of patients undergoing medical evacuation following combat trauma. Our primary objective was to review the utility of regional anesthetic techniques in patients undergoing aeromedical evacuation following surgical limb amputation as treatment for combat trauma. METHODS: This study was conducted as an observational retrospective cohort whereby acutely injured amputee patients were identified via the U...
August 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28700206/drug-porous-silicon-dual-luminescent-system-for-monitoring-and-inhibition-of-wound-infection
#3
Xisheng Chen, Fangjie Wo, Yao Jin, Jie Tan, Yan Lai, Jianmin Wu
Wound monitoring and curing is of great importance in biomedical research. This work created a smart bandage that can simultaneously monitor and inhibit wound infection. The main components of the smart bandage are luminescent porous silicon (LuPSi) particles loaded with ciprofloxacin (CIP). This dual luminescent system can undergo accelerated fluorescent color change from red to blue upon the stimulation of reactive oxygen species (ROS) and elevated pH, which are main biomarkers in the infected wound. The mechanism behind the chemical-triggered fluorescent color change was studied in detail...
July 17, 2017: ACS Nano
https://www.readbyqxmd.com/read/28682854/medical-device-related-pressure-injuries-in-long-term-acute-care-hospital-setting
#4
Mary Arnold-Long, Melissa Ayer, Kathleen Borchert
PURPOSE: The purpose of this study was to examine the epidemiology of medical device-related pressure injuries (MDRPIs) in 3 long-term acute care hospitals (LTACHs). DESIGN: Retrospective descriptive study. SUBJECTS AND SETTING: The sample comprised 304 adult inpatients at 3 geographically diverse LTACHs: Spaulding Hospital for Continued Medical Care, Drake Center, and Bethesda Hospital. The facilities are located in the Northeastern, Southeastern, and Midwestern United States...
July 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28678998/association-of-same-day-discharge-with-hospital-readmission-after-appendectomy-in-pediatric-patients
#5
Sarah B Cairo, Mehul V Raval, Marybeth Browne, Holly Meyers, David H Rothstein
Importance: Appendectomy is the most common abdominal operation performed in pediatric patients in the United States. Studies in adults have suggested that same-day discharge (SDD) after appendectomy is safe and does not result in higher-than-expected hospital readmissions. Objective: To evaluate the influence of SDD on 30-day readmission rates following appendectomy for acute appendicitis in pediatric patients. Design, Setting, and Participants: This retrospective cohort study used the American College of Surgeons National Surgical Quality Improvement Program-Pediatric database to evaluate 30-day readmission rates among pediatric patients who underwent an appendectomy for acute, nonperforated appendicitis...
July 5, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28659673/emergency-laparotomies-at-a-tertiary-care-center-a-hospital-based-cross-sectional-study
#6
G Gejoe, Induprabha Yadev, M Rahul
Emergency laparotomy is a common high-risk surgical procedure, but with a few outcome data and few data on postoperative care. This was a hospital-based descriptive study of 376 consecutive emergency midline laparotomies performed in a tertiary care center. The aim of the study was to identify the clinical presentation, surgical indications, preoperative delay, intraoperative findings, and postoperative complications. Majority of the patients belonged to the 40-80-year age group. Broadly, the indications could be divided into acute abdomen and trauma...
June 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28657899/a-descriptive-cross-sectional-survey-of-turkish-nurses-knowledge-of-pressure-ulcer-risk-prevention-and-staging
#7
Asiye Gul, Isil Isik Andsoy, Birgul Ozkaya, Ayten Zeydan
Nurses' knowledge of pressure ulcer (PU) prevention and management is an important first step in the provision of optimal care. To evaluate PU prevention/risk, staging, and wound description knowledge, a descriptive, cross-sectional survey was conducted among nurses working in an acute care Turkish hospital. The survey instrument was a modified and translated version of the Pieper Pressure Ulcer Knowledge Test (PUKT), and its validity and reliability were established. Nurses completed a Personal Characteristics Form, including sociodemographic information and exposure to educational presentations and information about and experience with PUs, followed by the 49-item modified PUKT which includes 33 prevention/risk items, 9 staging items, and 7 wound description items...
June 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/28643098/-importance-of-wound-irrigation-solutions-and-fluids-with-antiseptic-effects-in-therapy-and-prophylaxis-update-2017
#8
REVIEW
Christian Willy, Catharina Scheuermann-Poley, Marcus Stichling, Thomas von Stein, Axel Kramer
INTRODUCTION: Despite the use of modern antibiotics as well as complex perioperative, intraoperative and postoperative prophylactic measures, the rate of surgical site infections (SSI) could not be significantly reduced. The introduction of biocompatible antiseptic drugs with a high microbiocidal effect provided a successful alternative for infection prevention and therapy, particularly in a time of increasing occurrence of multi-drug resistant pathogens. Hence, questions about the risk-benefit ratio of antiseptic wound irrigation solutions, the prophylactic use of wound irrigation solutions for the reduction of SSI and the effect of negative pressure wound therapy combined with instillation (NPWTi) need to be answered...
July 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28633147/tranexamic-acid-safely-reduced-blood-loss-in-hemi-and-total-hip-arthroplasty-for-acute-femoral-neck-fracture-a-randomized-clinical-trial
#9
Chad D Watts, Matthew T Houdek, S Andrew Sems, William W Cross, Mark W Pagnano
OBJECTIVES: We aimed to determine whether (1) tranexamic acid (TXA) reduces the incidence of transfusion (2) TXA reduces the calculated blood loss, and (3) there are any observable differences in 30- and 90-day complications with TXA administration during arthroplasty for femoral neck fracture (FNF). DESIGN: Prospective, double-blinded, randomized controlled trial. SETTING: Level 1 Academic Trauma Center. PATIENTS/PARTICIPANTS: One hundred thirty-eight patients who presented with a low-energy, isolated, FNF (AO 31B) treated with either hemi- or total hip arthroplasty within 72 hours of injury were randomized to either the TXA group (69 patients) or placebo group (69 patients)...
July 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28629071/hemostatic-kaolin-polyurethane-foam-composites-for-multifunctional-wound-dressing-applications
#10
Jeffrey G Lundin, Christopher L McGann, Grant C Daniels, Benjamin C Streifel, James H Wynne
There are numerous challenges associated with the acute care of traumatic limb injuries in forward military settings. A lack of immediate medical facilities necessitates that the wound dressing perform multiple tasks including exudate control, infection prevention, and physical protection of the wound for extended periods of time. Here, kaolin was incorporated into recently developed robust polyurethane (PU) hydrogel foams at 1-10wt% in an effort to impart hemostatic character. ATR-IR and gel fraction analysis demonstrated that the facile, one-pot synthesis of the PU hydrogel was unaffected by kaolin loading, as well as the use of a non-toxic catalyst, which significantly improved cytocompatibility of the materials...
October 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28617751/economic-evaluations-of-strategies-to-prevent-hospital-acquired-pressure-injuries
#11
Wrechelle Ocampo, Amanda Cheung, Barry Baylis, Nancy Clayden, John M Conly, William A Ghali, Chester H Ho, Jaime Kaufman, Henry T Stelfox, David B Hogan
GENERAL PURPOSE: To provide information from a review of literature about economic evaluations of preventive strategies for pressure injuries (PIs). TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant should be better able to:1...
July 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/28617108/prevention-and-management-of-skin-tears-in-older-people
#12
Lorna McInulty
Skin tears are frequently encountered in emergency and unscheduled care, and are prevalent in older people. Patients may present soon after an acute skin tear, or at a later stage when the wound presentation is different and there are complications. This article describes evidence-based recommendations and strategies for the prevention, assessment and management of skin tears, discusses risk factors and explains when to refer patients for specialist management.
June 15, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28603823/early-versus-delayed-laparoscopic-cholecystectomy-for-lithiasic-acute-cholecystitis-during-emergency-admissions-results-of-a-monocentric-experience-and-review-of-the-literature
#13
Mohamed Salah Jarrar, Ibrahim Chouchène, Houssem Fadhl, Rafik Ghrissi, Amine Elghali, Fehmi Ferhi, Hedi Mraidha, Fehmi Hamila, Rached Letaief
BACKGROUND: It is established that the standard treatment for lithiasic acute cholecystitis is the laparoscopic cholecystectomie. However, the question of the timing of cholecystectomy remains controversial. AIM: To compare early laparoscopic cholecystectomies (within 72 hours of symptom onset) and delayed laparoscopic cholecystectomies (beyond 72 hours) for lithiasic acute cholecystitis in terms of intra-operative difficulties and post-operative complications. METHODS: The patients operated on for acute cholecystitis, between January 2007 and December 2012, were included in a retrospective study...
August 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/28602903/major-lower-limb-amputation-outcomes-are-improving
#14
David A Kelly, Stephanie Pedersen, Patrik Tosenovsky, Kishore Sieunarine
INTRODUCTION: Outcomes following major lower limb amputation (MLLA) between 2000 and 2002 from the department of vascular surgery at Royal Perth Hospital (RPH) have been published; mean postoperative length of stay 20 days, inpatient complication rate 54% and 30-day mortality 10%. The last decade has seen increasing endovascular revascularization techniques, increased focus on MLLA patients and general improvements in the model of care. The aim of this study is to compare outcomes between 2000-2002 and 2010-2012...
June 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28599047/acute-traumatic-wound-management-in-the-prolonged-field-care-setting
#15
Justin Rapp, Timothy P Plackett, Jonathan Crane, Jonathan Lu, Andrew Hall, David Hardin, Paul E Loos, Rick Kelly, Clinton K Murray, Sean Keenan, Stacy Shackelford
No abstract text is available yet for this article.
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28599034/a-prospective-randomized-controlled-two-arm-clinical-study-evaluating-the-efficacy-of-a-bioelectric-dressing-system-for-blister-management-in-us-army-ranger-recruits
#16
Greggory J Housler, Sue Cross, Vanessa Marcel, Daniel O Kennedy, Michael Husband, Andrew Register, Thomas Roberts, Seth Grubbs, Douglas Dudewicz, Nathan Setka, Curt Bay, Martin E Wendelken, Mina J Izadjoo
This study focused on a clinically relevant healthcare problem in the military: acute soft tissue wounds, or blisters. The trial was a prospective, controlled, randomized two-arm study evaluating the efficacy of a bioelectric dressing, Procellera®, applied topically two to three times per week for 2 weeks to blisters developed in Ranger trainees during training at Fort Benning, Georgia. A total of 80 US Army Ranger recruits with blister wounds below the knee were randomly assigned to one of two treatment groups (n = 40/group)...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28598761/the-health-economic-burden-that-acute-and-chronic-wounds-impose-on-an-average-clinical-commissioning-group-health-board-in-the-uk
#17
J F Guest, K Vowden, P Vowden
OBJECTIVE: To estimate the patterns of care and related resource use attributable to managing acute and chronic wounds among a catchment population of a typical clinical commissioning group (CCG)/health board and corresponding National Health Service (NHS) costs in the UK. METHOD: This was a sub-analysis of a retrospective cohort analysis of the records of 2000 patients in The Health Improvement Network (THIN) database. Patients' characteristics, wound-related health outcomes and health-care resource use were quantified for an average CCG/health board with a catchment population of 250,000 adults ≥18 years of age, and the corresponding NHS cost of patient management was estimated at 2013/2014 prices...
June 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28594320/silver-containing-foam-dressings-with-safetac-a-review-of-the-scientific-and-clinical-data
#18
Phil Davies, Sara McCarty, Kristina Hamberg
Background Topical antimicrobials, such as silver dressings, are progressively being used alongside systemic antibiotics to provide adjunctive, antimicrobial therapy to wounds that are clinically infected or at risk of infection. To help improve wound management, dressings that use Safetac soft silicone technology in combination with a silver-impregnated foam dressing material were developed by Mölnlycke Health Care (Gothenburg, Sweden). The range comprises Mepilex Ag, Mepilex Border Ag and Mepilex Transfer Ag...
June 1, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28576257/management-of-the-chronic-burn-wound
#19
REVIEW
Stephen Tyler Elkins-Williams, William A Marston, Charles Scott Hultman
This article reviews the current evidence in using hyperbaric oxygen therapy (HBOT) in burn wounds. There is also separate consideration of diabetic foot burns and a protocol for use of HBOT in a specific case. The challenges of using HBOT in an acute burn care setting are reviewed. Next the pathophysiology of Marjolin ulcers is reviewed. The current thinking in diagnosis, treatment, and prevention of Marjolin ulcers is discussed. Finally, a background in using topical growth factors (tGF) is provided, followed by a summary of the current evidence of tGF in burn wounds...
July 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28576256/negative-pressure-wound-therapy-for-burns
#20
REVIEW
Neel A Kantak, Riyam Mistry, David E Varon, Eric G Halvorson
Negative pressure wound therapy (NPWT) has become a widely used treatment for acute and chronic wounds. NPWT is indicated for a variety of complex wounds, and some studies validate its use for certain aspects of burn care. Although further research is needed to explore the benefits for burns, NPWT has proven beneficial in its use as a dressing that bolsters skin grafts, promotes integration of bilaminate dermal substitutes, promotes re-epithelialization of skin graft donor sites, and potentially reduces the zone of stasis...
July 2017: Clinics in Plastic Surgery
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