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pressure ulcer prevention

Kevin Woo
Maintaining skin integrity is espoused by several international authorities as a benchmark for patient safety and quality of care. National guidelines advocate the use of prophylactic multi-layer foam dressings over bony prominences for the prevention of pressure ulcers or injuries. The purpose of this study was to evaluate the implementation of best practice guidelines including the use of multi-layer foam dressings for the prevention of pressure injuries. The analysis involved data from a total number of 62 unique patients...
March 12, 2018: Surgical Technology International
Martine Barateau, Yvonne Gautier
The occurrence of a pressure ulcer can be considered as an avoidable adverse event. Its consequences are not only very harmful for the patient, but also in terms of the costs induced and for the nursing teams faced with the failure of the prevention treatment. For these reasons, nurses, nurse assistants and the multidisciplinary team must work together around a pressure ulcer prevention strategy.
March 2018: Revue de L'infirmière
Marek Kawecki, Jarosław Pasek, Grzegorz Cieślar, Aleksander Sieroń, Grzegorz Knefel, Mariusz Nowak, Justyna Glik
BACKGROUND: Diabetic foot ulcer is one of the major complications of diabetes mellitus in adults. OBJECTIVES: The aim of the study was to conduct a planimetry evaluation of the effectiveness of hyperbaric oxygen therapy (HBOT) in the treatment of patients with vascular disorders caused by diabetic foot. MATERIAL AND METHODS: The study included 94 patients, 30 females (32%) and 64 males (68%), aged 33-76 years, with diabetes lasting 1.5-32 years, who underwent HBOT due to diabetic foot...
January 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Daniel Podd
Pressure injuries (previously called pressure ulcers) are a common finding among patients in acute, long-term, or home settings. Numerous pathophysiologic and risk mechanisms factor into the development of pressure injuries. The timely recognition of these injuries is imperative. Many treatments exist for pressure injuries but the focus of patient management should be on preventing injury-related complications.
March 6, 2018: JAAPA: Official Journal of the American Academy of Physician Assistants
Jawad Chishtie, Farrukh Chishtie, Karen Yoshida, Robert Balogh
BACKGROUND: The 2005 South Asian earthquake led to large-scale injuries and disabilities in northern Pakistan, which were dealt with using various approaches. In this regard, a community-based rehabilitation approach was initiated in the Muzaffarabad district of Pakistan in early 2006, focused on preventing complications among persons with Spinal Cord Injury. This case study briefly describes its development, aims and service provision components, in addition to the distribution of injuries from the disaster...
March 7, 2018: Disability and Rehabilitation
Yonglai Zhang, Rui Sha, Kaiguo Wang, Hao Li, Bo Yan, Naibao Zhou
Tetrahydropalmatine exerts numerous pharmacological activities, including analgesic and narcotic effects; anti-arrhythmic, blood pressure lowering and cardioprotective effects; protective effects against cerebral ischemia-reperfusion injury; inhibition of platelet aggregation; prevention of ulcerative diseases and inhibition of gastric acid secretion; antitumor effects; and beneficial effects on the withdrawal symptoms associated with drug addiction. The present study aimed to investigate the protective effects of tetrahydropalmatine against ketamine‑induced learning and memory impairment in mice...
March 7, 2018: Molecular Medicine Reports
Muhammad Asif Rasheed, Ali Kashif, Aneeqa Naz, Sikandar Ali
Toothbrush is a rare foreign body to be ingested accidentally. The unusual shape of the toothbrush with no theoretical possibility of spontaneous passage mandates an interventional approach. If left untreated, it can lead to pressure necrosis, bleeding, perforation and ulceration. An endoscopic attempt in an expert clinic if available is the ideal approach. If failed, surgical management by laparoscope or mini laparotomy should be done. The evaluation for underlying psychiatric disorders like bulimia, schizophrenia or generalized eating disorder should be considered to prevent such recurrence...
January 2018: Journal of Ayub Medical College, Abbottabad: JAMC
Brecht Serraes, Martin van Leen, Jos Schols, Ann Van Hecke, Sofie Verhaeghe, Dimitri Beeckman
The aims of this study were to identify, assess, and summarise available evidence about the effectiveness of static air mattress overlays to prevent pressure ulcers. The primary outcome was the incidence of pressure ulcers. Secondary outcomes included costs and patient comfort. This study was a systematic review. Six electronic databases were consulted: Cochrane Library, EMBASE, PubMed (Medline), CINAHL (EBSCOhost interface), Science direct, and Web of Science. In addition, a hand search through reviews, conference proceedings, and the reference lists of the included studies was performed to identify additional studies...
March 5, 2018: International Wound Journal
Raymond Cavaliere, Danielle M Mercado, Malary Mani
Squamous cell carcinoma (SCC) has been commonly reported by foot and ankle specialists. Marjolin's ulcer is a malignancy that involves a posttraumatic scar or ulceration that can develop into SCC from chronic neuropathic pedal wounds, venous stasis, or decubitus ulcerations. Most Marjolin's ulcers are found in the lower extremity, specifically the feet, and it is twice as common in females as males. Biopsy of the tumor is the reference standard to diagnose SCC, and wide excision of SCC is the most common treatment option...
March 2, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Bjorn T Tam, Angus P Yu, Eric W Tam, Douglas A Monks, Xu P Wang, Xiao M Pei, Su P Koh, Thomas K Sin, Helen K W Law, Felix N Ugwu, Rashmi Supriya, Benjamin Y Yung, Shea P Yip, S C Wong, Lawrence W Chan, Christopher W Lai, Pin Ouyang, Parco M Siu
Pressure-induced injury (PI), such as a pressure ulcer, in patients with limited mobility is a healthcare issue worldwide. PI is an injury to skin and its underlying tissue such as skeletal muscle. Muscle compression, composed of mechanical deformation of muscle and external load, leads to localized ischemia and subsequent unloading reperfusion and, hence, a pressure ulcer in bed-bound patients. Although the gross factors involved in PI have been identified, little is known about the exact disease mechanism or its links to apoptosis, autophagy and inflammation...
February 27, 2018: Scientific Reports
Hong-Lin Chen, Bin Zhu, Rong Wei, Zhen-Yu Zhou
Patients with a hip fracture are at high risk for pressure injury. A retrospective review of the electronic medical records of consecutive patients with a hip fracture treated in 2016 in a single tertiary hospital in east China were examined to investigate whether time of year affected the incidence of hospital-acquired pressure injury. Data collected included demographic characteristics (patient name, hospital number, age, gender, and body mass index); possible risk factors for pressure injury, such as presence of diabetes mellitus, admission hemoglobin, admission albumin, length of surgery, and the lowest and/or last Braden Scale score before pressure injury developed; and pressure injury information, which included time of occurrence (days after surgery), location (sacrum and coccyx, ischial tuberosity, or heel), stage, and treatment outcome...
February 2018: Ostomy/wound Management
Anna Polak, Cezary Kucio, Luther C Kloth, Malgorzata Paczula, Ewa Hordynska, Tomasz Ickowicz, Edward Blaszczak, Ewa Kucio, Krystian Oleszczyk, Krzysztof Ficek, Andrzej Franek
The use of electrical stimulation (ES) should be considered for treating nonhealing pressure ulcers (PUs), but optimal ES wound treatment protocols have yet to be established. A randomized, controlled, double-blind clinical study was conducted to evaluate the effects of cathodal and anodal high-voltage monophasic pulsed current (HVMPC) on periwound skin blood flow (PSBF) and size reduction of Stage 2 to Stage 4 PUs of at least 4 weeks' duration. Persons >18 years of age, hospitalized with neurological injuries, at high risk for PU development (Norton scale <14 points; Waterlow scale >15 points), and with at least 1 Stage 2 to Stage 4 PU were eligible to participate in the study...
February 2018: Ostomy/wound Management
Elena Espejo, Marta Andrés, Rosa-Maria Borrallo, Emma Padilla, Enric Garcia-Restoy, Feliu Bella
The objective of this study is to evaluate the clinical and microbiological characteristics of bacteremia associated with pressure ulcers (BAPU) and factors associated with mortality. This study was a prospective observational cohort study of patients with BAPU at a teaching hospital between January 1984 and December 2015. Fifty-six episodes were included. The incidence of BAPU decreased from 2.78 cases per 10,000 hospital discharges in the period from 1984 to 1999 to 1.05 cases per 10,000 hospital discharges in the period from 2000 to 2015 (p < 0...
February 26, 2018: European Journal of Clinical Microbiology & Infectious Diseases
Monica Matos, Romeu Mendes, André B Silva, Nelson Sousa
BACKGROUND: Diabetic foot is one of the most common complications of diabetes. It has the potential risk of pathologic consequences including infection, ulceration and amputation, but a growing body of evidence suggests that physical activity and exercise may improve diabetic foot outcomes. OBJECTIVE: To analyze de effects of exercise and physical activity interventions on diabetic foot outcomes. METHODS: A comprehensive and systematic search was conducted according to PRISMA recommendations...
February 22, 2018: Diabetes Research and Clinical Practice
Chunhu Shi, Jo C Dumville, Nicky Cullum
BACKGROUND: Pressure ulcers are a prevalent and global issue and support surfaces are widely used for preventing ulceration. However, the diversity of available support surfaces and the lack of direct comparisons in RCTs make decision-making difficult. OBJECTIVES: To determine, using network meta-analysis, the relative effects of different support surfaces in reducing pressure ulcer incidence and comfort and to rank these support surfaces in order of their effectiveness...
2018: PloS One
Tracey L Yap, Susan M Kennerly, Susan D Horn, Nancy Bergstrom, Santanu Datta, Cathleen Colon-Emeric
BACKGROUND: Pressure ulcers/injuries (PrUs), a critical concern for nursing homes (NH), are responsible for chronic wounds, amputations, septic infections, and premature deaths. PrUs occur most commonly in older adults and NH residence is a risk factor for their development, with at least one of every nine U.S. NH residents experiencing a PrU and many NHs having high incidence and prevalence rates, in some instances well over 20%. PrU direct treatment costs are greater than prevention costs, making prevention-focused protocols critical...
February 20, 2018: BMC Geriatrics
S Kim, K Kim, S J Kim
BACKGROUND: Despite the increasing population of elderly individuals in Korea, there are no evidence-based geriatric nursing practice guidelines. AIM: This study aimed to identify and prioritize topics related to the development of evidence-based geriatric nursing practice guidelines in long-term care facilities in Korea. METHODS: To identify potential topics, 89 nurses responded to a questionnaire on activities that require further evidence and/or standardization in the long-term care facility setting...
February 20, 2018: International Nursing Review
Daisy Smith, Rebecca Lane, Rosemary McGinnes, Jane O'Brien, Renea Johnston, Lyndal Bugeja, Victoria Team, Carolina Weller
Standard best practice for the treatment of venous leg ulcers (VLUs) is compression bandaging of the lower leg to reduce hydrostatic pressure. There is considerable variation in reported healing rates when using this gold-standard approach; therefore, a systematic and robust evaluation of other interventions is required. Exercise interventions, in addition to standard compression therapy, could improve wound-healing time and prevent their recurrence. We have conducted a systematic review to examine the effects of exercise on wound characteristics, including time to heal, size and recurrence, pain, quality of life, adverse events, and economic outcomes...
February 15, 2018: International Wound Journal
Michael Clark, Trudie Young, Maureen Fallon
Successful prevention of pressure ulcers is the end product of a complex series of care processes including, but not limited to, the assessment of vulnerability to pressure damage; skin assessment and care; nutritional support; repositioning; and the use of beds, mattresses, and cushions to manage mechanical loads on the skin and soft tissues. The purpose of this review was to examine where and how Statistical Process Control (SPC) measures have been used to assess the success of quality improvement initiatives intended to improve pressure ulcer prevention...
February 15, 2018: International Wound Journal
Fariba Sadeghi Fazel, Nazi Derakhshanrad, Mir Saeed Yekaninejad, Fardis Vosoughi, Asal Derakhshanrad, Hooshang Saberi
Pressure Ulcers (PUs) remain among the most common complications after traumatic spinal cord Injuries (SCIs). The main goal of risk factor assessment with different tools has been to provisionally estimate the chance of developing pressure ulcers in patients with Spinal Cord Injury (SCI). Braden tool has been of good predictive value and most commonly employed in hospital communities for risk assessment of pressure sore development. The objective of this study was to determine the Braden risk factors as well as the prevalence of pressure injuries in SCI patients...
January 2018: Acta Medica Iranica
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