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Pressure ulcer management

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https://www.readbyqxmd.com/read/29301804/recurrent-hospitalisations-in-a-rare-case-of-hemicorporectomy-a-challenging-case-for-medical-management
#1
Ajit Thakur, Brittney Elliott, Rohan Naik, Nabeel Khan, Shayna McQuaid, Camelia Arsene
Hemicorporectomy, or translumbar amputation, is a radical surgery involving the dissection of the body at the waist and is usually reserved for complex medical conditions including locally invasive malignancy and terminal pelvic osteomyelitis. Only 71 cases have previously been reported. We present a rare case of hemicorporectomy in a 53-year-old patient with terminal pelvic osteomyelitis which occurred after he suffered a gunshot wound at T6 causing paraplegia at the age of 31. Unfortunately, this patient continued to suffer recurrent hospitalisations and sepsis events secondary to chronic, non-healing advanced pressure ulcers and complicated urinary tract infections despite repeated courses of broad-spectrum intravenous antibiotics and surgical debridements...
January 4, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29288099/diagnosis-and-management-of-peristomal-pyoderma-gangrenosum-a-systematic-review
#2
REVIEW
Ladan Afifi, Isabelle M Sanchez, Matthew M Wallace, Sara F Braswell, Alex G Ortega-Loayza, Kanade Shinkai
BACKGROUND: Peristomal pyoderma gangrenosum (PPG) is an uncommon subtype of pyoderma gangrenosum. PPG is a challenging condition to diagnose and treat; no evidence-based guidelines exist. OBJECTIVE: To identify important clinical features of PPG and effective treatments available for its management. METHODS: A systematic literature review of PPG was performed using PubMed, Medline, and Embase databases. RESULTS: We describe 335 patients with PPG from 79 studies...
December 26, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/29281061/electronic-medication-regimen-complexity-index-at-admission-and-complications-during-hospitalization-in-medical-wards-a-tool-to-improve-quality-of-care
#3
Marion Lepelley, Céline Genty, André Lecoanet, Benoit Allenet, Pierrick Bedouch, Marie-Reine Mallaret, Pierre Gillois, Jean-Luc Bosson
Objective: Adverse events during hospitalization are a major worry considering their frequency and their burden. Many could be avoided by immediate identification of at-risk patients at admission and adapted prevention. The complexity of a patient's medication regimen immediately available at admission is a good indicator of the complexity of the patient's condition. This study aims to determine whether the electronic Medication Regimen Complexity Index (MRCI) at admission is associated with complications during hospitalization...
December 21, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29280702/effective-management-of-extensive-tissue-loss-after-abdominoperineal-resection-for-buschke-loewenstein-tumor
#4
G Balducci, G Carbotta, M G Sederino, A Delvecchio, R Laforgia, P Sallustio, P Lobascio, F Ferrarese, M Minafra, S Fedele, N Palasciano
The giant condyloma acuminatum or Buschke-Loewenstein tumor is a rare, sexually transmitted disease. It is an epithelial tumor characterized by its high potential of malignancy towards developing into a highly invasive squamous cell carcinoma. The present case concerns a drug addicted 40-year-old man who smuggled drugs using his rectum. He had a partially ulcerated mass in the perianal area of about 20 x 10 cm. He reported a progressive growth of this neoplasm during the last 3 years associated with perianal pain, obstructed defecation, bad sitting posture, no fever and weight loss...
September 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29243399/diabetic-foot-ulcer-management-in-clinical-practice-in-the-uk-costs-and-outcomes
#5
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 diabetic foot ulcers (DFUs) 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 130 patients with a newly diagnosed DFU 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...
December 15, 2017: International Wound Journal
https://www.readbyqxmd.com/read/29243398/venous-leg-ulcer-management-in-clinical-practice-in-the-uk-costs-and-outcomes
#6
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...
December 15, 2017: International Wound Journal
https://www.readbyqxmd.com/read/29243033/incontinence-associated-dermatitis-pathogenesis-contributing-factors-prevention-and-management-options
#7
Hilde Beele, Steven Smet, Nele Van Damme, Dimitri Beeckman
Incontinence-associated dermatitis (IAD) is a common type of irritant contact dermatitis, seen in patients with urinary or faecal incontinence. Mechanical factors such as traumata and friction may aggravate the lesions. The fragile skin in elderly patients is more prone to developing IAD. The clinical picture of IAD consists of persistent redness on the one hand and skin loss on the other. Both categories may be associated with clinical signs of major colonisation or infection. It is important to distinguish IAD from pressure ulcers and other dermatoses in the genital region...
December 14, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29180925/marjolin-s-ulcer-in-chronic-wounds-review-of-available-literature
#8
REVIEW
Dariusz Bazaliński, Joanna Przybek-Mita, Beata Barańska, Paweł Więch
Marjolin's ulcer is a rare, aggressive skin cancer developing in scar tissue, chronic ulcers and areas affected by inflammations. Its incidence is estimated to range from 1% to 2% of all burn scars. It most frequently takes the form of squamous cell carcinoma which sometimes is diagnosed during examination of lesions developing in scars and hard-to-heal chronic wounds (pressure sores, leg ulcers). Therapeutic management of Marjolin's ulcer requires well-designed treatment plan to ensure optimal medical care and good quality of life for the patient...
2017: Contemporary Oncology Współczesna Onkologia
https://www.readbyqxmd.com/read/29174626/-impact-of-interventions-in-the-pressure-ulcer-rate
#9
I Araya Farías, N Febré
OBJECTIVE: To evaluate the impact of a risk management program for prevention of pressure ulcers (PUs) in an adult Intensive Care Unit (ICU). MATERIAL AND METHODS: A quantitative, prospective study performed with a «before and after» evaluation, and designed in three stages: 1) PU incidence study; 2) Intervention by implementing a risk management program, and 3) Assessment of the impact. RESULTS: Adherence to the preventive measures showed a significant increase (11...
November 23, 2017: Revista de Calidad Asistencial: Organo de la Sociedad Española de Calidad Asistencial
https://www.readbyqxmd.com/read/29125346/prevention-and-management-of-incontinence-associated-dermatitis
#10
David Voegeli
David Voegeli, Associate Professor of Nursing, Skin Health Research Group, Faculty of Health Sciences, University of Southampton, discusses the care of patients with incontinence-associated dermatitis and how to distinguish this condition from pressure ulcers.
November 9, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29120687/a-100-patient-clinical-evaluation-of-an-alternating-pressure-replacement-mattress-in-a-home-based-setting
#11
Jackie Stephen-Haynes, Rosie Callaghan
BACKGROUND: alternating pressure air mattresses (APAMs) support the prevention and management of pressure ulcers. A health and care NHS trust was seeking an APAM that would improve clinical outcomes in relation to pressure ulcers while considering financial cost. An APAM existed that could meet the trust's needs but there was a lack of evidence over its use in a community/home setting. This study examined the effect of using the Dual Professional (IQ Medical) APAM for patients at a high risk of pressure ulceration...
November 8, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29119297/pyoderma-gangrenosum-after-orthopaedic-or-traumatologic-surgery-a-systematic-revue-of-the-literature
#12
REVIEW
Stephan Ebrad, Mathieu Severyns, Ahmed Benzakour, Benoit Roze, Christian Derancourt, Guillaume-Anthony Odri, Jean-Louis Rouvillain
INTRODUCTION: Pyoderma gangrenosum (PG) is a neutrophilic dermatosis characterised by a painful ulceration mimicking infection of the operative site. To this day, there is still no general agreement on the medical and surgical treatment of PG. This systematic review of the literature aims to summarise recent studies about post-operative PG in orthopaedic surgery to improve its medical and surgical management. METHOD: In April 2017, we carried out an exhaustive review of the literature in MEDLINE, PubMed and Cochrane databases...
November 8, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29110516/minimally-invasive-distal-metatarsal-diaphyseal-osteotomy-dmdo-for-chronic-plantar-diabetic-foot-ulcers
#13
Carlo Biz, Stefano Gastaldo, Miki Dalmau-Pastor, Marco Corradin, Andrea Volpin, Pietro Ruggieri
BACKGROUND: The aims of this prospective study were first to evaluate the safety and effectiveness of minimally invasive distal metatarsal diaphyseal osteotomies (DMDOs) for treating a consecutive series of diabetic patients with chronic plantar diabetic foot ulcers (CPDFUs) and second to assess their clinical-functional and radiographic outcomes. METHODS: A consecutive series of patients affected by diabetes mellitus with CPDFUs, not responsive to previous nonoperative management, underwent DMDO...
November 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/29109873/the-traumatic-tube-bleeding-rectal-ulcer-caused-by-flexi-seal-device
#14
Abhinav Tiwari, Himani Sharma, Khola Qamar, Yaseen Alastal, Thomas Sodeman, Ali Nawras
Diarrhea and fecal incontinence are common in critically ill patients and present a challenging problem in patient management. The Flexi-Seal® Fecal Management System is a device to divert the stools away from the patient, thus improving the care to patients with fecal incontinence. There have been only few case reports describing the complications with the use of this device. Here, we present a case of a 77-year-old woman who was admitted due to massive hematochezia while on anticoagulation. She was found to have a large rectal ulcer caused by the Flexi-Seal device, used during the last hospital stay for fecal incontinence...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29109666/prevalence-of-pressure-ulcer-and-nutritional-factors-affecting-wound-closure-success-in-thailand
#15
Supakrit Auiwattanakul, Winai Ungpinitpong, Surakrant Yutthakasemsunt, Supawan Buranapin, Kaweesak Chittawatanarat
Introduction: The authors aimed to estimate the prevalence of pressure ulcers and to explore the nutritional effects of the prognostic factors on successful pressure ulcer closure in a public tertiary care hospital in Thailand. Patients and Methods: The study was a retrospective cohort analysis of seven-year census (2008 - 2014) at Surin hospital in Thailand. There were 424 of total 240,826 patients aged over than 15 years admitted to surgery, orthopedics and medicine wards during the study period with documented pressure ulcers (ICD 10TM)...
September 2017: Materia Socio-medica
https://www.readbyqxmd.com/read/29080572/clinical-update-on-nursing-home-medicine-2017
#16
Barbara J Messinger-Rapport, Milta O Little, John E Morley, Julie K Gammack
This is the 11th annual Clinical Update from the AMDA meeting article. This year the topics covered are hypertension after the Systolic Blood Pressure Intervention Trial; chronic obstructive pulmonary disease risk factors, diagnosis and management including end-of-life planning, and the difficulties with exacerbations such as breathlessness; diagnosis and treatment of cognitive impairment and dementia; and wound care and pressure ulcer management.
November 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29075642/chronic-open-infective-lateral-malleolus-bursitis-management-using-local-rotational-flap
#17
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
https://www.readbyqxmd.com/read/29049055/oxidized-regenerated-cellulose-collagen-dressings-review-of-evidence-and-recommendations
#18
Stephanie Wu, Andrew J Applewhite, Jeffrey Niezgoda, Robert Snyder, Jayesh Shah, Breda Cullen, Gregory Schultz, Janis Harrison, Rosemary Hill, Melania Howell, Marcus Speyrer, Howard Utra, Jean de Leon, Wayne Lee, Terry Treadwell
OBJECTIVE: Healthcare systems are being challenged to manage increasing numbers of nonhealing wounds. Wound dressings are one of the first lines of defense in wound management, and numerous options exist. The oxidized regenerated cellulose (ORC)/collagen dressing may offer healthcare providers a robust and cost-effective tool for use in a variety of wounds. DESIGN: A multidisciplinary panel meeting was convened to discuss the use of ORC/collagen dressings in wound care and provide practice recommendations...
November 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29036406/effects-of-computerized-decision-support-system-implementations-on-patient-outcomes-in-inpatient-care-a-systematic-review
#19
Julian Varghese, Maren Kleine, Sophia Isabella Gessner, Sarah Sandmann, Martin Dugas
Objectives: To systematically classify the clinical impact of computerized clinical decision support systems (CDSSs) in inpatient care. Materials and Methods: Medline, Cochrane Trials, and Cochrane Reviews were searched for CDSS studies that assessed patient outcomes in inpatient settings. For each study, 2 physicians independently mapped patient outcome effects to a predefined medical effect score to assess the clinical impact of reported outcome effects. Disagreements were measured by using weighted kappa and solved by consensus...
September 23, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29025198/foam-dressings-for-treating-pressure-ulcers
#20
REVIEW
Rachel M Walker, Brigid M Gillespie, Lukman Thalib, Niall S Higgins, Jennifer A Whitty
BACKGROUND: Pressure ulcers, also known as pressure injuries and bed sores, are localised areas of injury to the skin or underlying tissues, or both. Dressings made from a variety of materials, including foam, are used to treat pressure ulcers. An evidence-based overview of dressings for pressure ulcers is needed to enable informed decision-making on dressing use. This review is part of a suite of Cochrane Reviews investigating the use of dressings in the treatment of pressure ulcers...
October 12, 2017: Cochrane Database of Systematic Reviews
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