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"Pressure ulcers"

Lee Squitieri, Daniel A Waxman, Carol M Mangione, Debra Saliba, Clifford Y Ko, Jack Needleman, David A Ganz
OBJECTIVES: To evaluate national present-on-admission (POA) reporting for hospital-acquired pressure ulcers (HAPUs) and examine the impact of quality measure exclusion criteria on HAPU rates. DATA SOURCES/STUDY SETTING: Medicare inpatient, outpatient, and nursing facility data as well as independent provider claims (2010-2011). STUDY DESIGN: Retrospective cross-sectional study. DATA COLLECTION/EXTRACTION METHODS: We evaluated acute inpatient hospital admissions among Medicare fee-for-service (FFS) beneficiaries in 2011...
January 25, 2018: Health Services Research
Sérgio Dos Anjos Garnes, Adriana Bottoni, Fernanda Lasakosvitsch, Andrea Bottoni
OBJECTIVE: This study developed an instrument in table format to help determine the energy requirements of patients in adverse situations. The instrument allows for the weekly adjustment of nutrition therapy and energy intake, advocating a new approach to treatment based on clinical observation performed by staff specialized in individualized nutrition therapy. METHODS: The table was elaborated by grouping patients according to the following criteria: criticality, chronicity, and stability of the clinical status...
February 3, 2018: Nutrition
Bastiaan Van Grootven, Lynn McNicoll, Daniel A Mendelson, Susan M Friedman, Katleen Fagard, Koen Milisen, Johan Flamaing, Mieke Deschodt
OBJECTIVE: To find consensus on appropriate and feasible structure, process and outcome indicators for the evaluation of in-hospital geriatric co-management programmes. DESIGN: An international two-round Delphi study based on a systematic literature review (searching databases, reference lists, prospective citations and trial registers). SETTING: Western Europe and the USA. PARTICIPANTS: Thirty-three people with at least 2 years of clinical experience in geriatric co-management were recruited...
March 16, 2018: BMJ Open
Marco Artico, Daniela D'Angelo, Michela Piredda, Tommasangelo Petitti, Luciano Lamarca, Maria Grazia de Marinis, Angelo Dante, Maura Lusignani, Maria Matarese
CONTEXT: Patients with advanced illnesses show the highest prevalence for pressure ulcers. In the palliative care setting the ultimate goal is injury healing, but equally important is wound maintenance, wound palliation (wound-related pain and symptom management), and primary and secondary wound prevention. OBJECTIVES: To describe the course of healing for pressure ulcers in a home palliative care setting according to different end-points, and to explore patient and caregiver characteristics and specific care activities associated with their achievement...
March 13, 2018: Journal of Pain and Symptom Management
Angela D Rowe, Karen McCarty, Amy Huett
PURPOSE: A large, freestanding pediatric hospital in the southern United States saw a 117% increase in reported hospital acquired pressure injuries (HAPI) between 2013 and 2015, with the intensive care units being the units of highest occurrence. Design and Methods A quality improvement project was designed and implemented to assist with pressure injury prevention. Literature review confirmed that pediatric HAPIs are a challenge and that usage of bundles and user-friendly guidelines/pathways can help eliminate barriers to prevention...
March 13, 2018: Journal of Pediatric Nursing
Zhen Li, Xinmei Zhou, Jing Cao, Zheng Li, Xia Wan, Jiaqian Li, Jing Jiao, Ge Liu, Ying Liu, Fangfang Li, Baoyun Song, Jingfen Jin, Liu Yilan, Xianxiu Wen, Shouzhen Cheng, Xinjuan Wu
AIMS AND OBJECTIVES: To gain insight into nurses' knowledge and attitudes regarding major immobility complications (pressure ulcers, pneumonia, deep vein thrombosis and urinary tract infections) and explore the correlation of nurses' knowledge and attitudes with the incidence of these complications. BACKGROUND: Immobility complications have adverse consequences, and effective management requires appropriate knowledge, attitudes and skills. Evidence about nurses' knowledge and attitudes regarding immobility complications is lacking...
March 15, 2018: Journal of Clinical Nursing
Modupeola Omotara Samaila, Halima Oziohu Aliyu, Lazarus Mungu Yusufu, Shehu Abdullahi
Pseudoangiomatous stromal hyperplasia (PASH) is an uncommon benign mesenchymal tumor of the breast. Majority occur as diffuse lesions, and diagnosis is often incidental or in a background of other breast pathologies. Bilaterality with multiple tumoral masses in giant breasts is a rarity. We report a 34-year-old nonlactating female with 2-year history of rapid progressive painless bilateral enlargement of the breasts following surgical excision of ill-defined breast lumps which were not subjected to histopathological evaluation a year earlier...
April 2018: Annals of African Medicine
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
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
Kerri Elsabrout, Eleanor Orbacz, Leigh Anne McMahon, Susan Apold
BACKGROUND: Identifying strategies to protect patients most at risk for hospital-acquired pressure ulcers (HAPU) is essential. HAPUs have significant impact on patients and their families and have profound cost and reimbursement implications. AIMS: This article describes the successful implementation of a hospital-wide mattress switch-out program using a Multidisciplinary Task Force, which resulted in a decrease in HAPUs and significant cost savings. RESULTS: As a result of this quality improvement project supported by evidence, the hospital realized a 66...
March 8, 2018: Worldviews on Evidence-based Nursing
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
Chi Ching Goh, Maximilien Evrard, Shu Zhen Chong, Yingrou Tan, Leonard De Li Tan, Karen Wei Weng Teng, Wolfgang Weninger, David Laurence Becker, Hong Liang Tey, Evan William Newell, Bin Liu, Lai Guan Ng
Pressure ulcers are a chronic problem for patients or the elderly who require extended periods of bed rest. The formation of ulcers is due to repeated cycles of ischemia-reperfusion (IR), which initiates an inflammatory response. Advanced ulcers disrupt the skin barrier, resulting in further complications. To date, the immunological aspect of skin IR has been understudied, partly due to the complexity of the skin immune cells. Through a combination of mass cytometry, confocal imaging and intravital multiphoton imaging, this study establishes a workflow for multidimensionality single cell analysis of skin myeloid responses in the context of IR injury with high spatiotemporal resolution...
March 6, 2018: European Journal of Immunology
Hideyuki Yanagi, Hiroto Terashi, Yoshimitsu Takahashi, Katsuyuki Okabe, Katsumi Tanaka, Chu Kimura, Norihiko Ohura, Takahiro Goto, Ichiro Hashimoto, Madoka Noguchi, Junichi Sasayama, Kenichi Shimada, Ayumi Sugai, Mitsuko Tanba, Takeo Nakayama, Ryoji Tsuboi, Junko Sugama, Hiromi Sanada
OBJECTIVE: To clarify the surgical indications and the appropriate perioperative management of ischial pressure ulcers (PUs). METHOD: A two-year prospective, nationwide registry study was carried out across 26 medical institutions in Japan. All participating institutions managed ischial PUs according to the standardisation of total management and surgical application for the refractory decubitus (STANDARDS-I) perioperative protocol. Analysis was conducted on a range of clinically or statistically important variables for the achievement of primary or secondary endpoints: complete wound healing and hospital discharge at three months, and complete wound healing at one month after surgery, respectively...
March 2, 2018: Journal of Wound Care
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
Abhishek Jairam, Ping Song, Nirav B Patel, Michael S Wong
BACKGROUND: The National Pressure Ulcer Advisory Panel estimates pressure sore care to approach $11 billion annually. It is not uncommon for these patients to present to the emergency department (ED) with a chief concern of a pressure sore, while concurrently carrying an undiagnosed infectious process that is the culprit for the acute presentation, rather than the chronic pressure injury. We aim to identify patients who met systemic inflammatory response syndrome (SIRS) criteria at ED presentation who were referred to plastic and reconstructive surgery for pressure sore debridement prior to a complete medical workup...
February 27, 2018: Annals of Plastic Surgery
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
Chi-Yu Wang, Chien-Ju Wu, Tzi-Shiang Chu, Chun-Yu Chen, Chang-Yi Chou, Hao-Yu Chiao, Chun-Kai Chang, Niann-Tzyy Dai
Many types of flaps are available if surgical reconstruction of a pressure ulcer is indicated, including a gluteus maximus flap, V-Y advancement flap, and superior gluteal artery perforator flap. Regional flap failure can complicate treatment, requiring additional flap surgery. An 80-year old woman with a 2-year history of being unconscious following a cerebrovascular accident presented with a Stage 4 sacral pressure ulcer of 2 months' duration with eschar and abscess formation. Because the wound measured 15 × 10 cm2, bilateral V-Y advancement flaps were used for surgical closure...
February 2018: Ostomy/wound Management
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
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