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Pressure Ulcers

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https://www.readbyqxmd.com/read/28203494/flap-reconstruction-for-pressure-ulcers-an-outcomes-analysis
#1
Ravinder Bamba, James J Madden, Ashley N Hoffman, Justine S Kim, Wesley P Thayer, Lillian B Nanney, Marcia E Spear
BACKGROUND: Historically, complication rates after pressure ulcer reconstruction utilizing flap coverage have been high. Patients undergoing operations for pressure ulcer coverage typically have multiple risk factors for postoperative complications. The purpose of this study was to examine a large patient series in the pressure ulcer population to uncover objective evidence of the linkage between risk factors and outcomes after flap coverage. METHODS: This study was a retrospective chart review of patients who underwent flap reconstruction for a pressure ulcer between 1997 and 2015...
January 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28203074/temperature-and-ph-sensitive-wearable-materials-for-monitoring-foot-ulcers
#2
Pietro Salvo, Nicola Calisi, Bernardo Melai, Valentina Dini, Clara Paoletti, Tommaso Lomonaco, Andrea Pucci, Fabio Di Francesco, Alberto Piaggesi, Marco Romanelli
Foot ulcers account for 15% of comorbidities associated with diabetes. Presently, no device allows the status of foot ulcers to be continuously monitored when patients are not hospitalized. In this study, we describe a temperature and a pH sensor capable of monitoring diabetic foot and venous leg ulcers developed in the frame of the seventh framework program European Union project SWAN-iCare (smart wearable and autonomous negative pressure device for wound monitoring and therapy). Temperature is measured by exploiting the variations in the electrical resistance of a nanocomposite consisting of multiwalled carbon nanotubes and poly(styrene-b-(ethylene-co-butylene)-b-styrene)...
2017: International Journal of Nanomedicine
https://www.readbyqxmd.com/read/28198660/prediction-of-functional-recovery-six-months-following-traumatic-spinal-cord-injury-during-acute-care-hospitalization
#3
Andréane Richard-Denis, Debbie Feldman, Cynthia Thompson, Jean-Marc Mac-Thiong
OBJECTIVES: To determine factors associated with functional status six months following a traumatic cervical and thoracic spinal cord injury (SCI), with a particular interest in factors related to the acute care hospitalization stay. DESIGN: This is a prospective cohort study. Sixteen potential predictive variables were studied. Univariate regression analyses were first performed to determine the strength of association of each variable independently with the total Spinal Cord Independence Measure (SCIM) score...
February 15, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28198336/managing-tissue-viability-issues-in-patients-with-cancer-approaching-the-end-of-life
#4
Kenneth Robert Ripley, Mark Collier
This article provides an overview of tissue viability issues related to the care of patients with cancer who are approaching the end of life. Altered physiology as a result of various factors, including nutrition, medication and radiotherapy, is identified. The article discusses the presentation and treatment of cutaneous radiation injury, malignant wounds, pressure ulcers and Skin Changes At Life's End (SCALE), an acronym used to describe a set of clinical phenomena associated with skin changes in patients approaching the end of life, and makes recommendations for practice...
February 15, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28198150/the-effectiveness-of-negative-pressure-therapy-on-infected-wounds-preliminary-results
#5
Federico Lo Torto, Marco Ruggiero, Paola Parisi, Zachary Borab, Manuel Sergi, Bruno Carlesimo
Vacuum-assisted closure (VAC) therapy is a sophisticated system that maintains a closed, humid, sterile and isolated environment. Wound infection is considered a relative contraindication. The objective of this study is to extend the indications for VAC therapy to include infected wounds by demonstrating its ability to increase the antibiotic concentration in the damaged and infected tissues. Patients who presented with ulcers infected with daptomycin-sensitive bacteria were eligible to be enrolled in this prospective study...
February 15, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28195000/prevention-of-tracheostomy-related-hospital-acquired-pressure-ulcers
#6
Thomas R O'Toole, Natalie Jacobs, Brian Hondorp, Laura Crawford, Lisa R Boudreau, Jill Jeffe, Brian Stein, Phillip LoSavio
Objective To determine if standardization of perioperative tracheostomy care procedures decreased the incidence of hospital-acquired tracheostomy-related pressure ulcers. Methods All patients at least 18 years old who underwent placement of a tracheostomy tube in the operating room from July 1, 2014, through June 30, 2015, were cared for postoperatively through an institutionally adopted quality improvement protocol. This included 4 elements: (1) placement of a hydrocolloid dressing underneath the tracheostomy flange in the postoperative period, (2) removal of plate sutures within 7 days of the tracheostomy procedure, (3) placement of a polyurethane foam dressing after suture removal, and (4) neutral positioning of the head...
February 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28194393/resection-osteotomy-for-calcaneus-flattening-after-micro-surgical-flap-technical-note
#7
Mário Yoshihide Kuwae, Edegmar Nunes Costa, Ricardo Pereira da Silva, Alexandre Daher Albieri, Frederico Barra de Moraes
An open fracture of the calcaneus with loss of substance is a challenging injury and requires specialized care, involves high costs, and demands attention despite its lower incidence. The main complications are osteomyelitis, pressure ulcers, and fistulas, as well as pain conditions in the lateral, medial, and plantar regions. This is due to the wide loss of tissue and the change in anatomical conformation of the calcaneus in some cases. However, in cases of flattening of the calcaneus bone, these complications may be prevented or treated successfully...
January 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28194322/sural-artery-perforator-flap-with-posterior-tibial-neurovascular-decompression-for-recurrent-foot-ulcer-in-leprosy-patients
#8
Hossam El-Din Ali Ismail, Mohamed Hassan El Fahar
Introduction: The sensory loss and alteration of the shape of the foot make the foot liable to trauma and pressure, and subsequently cause more callus formation, blisters, and ulcers. Foot ulcers usually are liable to secondary infection as cellulitis or osteomyelitis, and may result in amputations. Foot ulcers are a major problem and a major cause of handicaps in leprosy patients. The current study is to present our clinical experience and evaluate the use of sural flap with posterior tibial neurovascular decompression (PTND) in recurrent foot ulcers in leprosy patients...
2017: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
https://www.readbyqxmd.com/read/28194186/safety-and-effectiveness-of-bone-marrow-cell-concentrate-in-the-treatment-of-chronic-critical-limb-ischemia-utilizing-a-rapid-point-of-care-system
#9
Venkatesh Ponemone, Saniya Gupta, Dalip Sethi, Manish Suthar, Monika Sharma, Richard J Powell, Kenneth Lee Harris, Nungshi Jungla, Priyadarshini Arambam, Upendra Kaul, Ashok Seth, Suhail Bukhari
Critical limb ischemia (CLI) is the end stage of lower extremity peripheral vascular disease (PVD) in which severe obstruction of blood flow results in ischemic rest pain, ulcers and/or gangrene, and a significant risk of limb loss. This open-label, single-arm feasibility study evaluated the safety and therapeutic effectiveness of autologous bone marrow cell (aBMC) concentrate in revascularization of CLI patients utilizing a rapid point-of-care device. Seventeen (17) no-option CLI patients with ischemic rest pain were enrolled in the study...
2017: Stem Cells International
https://www.readbyqxmd.com/read/28193242/process-evaluation-of-a-cluster-randomised-trial-testing-a-pressure-ulcer-prevention-care-bundle-a-mixed-methods-study
#10
Shelley Roberts, Elizabeth McInnes, Tracey Bucknall, Marianne Wallis, Merrilyn Banks, Wendy Chaboyer
BACKGROUND: As pressure ulcers contribute to significant patient burden and increased health care costs, their prevention is a clinical priority. Our team developed and tested a complex intervention, a pressure ulcer prevention care bundle promoting patient participation in care, in a cluster-randomised trial. The UK Medical Research Council recommends process evaluation of complex interventions to provide insight into why they work or fail and how they might be improved. This study aimed to evaluate processes underpinning implementation of the intervention and explore end-users' perceptions of it, in order to give a deeper understanding of its effects...
February 13, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28192845/-scleritis-progress-in-diagnosis-and-therapy
#11
D Pohlmann, U Pleyer
Inflammation of the sclera includes a wide range of morphological changes, which often occur in association with systemic diseases. While episcleritis is mainly harmless, scleritis often proceeds and is characterised by a destructive course. This may lead to important complications, that present as ulcerative keratitis, uveitis or secondary increases in intraocular pressure. As this form of inflammation is severe and there are often underlying diseases, this contribution focusses on differential diagnosis and current therapeutic approaches...
February 13, 2017: Klinische Monatsblätter Für Augenheilkunde
https://www.readbyqxmd.com/read/28188042/molecular-finds-of-pressure-ulcer-a-bioinformatics-approach-in-pressure-ulcer
#12
Eloa Mangabeira Santos, Lucyana Conceição Farias, Sérgio Henrique Sousa Santos, Alfredo Maurício Batista de Paula, Carla Silvana de Oliveira E Silva, André Luiz Sena Guimarães
BACKGROUND: Understanding the biological processes underlying Pressure Ulcer (PU) is an important strategy to identify new molecular targets. Bioinformatics has emerged as an important screening tool for a broad range of diseases. OBJECTIVE: This study aim of the current study is to investigate the protein-protein interaction in the PU context by bioinformatics. METHODS: We performed a search in gene databases, and bioinformatics algorithms were used to generate molecular targets for PU based in silico investigation...
January 28, 2017: Journal of Tissue Viability
https://www.readbyqxmd.com/read/28182537/inter-rater-and-intra-rater-reliability-outcomes-of-a-rapid-bacteria-counting-system-with-pressure-ulcer-samples
#13
G Nakagami, M Mori, M Yoshida, A Kitamura, A Hayashi, T Miyagaki, S Sasaki, J Sugama, H Sanada
OBJECTIVE: Evaluating bacterial load in pressure ulcers (PUs) is key to combat infection; therefore, using technologies to measure bacterial count can be particularly useful. A rapid bacteria counting system was recently developed and introduced to the wound care field. However, its reliability was not established. This cross-sectional study aimed to evaluate the inter-rater and intra-rater reliability of bacterial count using this rapid counting system. METHOD: We took bacterial swabs from patients with category I or greater PUs to assess inter- and intra-rater reliability...
February 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28182533/the-reality-of-routine-practice-a-pooled-data-analysis-on-chronic-wounds-treated-with-tlc-nosf-wound-dressings
#14
K C Münter, S Meaume, M Augustin, P Senet, J C Kérihuel
OBJECTIVE: A number of randomised controlled trials (RCT) have compared control groups with TLC-NOSF dressings (UrgoStart) on chronic wounds. Our aim was to determine whether the clinical trials' results translate into routine management of such wounds, by pooling the data from real-life observational studies. METHOD: Observational studies, conducted in France and Germany, evaluating current practices in patients suffering from non-selected chronic wounds treated with a TLC-NOSF dressing were identified...
February 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28182532/healing-of-an-arterial-leg-ulcer-by-compression-bandaging-a-case-report
#15
C Sanchez, H Partsch
This case report demonstrates that arterial ulcers may heal with compression therapy. The patient was a 72-year-old woman with elevated blood pressure and type II diabetes mellitus, who underwent angiography because of a painful, non-healing ulcer over the shin. The angiography showed multisegment arterial occlusive disease, not amenable to surgical revascularisation. After 4 months of wearing inelastic bandages, with increased pressure over the ulcer area and hypertension and diabetes under control, the patient was pain-free and the ulcer had healed...
February 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28177542/reduced-prevalence-and-severity-of-wounds-following-implementation-of-the-champions-for-skin-integrity-model-to-facilitate-uptake-of-evidence-based-practice-in-aged-care
#16
Helen E Edwards, Anne M Chang, Michelle Gibb, Kathleen J Finlayson, Christina Parker, Maria O'Reilly, Jan McDowell, Patricia Shuter
AIMS: To evaluate the implementation of the Champions for Skin Integrity Model on facilitating uptake of evidence-based wound management and improving skin integrity in residents of aged care facilities BACKGROUND: The incidence of skin tears, pressure injuries and leg ulcers increases with age and such wounds can be a serious issue in aged care facilities. Older adults are not only at higher risk for wounds related to chronic disease, but also injuries related to falls and manual handling requirements...
February 8, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28169293/a-latent-structural-equation-model-of-risk-behaviors-and-pressure-ulcer-outcomes-among-people-with-spinal-cord-injury
#17
C Li, N D DiPiro, J Krause
STUDY DESIGN: Cross-sectional. OBJECTIVE: Our purpose was to develop a latent structural model to demonstrate the relationship between factor structures of risk health behaviors and pressure ulcer (PrU) outcomes among participants with spinal cord injury (SCI). SETTING: Data were collected at a large specialty hospital and analyzed at a medical university in the Southeastern USA. METHODS: In total, 1871 participants with traumatic SCI of at least 1-year duration were recruited...
February 7, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28167343/association-between-ankle-equinus-and-plantar-pressures-in-people-with-diabetes-a-systematic-review-and-meta-analysis
#18
REVIEW
A Searle, M J Spink, A Ho, V H Chuter
BACKGROUND: Diabetes is one of the most common chronic diseases in the world and is associated with a life-time risk of foot ulcer of 12-25%. Diabetes related restriction in ankle joint range of dorsiflexion is proposed to contribute to elevated plantar pressures implicated in the development of foot ulcers. METHODS: A systematic search of EBSCO Megafile Premier (containing MEDLINE, CINAHL, SPORTSdiscus and Academic Search Complete) and The Cochrane Library was conducted to 23rd November 2016...
January 31, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28161027/update-on-traumatic-acute-spinal-cord-injury-part-2
#19
M Mourelo Fariña, S Salvador de la Barrera, A Montoto Marqués, M E Ferreiro Velasco, R Galeiras Vázquez
The aim of treatment in acute traumatic spinal cord injury is to preserve residual neurologic function, avoid secondary injury, and restore spinal alignment and stability. In this second part of the review, we describe the management of spinal cord injury focusing on issues related to short-term respiratory management, where the preservation of diaphragmatic function is a priority, with prediction of the duration of mechanical ventilation and the need for tracheostomy. Surgical assessment of spinal injuries based on updated criteria is discussed, taking into account that although the type of intervention depends on the surgical team, nowadays treatment should afford early spinal decompression and stabilization...
February 1, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28160941/the-topological-phase-diagram-of-cimetidine-a-case-of-overall-monotropy
#20
R Céolin, I B Rietveld
Cimetidine is a histamine H2-receptor antagonist used against peptic ulcers. It is known to exhibit crystalline polymorphism. Forms A and D melt within 0.35 degrees from each other and the enthalpies of fusion are similar as well. The present paper demonstrates how to construct a pressure-temperature phase diagram with only calorimetric and volumetric data available. The phase diagram provides the stability domains and the phase equilibria for the phases A, D, the liquid and the vapor. Cimetidine is overall monotropic with form D the only stable solid phase...
February 1, 2017: Annales Pharmaceutiques Françaises
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