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Anand Pandey, Vipin Gupta, Shailendra P Singh, Vijendra Kumar, Rajesh Verma
A trophic ulcer is a pressure ulcer caused by external trauma to a part of the body that is compromised due to disease, vascular insufficiency, or loss of afferent nerve fibers. Spinal dysraphism (ie, neural tube defects [NTD]) such as meningomyelocele is a risk factor for developing these ulcers in adults and pediatric patients. Information regarding the occurrence of trophic ulcers in pediatric patients with NTD is lacking. A review of the English-language literature on skin/neuropathic ulcers in patients with NTDs, irrespective of study design, published between 1975 and 2014, was undertaken using the PubMed database...
December 2015: Ostomy/wound Management
Zena Eh Moore, Menno T van Etten, Jo C Dumville
BACKGROUND: Pressure ulcers, which are localised injury to the skin or underlying tissue, or both, occur when people are unable to reposition themselves to relieve pressure on bony prominences. Pressure ulcers are often difficult to heal, painful, and impact negatively on the individual's quality of life. International guidelines suggest bed rest as a component of the treatment strategy to manage pressure ulcers among wheelchair users. The potential benefits and risks need to be considered when assessing the effectiveness of bed rest as an intervention for treating pressure ulcers in this population...
October 17, 2016: Cochrane Database of Systematic Reviews
Luis D Pacheco, Antonio F Saad, Gary D V Hankins, Giuseppe Chiosi, George Saade
Guillain-Barré syndrome has been reported in pregnancy and is a potentially lethal condition. It affects the nervous system with acute onset of symmetric ascending weakness and may result in frank respiratory failure and autonomic dysfunction. Most patients recall symptoms of a respiratory or gastrointestinal illness in the weeks preceding the onset of weakness. Recent evidence suggests a potential role of the Zika virus as a trigger for the syndrome. The diagnosis of Guillain-Barré is clinical. Supportive measures include venous thromboembolism prophylaxis, aggressive physical therapy, pressure ulcer prevention, enteral nutrition, and respiratory support...
October 6, 2016: Obstetrics and Gynecology
Mesut Mutluoglu, Gunalp Uzun, Michael Bennett, Peter Germonpré, David Smart, Daniel Mathieu
Diabetic foot ulcers (DFUs) are one of the most common indications for hyperbaric oxygen treatment (HBOT). The role of HBOT in DFUs is often debated. Recent evidence based guidelines, while recommending its use, urge further studies to identify the patient subgroups most likely to benefit from HBOT. A recent study in Diabetes Care aimed to assess the efficacy of HBOT in reducing the need for major amputation and improving wound healing in patients with chronic DFUs. In this study, patients with Wagner grade 2-4 diabetic foot lesions were randomly assigned to have HBOT (30 sessions/90 min/244 kPa) or sham treatment (30 sessions/90 min/air/125 kPa)...
September 2016: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
Brian Jarrett, Michael Secko
BACKGROUND: Choroid detachment is a rare disease process that has a multitude of etiologies; usually related to recent ophthalmological surgery, eye trauma, corneal ulcers, or intraocular pressure-lowering agents. Point-of-care ocular ultrasound has high utility and accuracy in diagnosing pathology of the eye. CASE REPORT: We present a case of a patient who presented with vision loss caused by a choroid detachment diagnosed on point-of-care ultrasound because fundoscopic examination was limited due to cataracts...
October 3, 2016: Journal of Emergency Medicine
Igal Kushnir, Alon Kushnir, Thomas E Serena, Doron Garfinkel
INTRODUCTION: The objective of this pilot study was to evaluate the efficacy and safety of a novel method using an autologous whole blood clot formed with the RedDress Wound Care System (RD1, RedDress Ltd, Israel), a provisional whole blood clot matrix used in the treatment of chronic wounds of various etiologies. METHODS AND MATERIALS: Patients were treated at the bedside with the whole blood clot matrix. Blood was withdrawn from each patient using citrate, mixed with a calcium gluconate/kaolin suspension, and injected into an RD1 clotting tray...
September 2016: Wounds: a Compendium of Clinical Research and Practice
Michele Ammendola, Rosario Sacco, Lucia Butrico, Giuseppe Sammarco, Stefano de Franciscis, Raffaele Serra
Diabetic foot ulcerations may determine minor or major amputation, with a high impact on patients' life expectation and quality of life and on economic burden. Among minor amputations, transmetatarsal amputation (TMA) appears to be the most effective in terms of limb salvage rates and in maintaining foot and ankle biomechanics. In spite of this, TMA needs particular pre- and postoperative management in order to avoid the frequent failure rates. A systematic review was undertaken of studies concerning TMA and its care in diabetic foot gangrene...
October 3, 2016: International Wound Journal
Luca Dalla Paola, Anna Carone, Giulio Boscarino, Giuseppe Scavone, Lucian Vasilache
Diabetic hindfoot ulcers, complicated by osteomyelitis, are associated with a high risk of major amputation. Partial calcanectomy, preceded by an effective management of the infection and of the eventual peripheral artery disease, can be considered as valid therapeutic option. We have evaluated a therapeutic protocol for diabetic hindfoot ulcers complicated by osteomyelitis, which, besides an adequate surgical debridement, considers a reconstructive pathway assisted by the positioning of a circular external fixator...
September 29, 2016: International Journal of Lower Extremity Wounds
Lei Lin, Chris Wade
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Shingo Chihara, Kentaro Sawada, Hiroshi Tomoeda, Shigeaki Aoyagi
We report a case of pulsatile varicose veins successfully managed by endovenous laser treatment (EVLT) of the great saphenous vein (GSV). A 77-year-old woman taking an anticoagulant was transferred to our hospital for pulsatile varicose veins complicated with repeated venous bleeding from an ulcer of her left lower leg. Doppler echocardiography showed severe tricuspid regurgitation, and duplex ultrasonography revealed an arterial-like pulsating flow in the saphenofemoral junction and along the GSV, but an arteriovenous fistula, obstruction of the deep veins, and the distal incompetent perforators were not detected...
September 22, 2016: Annals of Vascular Surgery
H E W de Laat, A C de Munter, M J van der Burg, D J O Ulrich, O Kloeters
INTRODUCTION: Little is known about health activation and self-management behavior in preventing pressure ulcers (PU) in paraplegic patients. Therefore this study aimed to describe the extent of health activation and self-management behavior in paraplegics to prevent PU's and associations between this behavior and patient characteristics. Furthermore, we aimed to find differences in health activation in paraplegics who never had a PU compared to paraplegics with a previous history of PU's or a new-onset PU's...
August 24, 2016: Journal of Tissue Viability
Ekta Agarwal, Skye Marshall, Michelle Miller, Elisabeth Isenring
In developed countries the prevalence of protein-energy malnutrition increases with age and multi-morbidities increase nutritional risk in aged care residents in particular. This paper presents a narrative review of the current literature on the identification, prevalence, associated risk factors, consequences, and management of malnutrition in the residential aged care (RAC) setting. We performed searches of English-language publications on Medline, PubMed, Ovid and the Cochrane Library from January 1, 1990 to November 25, 2015...
October 2016: Maturitas
Eunhee Lee, Jinhyun Kim
PURPOSE: In this study the costs and benefits of a home health care program were examined to evaluate the economic feasibility of the program. METHODS: The study participants included 349 patients in the community who had been registered at a home health care center for 5 years. The costs and benefits of the program were analyzed using performance data and health data. The benefits were classified as the effects of pressure ulcer care, skin wound care and catheters management...
August 2016: Journal of Korean Academy of Nursing
M Haiun, D Feuvrier, T Bayti, I Pluvy, J Pauchot
INTRODUCTION: Retrospective study about pressure ulcers surgical treatments in a series of 61 in 43 patients. OBJECTIVE: To assess the management of pressure ulcers in spinal cord injury patients who had been operated in our institution. RESULTS: On the 61 pressure ulcers, location was ischial in 35 cases, sacral in 15 cases, trochanteric in 7 cases, lateral malleolar in 2 cases, on the heel in 1 case, and 1 was located lateral to the fibular head...
September 7, 2016: Annales de Chirurgie Plastique et Esthétique
Justine Baron, Jillian Swaine, J Presseau, Arlene Aspinall, Susan Jaglal, Barry White, Dalton Wolfe, Jeremy Grimshaw
BACKGROUND: Pressure ulcers are a serious, common, lifelong, and costly secondary complication of spinal cord injury (SCI). Community-dwelling people with a SCI can prevent them with appropriate skin care (i.e. pressure relieving activities, skin checks). Adherence to skin care remains suboptimal however, and self-management interventions that focus on improving this have been designed. Little is known on their content, effectiveness, or theoretical basis. The aim of the proposed systematic review is to synthesize the literature on self-management interventions to improve skin care in people with a SCI...
2016: Systematic Reviews
Sylvie Hampton
The district nurse and community nurse has a duty of care to provide the most appropriate care for any individual who is at risk of pressure injury. This is often difficult as time constraints mean that education can be absent or reliant on other nurses who may not be up to date with the latest thinking on prevention. Also, district and community nurses cannot be in a patient's home 24 hours a day in order to provide the turning regime that is required for prevention of pressure ulcers. Therefore, they are reliant on education for the carers and provision of the most appropriate equipment for the individual patient...
September 2016: British Journal of Community Nursing
Jan Shepherd
Venous leg ulceration (VLU) is a chronic condition associated with chronic venous insufficiency (CVI), where the most frequent complication is recurrence of ulceration after healing. Traditionally, graduated compression therapy has been shown to increase healing rates and also to reduce recurrence of VLU. Graduated compression occurs because the circumference of the limb is narrower at the ankle, thereby producing a higher pressure than at the calf, which is wider, creating a lower pressure. This phenomenon is explained by the principle known as Laplace's Law...
September 2016: British Journal of Community Nursing
Sandra F Simmons, Susan Bell, Avantika A Saraf, Chris S Coelho, Emily A Long, J M L Jacobsen, John F Schnelle, Eduard E Vasilevskis
OBJECTIVES: To assess multiple geriatric syndromes in a sample of older hospitalized adults discharged to skilled nursing facilities (SNFs) and subsequently to home to determine the prevalence and stability of each geriatric syndrome at the point of these care transitions. DESIGN: Descriptive, prospective study. SETTING: One large university-affiliated hospital and four area SNFs. PARTICIPANTS: Fifty-eight hospitalized Medicare beneficiaries discharged to SNFs (N = 58)...
September 2, 2016: Journal of the American Geriatrics Society
Apirag Chuangsuwanich, Tananchai Assadamongkol, Dheerawan Boonyawan
Pressure ulcers are difficult to treat. Recent reports of low-temperature atmospheric-pressure plasma (LTAPP) indicated its safe and effectiveness in chronic wound care management. It has been shown both in vitro and vivo studies that LTAPP not only helps facilitate wound healing but also has antimicrobial efficacy due to its composition of ion and electron, free radicals, and ultraviolet ray. We studied the beneficial effect of LTAPP specifically on pressure ulcers. In a prospective randomized study, 50 patients with pressure ulcers were divided into 2 groups: Control group received standard wound care and the study group was treated with LTAPP once every week for 8 consecutive weeks in addition to standard wound care...
August 31, 2016: International Journal of Lower Extremity Wounds
Olivia B Hughes, Adele Rakosi, Flor Macquhae, Ingrid Herskovitz, Joshua D Fox, Robert S Kirsner
BACKGROUND: Wound healing is a dynamic process whereby cells, growth factors (GFs), and the extracellular matrix (ECM) interact to restore the architecture of damaged tissue. Chronic wounds can be difficult to treat due to the increased presence of inflammatory cells that degrade the ECM, GF, and cells necessary for wound healing to occur. Cellular and acellular matrix products can be used in the management of a variety of chronic wounds including venous, diabetic, and pressure ulcers and other conditions such as burns, epidermolysis bullosa, pyoderma gangrenosum, and surgical wounds...
September 2016: Plastic and Reconstructive Surgery
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