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Pressure sores

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https://www.readbyqxmd.com/read/28930780/splinting-after-ear-reconstruction-a-stepwise-and-inexpensive-workflow-protocol
#1
Herman Vercruysse, James I J Green, Gaynor Osman, Brigitte Harrison, Kana Miyagi, Neil W Bulstrode
BACKGROUND: Long-term postoperative splinting plays a role in the prevention of contracture of the grafted skin after a second-stage ear reconstruction. The scar retraction could lead to an unfavorable aesthetic outcome. Splinting could play a role to overcome or prevent the loss of projection and the obliteration of the sulcus. MATERIAL AND METHODS: We have defined the characteristics of an ideal long-term splint and present a stepwise clinical protocol for the fabrication of an ethylene-vinyl acetate splint...
September 19, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28922625/living-and-dying-with-advanced-dementia-a-prospective-cohort-study-of-symptoms-service-use-and-care-at-the-end-of-life
#2
Elizabeth L Sampson, Bridget Candy, Sarah Davis, Anna Buylova Gola, Jane Harrington, Michael King, Nuriye Kupeli, Gerry Leavey, Kirsten Moore, Irwin Nazareth, Rumana Z Omar, Victoria Vickerstaff, Louise Jones
BACKGROUND: Increasing number of people are dying with advanced dementia. Comfort and quality of life are key goals of care. AIMS: To describe (1) physical and psychological symptoms, (2) health and social care service utilisation and (3) care at end of life in people with advanced dementia. DESIGN: 9-month prospective cohort study. SETTING AND PARTICIPANTS: Greater London, England, people with advanced dementia (Functional Assessment Staging Scale 6e and above) from 14 nursing homes or their own homes...
August 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28915955/implications-of-bisphosphonate-calcium-ion-depletion-interfering-with-desmosome-epithelial-seal-in-osseointegrated-implants-and-pressure-ulcers
#3
Louis Z G Touyz, Kelvin I Afrashtehfar
Osteoporosis (OP) is a global bone disease prevalent in aging in humans, especially in older women. Bisphosphonates (BPs) are commonly used as therapy for OP as it influences hard and soft tissues calcium metabolism. Mucosal and dermal ulceration with exposure of underlying bone arises from incomplete epithelial recovery due to reduced desmosome formation deriving from lack of available calcium. Pathological situations such as bisphosphonate-related osteonecrosis of the jaw have been described. This hypothesis states other situations which demand intact functional desmosomes such as healing skin over chronic pressure points leading to pressure ulcers (as well-known as bedsores, pressure sores, pressure injuries, decubitus ulcers), and hemidesmosomes such as epithelial seals in contact with titanium surfaces will have a higher prevalence of breakdown among patients being treated with BPs...
September 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28904657/risk-factors-for-postoperative-throat-pain-after-general-anaesthesia-with-endotracheal-intubation-at-the-university-of-gondar-teaching-hospital-northwest-ethiopia-2014
#4
Biruk Melkamu Gemechu, Endale Gebreegziabher Gebremedhn, Tadesse Belayneh Melkie
INTRODUCTION: Postoperative sore throat is listed from the top as patients' most undesirable outcome in the postoperative period. It is believed to originate from mucosal dehydration or edema, tracheal ischemia secondary to the pressure of endotracheal tube cuffs, aggressive oropharyngeal suctioning, and mucosal erosion from friction between delicate tissues and the endotracheal tube. Even if the problem was indicated in many literatures, it has never been studied in our country. The study aimed to assess prevalence and factors associated with postoperative sore throat among patients who were operated under general anesthesia with endotracheal intubation...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28895290/design-of-a-novel-two-component-hybrid-dermal-scaffold-for-the-treatment-of-pressure-sores
#5
Vaibhav Sharma, Nupur Kohli, Dale Moulding, Halimat Afolabi, Lilian Hook, Chris Mason, Elena García-Gareta
The aim of this study is to design a novel two-component hybrid scaffold using the fibrin/alginate porous hydrogel Smart Matrix combined to a backing layer of plasma polymerized polydimethylsiloxane (Sil) membrane to make the fibrin-based dermal scaffold more robust for the treatment of the clinically challenging pressure sores. A design criteria are established, according to which the Sil membranes are punched to avoid collection of fluid underneath. Manual peel test shows that native silicone does not attach to the fibrin/alginate component while the plasma polymerized silicone membranes are firmly bound to fibrin/alginate...
September 12, 2017: Macromolecular Bioscience
https://www.readbyqxmd.com/read/28877110/predictors-of-intraoperative-pressure-injury-in-patients-undergoing-major-hepatobiliary-surgery
#6
Yan Chen, Li He, Wei Qu, Chen Zhang
PURPOSE: The purpose of this study was to identify risk factors associated with pressure injury (PI) development in patients undergoing major hepatobiliary surgery requiring general anesthesia. DESIGN: Retrospective medical review and analysis. SUBJECTS AND SETTING: Medical records from 803 patients undergoing hepatobiliary surgery from October 2015 to October 2016 were reviewed. The study setting was a 3400-bed military academic medical center in the northeast region of China...
September 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28877109/the-efficacy-of-a-viscoelastic-foam-overlay-on-prevention-of-pressure-injury-in-acutely-ill-patients-a-prospective-randomized-controlled-trial
#7
Kyung Hee Park, Joohee Park
PURPOSE: The purpose of this study was to compare a viscoelastic foam overlay (VEFO) to a standard hospital mattress for pressure injury (PI) prevention. We also compared interface pressures (IPs) of the VEFO to our facility's standard hospital mattress. DESIGN: Prospective, randomized controlled trial. SUBJECTS AND SETTING: Data analysis was based on 110 participants (55 in each group) who were 19 years or older, had a Braden Scale for Pressure Sore Risk score of 16 or less, and were cared for on a neurology, oncology, or pulmonology inpatient care unit...
September 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28877108/prevention-of-heel-pressure-injuries-and-plantar-flexion-contractures-with-use-of-a-heel-protector-in-high-risk-neurotrauma-medical-and-surgical-intensive-care-units-a-randomized-controlled-trial
#8
Tina Meyers
PURPOSE: The purpose of this study was to compare the use of a heel protector to standard of care (pillows) in the prevention of hospital-acquired pressure injuries (HAPI) of the heels and prevention of plantar flexion contractures. DESIGN: Randomized controlled trial. SUBJECTS AND SETTING: The study took place on a surgical intensive care unit, medical intensive care unit, and neurotrauma intensive care unit. Inclusion criteria were a minimum of 5 days of sedation related to care for a critical illness, immobility for 6 to 8 hours before study initiation, a Braden Scale for Pressure Sore Risk score 18 or less, and a mobility subscale score 2 or less...
September 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28873882/not-just-the-right-to-a-wheelchair-but-the-right-wheelchair-improving-brazilian-wheelchair-service-delivery
#9
Tulio Maximo, Laurence Clift
This paper discusses the barriers encountered before and after the implementation of good practice in the delivery of wheelchair provision services in Belo Horizonte city, Brazil. The results demystify some participants' initial idea that using an assessment form might take significantly more time. Major barriers to implementation had regard to the assessment of pressure sores and a lack of wheelchair suppliers.
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28868990/the-effects-of-whole-body-vibration-on-pulse-wave-velocity-in-men-with-chronic-spinal-cord-injury
#10
Julia O Totosy de Zepetnek, Masae Miyatani, Maggie Szeto, Lora M Giangregorio, B Catharine Craven
Objective A pilot study to evaluate the therapeutic potential of 40 weeks of passive standing with whole body vibration (PS-WBV) on central and peripheral arterial stiffness among men with chronic spinal cord injury (SCI). Methods Consenting participants were pre-screened to ensure safe participation. Fifteen individuals with chronic SCI were enrolled to participate in PS-WBV sessions three times per week for 40 weeks on a modified WAVE platform custom-fitted with an EASYStand 5000. Knee angle was set at 160°, and vibration parameters were 45Hz frequency and 0...
September 4, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28854522/an-investigation-on-effects-of-amputee-s-physiological-parameters-on-maximum-pressure-developed-at-the-prosthetic-socket-interface-using-artificial-neural-network
#11
Chitresh Nayak, Amit Singh, Himanshu Chaudhary, Deepak Rajendra Unune
Technological advances in prosthetics have attracted the curiosity of researchers in monitoring design and developments of the sockets to sustain maximum pressure without any soft tissue damage, skin breakdown, and painful sores. Numerous studies have been reported in the area of pressure measurement at the limb/socket interface, though, the relation between amputee's physiological parameters and the pressure developed at the limb/socket interface is still not studied. Therefore, the purpose of this work is to investigate the effects of patient-specific physiological parameters viz...
August 1, 2017: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/28828364/prone-positioning-acute-respiratory-distress-syndrome-patients
#12
REVIEW
Claude Guérin
Prone position has been used in acute respiratory distress syndrome (ARDS) patients for more than 40 years in ICU. After having demonstrated its capability to significantly improve oxygenation in a large number of patients, sometimes dramatically, this procedure has been found to prevent ventilator-induced lung injury, the primary concern for the intensivists managing ARDS patients. Over the time, several trials have been done, which regularly improved and refined from each other. At the end, significant improvement in survival has been demonstrated in the most severe ARDS patients, at a threshold of 100-150 mmHg PaO2/FiO2 ratio...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28767166/radiological-anatomy-of-the-perforators-of-the-gluteal-region-the-radiosome-based-anatomy
#13
Enrico Vigato, Eleonora De Antoni, Cesare Tiengo, Andrea Porzionato, Cinzia Tortorella, Maurizio Governa, Veronica Macchi, Raffaele De Caro
BACKGROUND: The superior (SGA) and the inferior gluteal artery (IGA) perforator flaps are widely used in pressure-sore repair and in breast reconstruction. The aim was to exhaustively depict the topographical anatomy of the whole system of perforators in the buttock. METHODS: Eighty lower-extremity computed tomographic angiography (CTA) of patients (20 males/20 females, mean age 61-years old, range 38-81) were considered. The source artery, location, type, and caliber of gluteal perforators were analyzed...
August 2, 2017: Microsurgery
https://www.readbyqxmd.com/read/28764268/comparison-between-two-endotracheal-tube-cuff-inflation-methods-just-seal-vs-stethoscope-guided
#14
Rishiraj Borhazowal, Minal Harde, Rakesh Bhadade, Sona Dave, Swapnil Ganeshrao Aswar
INTRODUCTION: The Endotracheal Tube (ETT) cuff performs a critical function of sealing the airway during positive pressure ventilation. There is a narrow range of cuff pressure required to maintain a functionally safe seal without exceeding capillary blood pressure. AIM: We aimed to compare Just-Seal (JS) and Stethoscope-Guided (SG) method of ETT cuff inflation with respect to the volume of air required to inflate the cuff, the manometric cuff pressure achieved and also to assess for the occurrence of postoperative sore throat after extubation in both the groups...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28746268/101-consecutive-profunda-artery-perforator-flaps-in-breast-reconstruction-lessons-learned-with-our-early-experience
#15
Nicholas T Haddock, Andrew Gassman, Min-Jeong Cho, Sumeet S Teotia
BACKGROUND: Free and local flaps based on the profunda artery perforators were first used for reconstruction of pressure sores, burn contractures, and extremity wounds. Recently, a revised profunda artery perforator flap was introduced for breast reconstruction. However, despite increasing reports of the use of the flap, it remains a rarely used option. The authors present their early experience with the first 101 profunda artery perforator flaps used for breast reconstruction at their institution...
August 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28742609/the-efficacy-of-dynamic-contract-relax-stretching-on-delayed-onset-muscle-soreness-among-healthy-individuals-a-randomized-clinical-trial
#16
Yanfei Xie, Beibei Feng, Kedi Chen, Lars L Andersen, Phil Page, Yuling Wang
OBJECTIVE: To evaluate the efficacy of dynamic contract-relax stretching on delayed-onset muscle soreness (DOMS) in the calf muscle of healthy individuals. DESIGN: Randomized clinical trial. SETTING: Research laboratory. PARTICIPANTS: Three groups of 16 healthy participants (n = 48) were recruited by convenience sampling. INTERVENTIONS: Three sets of resisted bilateral heel-raising exercises until exhaustion were conducted to initiate DOMS...
July 21, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/28741716/influence-of-lateral-position-and-pneumoperitoneum-on-oropharyngeal-leak-pressure-with-two-types-of-laryngeal-mask-airways
#17
S Lan, Y Zhou, J T Li, Z Z Zhao, Y Liu
BACKGROUND: An important parameter to monitor adequate ventilation for laryngeal mask airway (LMA) is its oropharyngeal leak pressure (OLP). This study was designed to evaluate and compare the effect of lateral position and pneumoperitoneum on the OLP and ventilation efficiency between LMA™ Proseal (PLMA) and LMA™ Supreme (SLMA). METHODS: Patients were randomized to receive either the PLMA or the SMLA. The OLP was assessed in both the supine position and the lateral position with or without pneumoperitoneum...
July 25, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28736958/intraoperative-indocyanine-green-fluorescent-angiography-assisted-modified-superior-gluteal-artery-perforator-flap-for-reconstruction-of-sacral-pressure-sores
#18
Chun-Kai Chang, Chien-Ju Wu, Chun-Yu Chen, Chi-Yu Wang, Tzi-Shiang Chu, Kuo-Feng Hsu, Han-Ting Chiu, Hung-Hui Liu, Chang-Yi Chou, Chih-Hsin Wang, Chin-Ta Lin, Niann-Tzyy Dai, Yuan-Sheng Tzeng
Pressure sores are often observed in patients who are bedridden. They can be a severe problem not only for patients and their caregivers but also for plastic surgeons. Here, we describe a new method of superior gluteal artery perforator flap harvesting and anchoring with the assistance of intraoperative indocyanine green fluorescent angiography. In this report, we describe the procedure and outcomes for 19 patients with grades III and IV sacral pressure sores who underwent the operation between September 2015 and November 2016...
July 23, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28727896/proseal-versus-classic-laryngeal-mask-airway-lma-for-positive-pressure-ventilation-in-adults-undergoing-elective-surgery
#19
REVIEW
Muhammad Qamarul Hoda, Khalid Samad, Hameed Ullah
BACKGROUND: The development of supraglottic airway devices has revolutionized airway management during general anaesthesia. Two devices are widely used in clinical practice to facilitate positive pressure ventilation: the ProSeal laryngeal mask airway (pLMA) and the Classic laryngeal mask airway (cLMA). It is not clear whether these devices have important clinical differences in terms of efficacy or complications. OBJECTIVES: To compare the effectiveness of the ProSeal laryngeal mask airway (pLMA) and the Classic LMA (cLMA) for positive pressure ventilation in adults undergoing elective surgery...
July 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28707450/a-simple-concept-for-covering-pressure-sores-wound-edge-based-propeller-perforator-flap
#20
Osman Kelahmetoglu, Koenraad Van Landuyt, Caglayan Yagmur, Casper E Sommeling, Musa K Keles, Volkan Tayfur, Tekin Simsek, Yener Demirtas, Ethem Guneren
We present a new surgical modification to allow propeller perforator flaps to cover pressure sores at various locations. We used a propeller perforator flap concept based on the detection of newly formed perforator vessels located 1 cm from the wound margin and stimulated by the chronic inflammation process. Between January 2009 and January 2017, 33 wound edge-based propeller perforator flaps were used to cover pressure sores at various locations in 28 patients. In four cases more than one flap was used on the same patient...
July 13, 2017: International Wound Journal
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