1/23. Treating stage IV pressure ulcers with negative pressure therapy: a case report.Decubitus ulcers remain a significant healthcare concern today, especially in the elderly and immobile population. Following the observation of three Stage IV decubitus ulcers refractory to standard medical and surgical therapy for 10 months, a new vacuum-assisted closure device (V.A.C.) was initiated to speed wound healing. The V.A.C. was initiated in August 1996. The three Stage IV ulcers were located on the patient's right ischium, left ischium, and sacrum. On initiation, they measured 7 1/2 cm x 2 1/2 cm x 2 1/2 cm, 8 cm x 3 1/2 cm x 2 1/2 cm, and 3 1/2 cm x 2 cm x 2 cm respectively. The treatment consisted of insertion of sterile sponge into the wound bed connected to the negative pressure device by suction hose. The device operated at a negative pressure of 125 mm Hg with a 5-minute-on 2-minute-off-cycle. Dressing changes were performed every 48 hours during the treatment period. Successful closure of the sacral ulcer occurred in October 1996. The ischial ulcers were small enough to be taken off V.A.C. therapy in early November 1996. While we are encouraged by the results of this study, further additional clinical studies are warranted.- - - - - - - - - - ranking = 1keywords = health (Clic here for more details about this article) |
2/23. The ethics of using contingency management to reduce pressure ulcers: data from an exploratory study.Although there is a widely held argument that pressure ulcers are preventable, they continue to cause major healthcare and financial problems. The blame for pressure ulcers has typically focused on the patient's self-neglect or self-destructiveness. However, more recently, there has been a call for a paradigm shift from the current "paternalistic" medical model to one that includes the patient as a participant in his or her own care. Contingency management, a procedure well known in behaviorism, is presented as one such possibility. Controversy about the use of monetary reward, as well as discussion of initial efficacy in a current study, are discussed.- - - - - - - - - - ranking = 1keywords = health (Clic here for more details about this article) |
3/23. Pressure ulcers: an unusual complication of indwelling urethral catheter.INTRODUCTION: Pressure ulcers are common among patients with spinal cord disorders (SCD) and occur due to unrelieved pressure on soft tissues. case reports: Two ladies with paraplegia following acute transverse myelitis developed pressure ulcers over medial aspects of thighs due to indwelling urethral catheter. Absence of sensation, weakness of both legs and lack of knowledge about catheter care contributed to ulcer formation. CONCLUSION: Indwelling urethral catheter may unusually result in pressure ulcers over the thighs in patients with SCD. Among health professionals involved in the care of these subjects awareness is essential for preventing this complication.- - - - - - - - - - ranking = 1keywords = health (Clic here for more details about this article) |
4/23. Chronic wound caring ... a long journey toward healing.Healthcare professionals use words like "frustrating," "expensive," and "time-consuming" to describe chronic wound care. Healing a wound that has been present for an extended period of time is difficult. Often the problem is not just the wound but also the "woundedness" of the individual with the wound. The patient's needs in chronic wound care often continue over months, years, or even a lifetime. This article addresses more than the wound--it offers healthcare professionals' accounts of patient stories and their active involvement in the long journey toward chronic wound healing.- - - - - - - - - - ranking = 1keywords = health (Clic here for more details about this article) |
5/23. Interim analysis of a prospective, randomized trial of vacuum-assisted closure versus the healthpoint system in the management of pressure ulcers.Twenty-eight patients with 41 full-thickness decubitus ulcers were randomized to compare the vacuum-Assisted Closure device (VAC) with the Healthpoint System (HP) of wound gel products in promoting ulcer healing. A total of 22 patients with 35 full-thickness ulcers completed the 6-week trial of treatment, during which time 2 patients (10%) in the VAC group (N =20) and 2 patients (13%) in the HP group (N = 15) healed completely. The mean percent reduction in ulcer volume was 42.1% with HP and 51.8% with VAC (p = 0.46). The mean number of PMNs and lymphocytes per high-power field decreased in the VAC group and increased in the HP group (p = 0.13, p = 0.41 respectively). The mean number of capillaries per high-power field was greater in the VAC group (p = 0.75). There were 15 cases of biopsy-proven osteomyelitis underlying the ulcers; three (37.5%) improved with VAC and none improved with HP (p = 0.25). VAC promotes an increased rate of wound healing and favorable histological changes in soft tissue and bone compared with HP.- - - - - - - - - - ranking = 4keywords = health (Clic here for more details about this article) |
6/23. Pressure relief splinting for an infant: a systemic approach.BACKGROUND: This case report describes a unique splinting design used on a 6 month-old infant with a grade II heel pressure sore. Traditional methods of attaining pressure relief such as gel pads and repositioning may benefit an inactive, relatively healthy child. However, a 6 month-old infant who is actively at the developmental age of reciprocal kicking is less likely to respond to these interventions. Furthermore, children with multiple systemic diagnosis may demonstrate a rapid deterioration of their pressure sore when the most effective intervention is not initially chosen. METHOD: This paper reviews the multiple systems which impact wound healing to assist the occupational therapist in choosing efficient methods of pressure relief. The splint design described was chosen due to the age and the complex medical history of the infant. PRACTICE IMPLICATIONS: The effectiveness of total pressure relief initiated early in the infant's treatment resulted in complete visual healing within one month. It was worn for six weeks to avoid recurrence on an already susceptible area of skin.- - - - - - - - - - ranking = 1keywords = health (Clic here for more details about this article) |
7/23. air support therapy: ethical considerations.Pressure ulcers are a major health problem for the elderly population in the united states. Billion of health care dollars are spent for hospitalization, air support therapy, wound care products, and nursing care. In addition, the cost in human suffering is priceless. Many patients with pressure ulcers have several chronic diseases that make wound healing difficult. nurses must begin to examine the ethical principles that guide their care of these patients. This article focuses on some ethical issues related to the care of patients with pressure ulcers and the difficulties encountered with pressure ulcer care. Careful analysis of the goals of pressure ulcer treatment may help nurses develop ethical guidelines to direct them in the care of these patients.- - - - - - - - - - ranking = 2keywords = health (Clic here for more details about this article) |
8/23. ProfiCare: an alternating pressure-relieving mattress.risk assessment tools should only act as a guide to patient status rather than definitive diagnosis. Emphasis must be placed on not using the Waterlow score in isolation but in conjunction with clinical judgement. We must therefore attempt to minimize opportunities for disagreement over pressure ulcer risk scores through the selection of appropriate support surfaces based on a thorough consideration of costs of pressure ulcers for the patients, institutions and healthcare professionals. This product focus advocates that ProfiCare replacement mattresses are an option as they are designed for use on a hospital bed frame and provide alternating and static patient support surfaces.- - - - - - - - - - ranking = 1keywords = health (Clic here for more details about this article) |
9/23. The influence of moisture wound healing on the incidence of bacterial infection and histological changes in healthy human skin after treatment of interactive dressings.In this article the authors discuss the problem faced by physicians when trying to use moisture-retentive dressing in pressure sores (decubitus ulcers). First, they report the results of an in vitro study using a new model of experimental wound (radio-isotopic investigation) that assesses the release of Ringer's solution from interactive dressings continually during fourteen hours. Second, they perform an animal experiment that assesses the incidence of wound infection in defects treated conventionally or using interactive dressings. The defects treated with interactive pads had lower incidence of wound infection, and the process of wound healing was rapid. Finally, the authors discuss their experience in four paraplegic patients with decubitus ulcers where they used moisture-retentive dressing on ulcers and on the surrounding intact skin before surgical procedure to detect the possibility of maceration of healthy skin. Histological evaluation was performed in order to find microscopically changes after moisture healing. The changes of healthy skin were not significant after treatment of moisture-retentive dressings.- - - - - - - - - - ranking = 6keywords = health (Clic here for more details about this article) |
10/23. Pressure sore as a complication of labor epidural analgesia.Lumbar epidural analgesia has become a common mode of pain control for laboring patients. Side effects, such as hypotension, motor blockade, respiratory depression, dural puncture, and urinary retention, are well described. Although pressure sores have been thought of as a complication limited to elderly, emaciated, unconscious, or bedridden patients, we describe the occurrence of pressure sores in a young and healthy parturient after lumbar epidural analgesia. IMPLICATIONS: We report a pressure sore that resulted from lumbar epidural analgesia for labor.- - - - - - - - - - ranking = 1keywords = health (Clic here for more details about this article) |
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