Advances in skin & wound care
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This paper focuses on key pressure ulcer research issues in surgical patients pertaining to incidence, risk assessment, temporality, methodology, and interpretation and utilization of findings. The recent emphasis on the effect of intraoperative events on pressure ulcer occurrence is discussed in terms of the underlying conceptualization, theoretical and empirical evidence, and consequences for research. The ongoing quest for predictors of pressure ulcers in surgical patients and the results of clinical studies in this population illustrate the limitations of current pressure ulcer risk assessment instruments; therefore, an example of an alternative risk assessment strategy for surgical patients is presented. Addressing these issues in a timely fashion is important given their potential impact on future research and the growing interest in studying pressure ulcers in surgical patients.
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Adv Skin Wound Care · Sep 2012
Randomized Controlled Trial Comparative StudyProspective cohort study on surgical wounds comparing a polyhexanide-containing biocellulose dressing with a dialkyl-carbamoyl-chloride-containing hydrophobic dressing.
Postsurgery dressing changes in diabetic foot amputation wounds and surgical wounds healing by secondary intention are often conducted in the operating room under general anesthesia. A prospective comparative cohort study was performed in 60 patients (n = 60: n = 30/n = 30) with secondary-intention surgical wounds (82% had forefoot and/or digit[s] amputations) to compare 2 different dressing types. ⋯ Pain levels were significantly lower and the dressing adhered significantly less in group A, compared with group B, demonstrating a better quality of life for the patients in group A.
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Adv Skin Wound Care · Jun 2012
ReviewEvidence for interventional procedures as an adjunct therapy in the treatment of shingles pain.
To enhance the learner's competence with knowledge of interventional procedures as an adjunct therapy in the treatment of shingles pain. ⋯ Shingles (herpes zoster) is a painful manifestation of infection of the dorsal root ganglia of the spine and seen as blisters or vesicles in linear formation, usually on the upper torso. Up to one-third of those afflicted will experience complications, with the most common complication being postherpetic neuralgia (PHN). The risk of PHN increases for each decade of life after age 50 years, and the pain associated with this complication has the potential to endure for years, be unrelenting, and decrease an individual's quality of life. Treatment options, including adjunct interventional procedures, are presented to address the common complication of PHN. Although no conclusive evidence base is present for the use of any particular interventional procedure in the treatment of acute pain or refractory pain of shingles, a number of therapies have been indicated to have some level of effectiveness. Standard therapy options in the form of oral medications and topical agents should be used first. For those situations of refractory pain, a referral to an interventional pain management specialist is warranted to explore possible adjunct procedures to lessen the pain of PHN. A comprehensive care management approach, incorporating interventional pain management procedures as an adjunct therapy, will enable patients to have their pain treated as effectively as possible by utilizing appropriate methods available.
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Adv Skin Wound Care · Nov 2015
Comparative StudySurgical Treatment of Pressure Ulcers with a Fibrin Sealant in Patients with Spinal Cord Injury: A Cost-Consequence Analysis.
A comparative study was performed to evaluate the effectiveness and costs of a fibrin sealant (Tissucol Duo [known as Tisseel in the United States], Baxter International, Deerfield, Illinois) to improve postoperative outcomes in patients with spinal cord injury undergoing surgical treatment for pressure ulcers (PrUs). ⋯ The application of Tissucol Duo during surgical treatment of PrUs in patients with spinal cord injury has been shown to be effective in reducing postoperative complications and in shortening the duration of the hospital stay with a consequent savings in costs.
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Adv Skin Wound Care · Nov 2014
Braden Scale and Norton Scale modified by INSALUD in an acute care hospital: validity and cutoff point.
The objective of this article was to determine the most suitable cutoff point (CP) for the Braden Scale and Norton Modified Scale by INSALUD Scale (Norton-MI) in an acute care hospital. ⋯ Both scales show good validity data. If the CP is raised: MI-Norton (CP 15): sensitivity: 77.36 (72.43-82.30), specificity 74.27 (72.94-75.61), PPV: 17.52 (15.42-19.62), NPV: 97.89 (97.38-98.41). The Braden scale with a CP of 17 presents sensitivity: 78.38 (73.52-83.24), specificity: 73.44 (72.09-74.79), PPV: 17.25 (15.19-19.31), NPV: 97.96 (97.45-98.47). These CPs improved the predictive capacity of both scales in the authors' hospital environment.