(Decubitus Ulcers) articles in PubMed
- [The gluteus maximus inferior split-muscle flap for the cover of ischiatic pressure ulcers: Study of 61 cases]. [Journal Article]
- Ann Chir Plast Esthet 2016 Sep 21AC
- CONCLUSIONS: The gluteus maximus inferior split-muscle flap, simple to implement, provides coverage of ischial pressure sores while sparing muscle flaps usually used for this indication. The recurrence rate associated with the gluteus maximus inferior split-muscle flap is comparable to biceps femoris and gluteus maximus muscle flaps (totally harvested). It does not sacrifice function gluteus maximus muscle and can be performed in the valid patient. This flap keeps the Superior split-muscle, mobilized in case of sacral pressure ulcer. The gluteus maximus inferior split-muscle flap is the first intention flap indicated for the cover of cover of ischiatic pressure ulcers of less than 8cm in diameter.
- Predictors for Development of Pressure Ulcer in End-of-Life Care: A National Quality Register Study. [Journal Article]
- J Palliat Med 2016 Sep 22JP
- CONCLUSIONS: The SRPC could be a unique resource for quality improvement and research. The present study cannot prove causation, but it can report correlations between background variables and PU prevalence. More studies, with different designs, are warranted to establish the roles of risk factors for PU in end-of-life care.
- Preventive Effects of Poloxamer 188 on Muscle Cell Damage Mechanics Under Oxidative Stress. [Journal Article]
- Ann Biomed Eng 2016 Sep 20AB
- High oxidative stress can occur during ischemic reperfusion and chronic inflammation. It has been hypothesized that such oxidative challenges could contribute to clinical risks such as deep tissue pr...
High oxidative stress can occur during ischemic reperfusion and chronic inflammation. It has been hypothesized that such oxidative challenges could contribute to clinical risks such as deep tissue pressure ulcers. Skeletal muscles can be challenged by inflammation-induced or reperfusion-induced oxidative stress. Oxidative stress reportedly can lower the compressive damage threshold of skeletal muscles cells, causing actin filament depolymerization, and reduce membrane sealing ability. Skeletal muscles thus become easier to be damaged by mechanical loading under prolonged oxidative exposure. In this study, we investigated the preventive effect of poloxamer 188 (P188) on skeletal muscle cells against extrinsic oxidative challenges (H2O2). It was found that with 1 mM P188 pre-treatment for 1 h, skeletal muscle cells could maintain their compressive damage threshold. The actin polymerization dynamics largely remained stable in term of the expression of cofilin, thymosin beta 4 and profilin. Laser photoporation demonstrated that membrane sealing ability was preserved even as the cells were challenged by H2O2. These findings suggest that P188 pre-treatment can help skeletal muscle cells retain their normal mechanical integrity in oxidative environments, adding a potential clinical use of P188 against the combined challenge of mechanical-oxidative stresses. Such effect may help to prevent deep tissue ulcer development.
- Predictability of Pressure Ulcers Based on Operation Duration, Transfer Activity, and Body Mass Index Through the Use of an Alternating Decision Tree. [Journal Article]
- J Med Invest 2016; 63(3-4):248-55JM
- CONCLUSIONS: Among the factors identified, only "transfer activity" can be modified by nursing intervention. While shear force and friction are known to lead to pressure ulcers, transfer activity has not been identified as such. Our results suggest that transfer activities creating shear force and friction correlate with pressure ulcer development. The ADT algorithm was effective in determining prediction factors, especially for highly imbalanced data. Our three stumps ADT yielded accuracy, sensitivity, and specificity values of 72.1%±3.7%, 79.3%±18.1%, and 72.1%±3.8%, respectively.Transfer activity, identified as an interventional factor, can be modified through nursing interventions to prevent pressure ulcer formation. The ADT method was effective in identifying factors within largely imbalanced data. J. Med. Invest. 63: 248-255, August, 2016.
- Use of Indwelling Urinary Catheters in Nursing Homes: Implications for Quality Improvement Efforts. [Journal Article]
- J Am Geriatr Soc 2016 Sep 19JA
- CONCLUSIONS: These findings suggest that indwelling urinary catheter use in long-stay NH residents is uncommon and generally appropriate and that efforts to improve catheter care and outcomes should extend beyond a singular focus on reducing use.
- Pressure Ulcer Prevention in the Hospital Setting Using Silicone Foam Dressings. [Review]
- Cureus 2016; 8(8):e730C
- Patient care is of the utmost importance in the hospital setting. Bedrest and immobility during hospitalization, especially in the surgical and intensive care setting, place the patient at high risk ...
Patient care is of the utmost importance in the hospital setting. Bedrest and immobility during hospitalization, especially in the surgical and intensive care setting, place the patient at high risk for pressure ulcers. It is very important to prevent or notice a pressure ulcer forming due to the significant health care costs involved and patient health associated with them. Various measures are in place to prevent patients from getting pressure ulcers, but a newer material, silicone foam dressings, has been introduced as an alternative solution for the prevention of these ulcers. We review the current literature to examine whether the standard protocol or silicone material is superior to the prevention of pressure ulcer formation. We conclude that silicone foam dressings, when used as prophylactic treatment, seems very promising and may even be superior to the standard care of prevention. However, there were limitations to some studies and further research is needed to confirm the role of silicone foam dressings.
- Plantar pressures are higher in cases with diabetic foot ulcers compared to controls despite a longer stance phase duration. [Journal Article]
- BMC Endocr Disord 2016; 16(1):51BE
- CONCLUSIONS: This study shows that plantar pressures are higher in cases with active diabetic foot ulcers despite having a longer stance phase duration which would be expected to lower plantar pressure. Whether plantar pressure changes can predict ulcer healing should be the focus of future research. These results highlight the importance of offloading feet during active ulceration in addition to before ulceration.
- Calciphylaxis and Martorell Hypertensive Ischemic Leg Ulcer: Same Pattern - One Pathophysiology. [Journal Article]
- Dermatology 2016 Sep 14D
- This review presents a closer look at four diseases which are probably closely related to one another pathophysiologically: (a) calciphylaxis (distal pattern); (b) calciphylaxis (proximal pattern); (...
This review presents a closer look at four diseases which are probably closely related to one another pathophysiologically: (a) calciphylaxis (distal pattern); (b) calciphylaxis (proximal pattern); (c) Martorell hypertensive ischemic leg ulcer; (d) calciphylaxis with normal renal and parathyroid function (synonym: eutrophication). The four diseases have largely the same risk factors: (1) arterial hypertension, (2) diabetes mellitus (types 1 and 2), (3) secondary or tertiary hyperparathyroidism (in end-stage kidney disease) and (4) oral anticoagulation with vitamin K antagonists. They share the same clinical patterns: necrotizing livedo, skin infarctions at typical locations and acral gangrene in calciphylaxis. They also share the same histopathology: ischemic subcutaneous arteriolosclerosis and small-artery disease and 'miniaturizing' Mönckeberg medial calcinosis. The treatment concept for the acute phase of the diseases is also broadly similar. In addition to an optimized control of the cardiovascular risk factors, a proactive wound approach (necrosectomy, negative pressure wound treatment with vacuum dressings, and early skin grafts supported by systemic antibiotic therapy) leads most rapidly and effectively to a reduction of the initially severe wound pain, and finally to complete healing of the wound. Oral anticoagulation with vitamin K antagonists should be stopped. In extensive cases, the use of intravenous sodium thiosulfate is recommended. All four diagnoses are little known in the medical schools of most countries. The need to improve familiarity with these four closely related disorders is therefore great. In particular, the risk of confusion with pyoderma gangrenosum is a major diagnostic problem which can lead to false and even damaging treatment.
- A cross-sectional study on self-management of pressure ulcer prevention in paraplegic patients. [Journal Article]
- J Tissue Viability 2016 Aug 24JT
- CONCLUSIONS: Level of education and level of paraplegia are significantly associated with health activation. A positive PU-history is not associated with future responsible behavior nor for compliant behavior in terms of health management.
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- Systematic Review and Operative Technique of Recalcitrant Pressure Ulcers Using a Fillet Flap Technique. [Journal Article]
- Plast Reconstr Surg Glob Open 2016; 4(8):e1001PR
- CONCLUSIONS: The fillet of leg flap remains a useful and reliable method of reconstructing end-stage pressure ulcers.