Database : MEDLINE
Search on : Pressure and Ulcer [Words]
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[PMID]: 29288099
[Au] Autor:Afifi L; Sanchez IM; Wallace MM; Braswell SF; Ortega-Loayza AG; Shinkai K
[Ad] Address:Departments of Dermatology at the University of California, San Francisco, San Francisco, California.
[Ti] Title:Diagnosis and management of peristomal pyoderma gangrenosum: A systematic review.
[So] Source:J Am Acad Dermatol;, 2017 Dec 27.
[Is] ISSN:1097-6787
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Peristomal pyoderma gangrenosum (PPG) is an uncommon subtype of pyoderma gangrenosum. PPG is a challenging condition to diagnose and treat; no evidence-based guidelines exist. OBJECTIVE: We sought to identify important clinical features of PPG and effective treatments available for its management. METHODS: A systematic literature review of PPG was performed using PubMed, Medline, and Embase databases. RESULTS: We describe 335 patients with PPG from 79 studies. Clinical features include a painful, rapidly progressing ulcer with undermined, violaceous borders with a history of ostomy leakage and local skin irritation or trauma. Systemic steroids are first-line therapy; infliximab and adalimumab provide concomitant control of active inflammatory bowel disease. Combination local and systemic therapy was commonly used. Wound dressings, vehicle selection, and appropriate ostomy devices to minimize leakage, irritation, and pressure-induced ischemia can improve healing. Distinct from classic ulcerative pyoderma gangrenosum, surgical approaches, such as stoma closure and resection of active inflammatory bowel disease, have an effective role in PPG management. LIMITATIONS: PPG is a rare disease lacking randomized trials or diagnostic guidelines. Treatment duration and follow-up time among studies are variable. CONCLUSIONS: Key clinical characteristics of PPG are highlighted. Several treatments, including a more prominent role for surgical intervention, may be effective for PPG treatment.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1712
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  2 / 19529 MEDLINE  
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[PMID]: 29521041
[Au] Autor:Kawecki M; Pasek J; Cieslar G; Sieron A; Knefel G; Nowak M; Glik J
[Ad] Address:Centre for Burns Treatment, Siemianowice Slaskie, Poland.
[Ti] Title:Computerized planimetry evaluation of hyperbaric oxygen therapy in the treatment of diabetic foot.
[So] Source:Adv Clin Exp Med;27(1):39-44, 2018 Jan.
[Is] ISSN:1899-5276
[Cp] Country of publication:Poland
[La] Language:eng
[Ab] Abstract:BACKGROUND: Diabetic foot ulcer is one of the major complications of diabetes mellitus in adults. OBJECTIVES: The aim of the study was to conduct a planimetry evaluation of the effectiveness of hyperbaric oxygen therapy (HBOT) in the treatment of patients with vascular disorders caused by diabetic foot. MATERIAL AND METHODS: The study included 94 patients, 30 females (32%) and 64 males (68%), aged 33-76 years, with diabetes lasting 1.5-32 years, who underwent HBOT due to diabetic foot. All patients from that group underwent vascular procedures prior to HBOT. In qualifying patients for hyperbaric oxygen therapy, transcutaneous oximetry method was applied (30-60 exposures in hyperbaric oxygen at pressure of 2.5 ATA). Progress in wound healing was evaluated by computerized planimetry system IRIS 4. RESULTS: In 26 patients the wounds were completely closed and in 37 patients the topical state was significantly improved - the wound surface decreased by 34% in average. During the treatment, in 11 patients amputation of fingers and metatarsal necrotic bones was performed, while in 9 patients amputation was prevented. CONCLUSIONS: A planimetry evaluation showed that the application of HBOT in the treatment of diabetic foot enhances foot ulcer healing, reduces tissue damage, contributes to the reduction of complications related to soft tissue and bone infections.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Data-Review
[do] DOI:10.17219/acem/66392

  3 / 19529 MEDLINE  
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[PMID]: 29441973
[Au] Autor:Gong F; Niu J; Pei X
[Ti] Title:Clinical effects of dressing on patients with I-II phase pressure sores.
[So] Source:Pharmazie;71(11):665-669, 2016 Nov 02.
[Is] ISSN:0031-7144
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:OBJECTIVE: Angelica dahurica is a well-known traditional Chinese Medicine (TCM), while little information is available about its effects on pressure sores. We aimed to investigate the clinical effect of Angelica dahurica on patients with I-II phase pressure sores, as well as the underlying mechanism. METHODS: Patients (n = 98) with phase I and phase II pressure sores were enrolled and randomly assigned to control and treated groups. In addition to holistic nursing, patients in the control group received compound clotrimazole cream, while patients in the treated group received continuous 4 weeks of external application of Angelica dahurica dressing. Therapeutic effect was recorded, along with the levels of interleukin-8 (IL-8), epidermal growth factor (EGF), transforming growth factor (TGF)-ß, and vascular endothelial growth factor (VEGF). Besides, HaCaT cells were cultured with different concentrations of Angelica dahurica, and then cell viability, clone formation numbers, cell cycle, and levels of cyclin D1 and cyclin-dependent kinase (CDK) 2 were determined. RESULTS: The total effective rate in the treated group was significantly higher than in the control group. Levels of IL-8, EGF, TGF-ß, and VEGF were statistically increased by Angelica dahurica. In addition, the cell viability and clone formation numbers were significantly upregulated by Angelica dahurica in a dose-dependent manner. Also, the percentage of cells in G0/G1 phase, and levels of cyclin D1 and CDK2 were significantly elevated. CONCLUSION: Our results suggest that Angelica dahurica may provide an effective clinical treatment for I-II phase pressure sores.
[Mh] MeSH terms primary: Angelica/chemistry
Pressure Ulcer/drug therapy
[Mh] MeSH terms secundary: Administration, Topical
Aged
Bandages
Cell Cycle/drug effects
Cell Line
Cell Survival/drug effects
Cytokines/biosynthesis
Dose-Response Relationship, Drug
Female
Humans
Intercellular Signaling Peptides and Proteins/biosynthesis
Male
Middle Aged
Ointments
Phytotherapy
Pressure Ulcer/metabolism
Pressure Ulcer/pathology
[Pt] Publication type:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Name of substance:0 (Cytokines); 0 (Intercellular Signaling Peptides and Proteins); 0 (Ointments)
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[Js] Journal subset:IM
[Da] Date of entry for processing:180215
[St] Status:MEDLINE
[do] DOI:10.1691/ph.2016.6704

  4 / 19529 MEDLINE  
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[PMID]: 29517127
[Au] Autor:Elsabrout K; Orbacz E; McMahon LA; Apold S
[Ad] Address:Director of Nursing, White Plains Hospital, Nursing Administration, White Plains, NY, USA.
[Ti] Title:Large-Scale Hospital Mattress Switch-Out Leads to Reduction Hospital-Acquired Pressure Ulcers: Operationalization of a Multidisciplinary Task Force.
[So] Source:Worldviews Evid Based Nurs;, 2018 Mar 08.
[Is] ISSN:1741-6787
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Identifying strategies to protect patients most at risk for hospital-acquired pressure ulcers (HAPU) is essential. HAPUs have significant impact on patients and their families and have profound cost and reimbursement implications. AIMS: This article describes the successful implementation of a hospital-wide mattress switch-out program using a Multidisciplinary Task Force, which resulted in a decrease in HAPUs and significant cost savings. RESULTS: As a result of this quality improvement project supported by evidence, the hospital realized a 66.6% decrease in Stage III and IV HAPUs, a 50% reduction in patient complaints about mattress comfort, a cost savings of $714,724, and an endorsement of bedside nurse clinical autonomy by nursing and executive leaders. LINKING EVIDENCE TO ACTION: Nursing leaders can effectively realize large-scale initiatives by developing and implementing wide-ranging operational projects, like this 2.5-day, 275-bed hospital mattresses switch-out.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1111/wvn.12280

  5 / 19529 MEDLINE  
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[PMID]: 29381242
[Au] Autor:Wurzer P; Winter R; Stemmer SO; Ivancic J; Lebo PB; Hundeshagen G; Cambiaso-Daniel J; Quehenberger F; Kamolz LP; Lumenta DB
[Ad] Address:Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.
[Ti] Title:Risk factors for recurrence of pressure ulcers after defect reconstruction.
[So] Source:Wound Repair Regen;, 2018 Jan 30.
[Is] ISSN:1524-475X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Patients suffering from pressure ulcers remain to be a challenging task for nursing staff and doctors in the daily clinical management, putting-notably in the case of recurrences-additional strain on the constantly reduced resources in public healthcare. We aimed to assess the risk factors for the recurrence of pressure ulcers at our institution, a tertiary referral center. In this retrospective analysis of patients admitted to our division we identified risk factors for pressure ulcer recurrence. The hospital patient database search included all patients with a diagnosis of pressure ulcers of the torso and lower extremity. One hundred sixty-three patients were diagnosed with pressure ulcers and 55 patients with 63 pressure ulcers met our inclusion criteria. The 17 recurrences (27%) had an average follow-up of 728 days. Most presented with lesions of the ischial tuberosity (n=24). Recurrence was statistically associated with defect size (p = 0.013, Cox regression analysis), and serum albumin levels (p = 0.045, Spearman correlation), but no association was found for body mass index, bacterial profile, comorbidities, localization, previous surgery, or time-to-admission for reconstruction (all p > 0.05). Supported by the recent literature we identified factors like defect size to be associated with pressure ulcer recurrence, but not with time-to admission for reconstruction or number of previous debridements. Whether laboratory values like serum albumin levels were the cause, the result or associated with pressure ulcer recurrence warrants further investigation.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:Publisher
[do] DOI:10.1111/wrr.12613

  6 / 19529 MEDLINE  
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[PMID]: 29326410
[Au] Autor:Shine JS; Kim SJ; Lee JH; Yu M
[Ad] Address:Surgical Intensive Care Unit, Gyeongsang National University Hospital, Jinju, Korea.
[Ti] Title:[Factors Predicting the Interface Pressure Related to Pressure Injury in Intensive Care Unit Patients].
[So] Source:J Korean Acad Nurs;47(6):794-805, 2017 Dec.
[Is] ISSN:2093-758X
[Cp] Country of publication:Korea (South)
[La] Language:kor
[Ab] Abstract:PURPOSE: Interface pressure is a factor that contributes to the occurrence of pressure injuries. This study aimed to investigate interface pressure at common sites of pressure injury (occipital, gluteal and peritrochanteric areas), to explore the relationships among risk factors, skin condition and interface pressure, and to identify risk factors influencing interface pressure. METHODS: A total of 100 patients admitted to the intensive care unit were enrolled at a tertiary teaching hospital in Korea. Interface pressure was recorded by a scanning aid device (PalmQ). Patient data regarding age, pulmonary disease, Braden Scale score, body mass index, serum albumin, hemoglobin, mean blood pressure, body temperature, and oxygen saturation were included as risk factors. Data collected from July to September 2016 were analyzed using binary logistic regression. RESULTS: The mean interface pressure of the occipital, gluteal, and right and left peritrochanteric areas were 37.96 (±14.90), 41.15 (±16.04), 53.44 (±24.67), and 54.33 (±22.80) mmHg, respectively. Predictive factors for pressure injuries in the occipital area were age ≥70 years (OR 3.45, 95% confidence interval [CI]: 1.19~9.98), serum albumin deficit (OR 2.88, 95% CI: 1.00~8.26) and body temperature ≥36.5℃ (OR 3.12, 95% CI: 1.17~8.17); age ≥70 years (OR 2.81, 95% CI: 1.10~7.15) in the right peritrochanteric area; and body temperature ≥36.5℃ (OR 2.86, 95% CI: 1.17~6.98) in the left peritrochanteric area. CONCLUSION: Our findings suggest that old age, hypoalbuminemia, and high body temperature may be contributory factors to increasing interface pressure; therefore, careful assessment and nursing care of these patients are needed to prevent pressure injury. Further studies are needed to establish cutoff values of interface pressure for patients with pressure ulcers.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Process
[do] DOI:10.4040/jkan.2017.47.6.794

  7 / 19529 MEDLINE  
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[PMID]: 29513051
[Au] Autor:Chishtie J; Chishtie F; Yoshida K; Balogh R
[Ad] Address:a International Centre for Disability and Rehabilitation, Rehabilitation Sciences Institute, Faculty of Medicine , University of Toronto , Toronto , Canada.
[Ti] Title:Spinal cord injury rehabilitation and pressure ulcer prevention after the 2005 South Asian Earthquake: a CBR case study from Pakistan.
[So] Source:Disabil Rehabil;:1-9, 2018 Mar 07.
[Is] ISSN:1464-5165
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: The 2005 South Asian earthquake led to large-scale injuries and disabilities in northern Pakistan, which were dealt with using various approaches. In this regard, a community-based rehabilitation approach was initiated in the Muzaffarabad district of Pakistan in early 2006, focused on preventing complications among persons with Spinal Cord Injury. This case study briefly describes its development, aims and service provision components, in addition to the distribution of injuries from the disaster. Pressure ulcer prevention education, its recall and decrease in prevalence over a year are presented as key outcomes and illuminate the process of implementing rehabilitation in this context. METHODS: This case study presents findings from a larger internal program evaluation in 2010-11. The study design was cross-sectional, to elicit recall of education components and the resulting prevalence of pressure ulcers over the year, in 33 randomly selected persons with Spinal Cord Injury. Outcomes included retention of knowledge about pressure ulcer prevention, practices and reduction in the prevalence of pressure ulcers over the last year. We also conducted a narrative literature review on the types of injuries and complications in the Spinal Cord population from Northern Pakistan. RESULTS: Hospital cohort studies reported "spine" injuries at 5%, while persons with spinal cord injury were identified as the most underserved needing rehabilitation services after the quake. Results from the evaluation of prevention education revealed that all 33 respondents were trained in detection of pressure ulcers, while 32 recalled "danger signs" for which they would seek immediate help. All correctly recalled postural change timings, however, their actual practices differed. Twenty-seven respondents (82%) reported no pressure ulcers over the last year. CONCLUSION: The decrease in pressure ulcer prevalence over the last year in persons with spinal cord injury highlights the strengths of the community-based rehabilitation approach, particularly preventive education in geographically challenging and highly resource constrained settings. The research also begins to fill a critical gap in the present literature as most research is limited to hospital based interventions from the first year of the 2005 earthquake. Implications for Rehabilitation Prevention education for targeting pressure ulcers can be effective in reducing incidence of this important complication in persons with spinal cord injury. Community-based rehabilitation approaches can prove beneficial in post-disaster settings, especially in resource constrained settings and difficult hilly terrain. Rehabilitation programs should consider nutrition interventions to reduce multiple pressure ulcers, especially in lower middle income countries.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:Publisher
[do] DOI:10.1080/09638288.2018.1445783

  8 / 19529 MEDLINE  
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[PMID]: 29225161
[Au] Autor:Hug K; Stumm C; Debecker I; Fellinghauer CS; Peter C; Hund-Georgiadis M
[Ad] Address:REHAB Basel, Clinic for Neurorehabilitation and Paraplegiology, Basel, Switzerland.
[Ti] Title:Self-Efficacy and Pressure Ulcer Prevention After Spinal Cord Injury-Results From a Nationwide Community Survey in Switzerland (SwiSCI).
[So] Source:PM R;, 2017 Dec 07.
[Is] ISSN:1934-1563
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Pressure ulcers (PUs) are a common and severe health condition in persons with spinal cord injury (SCI). Skin-care strategies for PU prevention are usually provided during the first rehabilitation session. However, individuals with SCI often do not perform these strategies continuously, especially after discharge. The influence of psychological factors such as general self-efficacy (GSE) on the performance of PU prevention behavior has not yet been sufficiently explored. OBJECTIVE: To investigate whether persons with greater levels of GSE are more likely to perform skin-care strategies for PU prevention regularly. DESIGN: Nationwide cross-sectional survey within the Swiss Spinal Cord Injury Cohort Study. SETTING: Community setting, data collection between 2011 and 2013. PARTICIPANTS: A total of 456 subjects with a traumatic or nontraumatic SCI living in Switzerland. METHODS: Associations between GSE and PU prevention behavior were analyzed by multivariate proportional odds regression models, including potential sociodemographic, lesion-related, and lifestyle-related confounders without and with interaction terms between GSE and potential effect modifiers. MAIN OUTCOME MEASUREMENTS: Self-efficacy was assessed by the GSE scale comprising 10 items. PU preventive behavior was operationalized using 5 items of an adapted version of the Spinal Cord Injury Lifestyle scale. Both measurements were components of a self-administered questionnaire. RESULTS: Based on the regression model without interaction terms, GSE levels were not associated with skin-care PU prevention. After we included interaction terms, the final model showed statistically significant associations between GSE and 3 skin-care items with odds ratios ranging from 1.09 to 1.17 (all P < .001). The slightly positive effect of GSE on PU prevention behavior was restricted to persons who sustained their SCI at a younger age. CONCLUSIONS: GSE was generally not associated with skin-care PU prevention behavior among persons with SCI in this study. In further research, it might be of interest to assess SCI-specific concepts of self-efficacy. LEVEL OF EVIDENCE: ▪▪▪.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:Publisher

  9 / 19529 MEDLINE  
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[PMID]: 29415014
[Au] Autor:Sonenblum SE; Sprigle SH
[Ad] Address:George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, Georgia, United States of America.
[Ti] Title:Buttock tissue response to loading in men with spinal cord injury.
[So] Source:PLoS One;13(2):e0191868, 2018.
[Is] ISSN:1932-6203
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE/BACKGROUND: Despite the fact that most people with a spinal cord injury who use a wheelchair for mobility are considered at-risk for pressure ulcer (PrU) development, there still exists a spectrum of risk amongst this group. Efforts to differentiate risk level would benefit from clinical tools that can measure or predict the buttocks response to loading. Therefore, the goal of this study was to identify how tissue compliance and blood flow were impacted by clinically-measurable risk factors in young men with SCI. METHODS: Blood flow at the ischial tuberosity was measured using laser Doppler flowmetry while the seated buttock was unloaded, and loaded at lower (40-60 mmHg) and high (>200 mmHg) loads. Tissue compliance of the buttock was measured using the Myotonometer while subject were lifted in a Guldmann Net. RESULTS: Across 28 participants, blood flow was significantly reduced at high loads, while no consistent, significant changes were found at lower loads. At 40-60 mmHg, blood flow decreased in participants with a pressure ulcer history and lower BMI, but stayed the same or increased in most other participants. The buttock displaced an average of 9.3 mm (2.7 mm) at 4.2 N, which represented 82% (7%) of maximum displacement. BMI was related to the amount of buttock tissue displacement while smoking status explained some of the variation in the percent of max displacement. CONCLUSION: Wide variability in tissue compliance and blood flow responses across a relatively homogeneous population indicate that differences in biomechanical risk may provide an explanation for the spectrum of PrU risk among persons with SCI.
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Entry month:1802
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[St] Status:In-Process
[do] DOI:10.1371/journal.pone.0191868

  10 / 19529 MEDLINE  
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[PMID]: 29371701
[Au] Autor:Atkinson RA; Cullum NA
[Ad] Address:Division of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology, Medicine & Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK. ross.atkinson@manchester.ac.uk.
[Ti] Title:Interventions for pressure ulcers: a summary of evidence for prevention and treatment.
[So] Source:Spinal Cord;56(3):186-198, 2018 Mar.
[Is] ISSN:1476-5624
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:STUDY DESIGN: Narrative review. OBJECTIVES: Pressure ulcers are a common complication in people with reduced sensation and limited mobility, occurring frequently in those who have sustained spinal cord injury. This narrative review summarises the evidence relating to interventions for the prevention and treatment of pressure ulcers, in particular from Cochrane systematic reviews. It also aims to highlight the degree to which people with spinal cord injury have been included as participants in randomised controlled trials included in Cochrane reviews of such interventions. SETTING: Global. METHODS: The Cochrane library (up to July 2017) was searched for systematic reviews of any type of intervention for the prevention or treatment of pressure ulcers. A search of PubMed (up to July 2017) was undertaken to identify other systematic reviews and additional published trial reports of interventions for pressure ulcer prevention and treatment. RESULTS: The searches revealed 38 published systematic reviews (27 Cochrane and 11 others) and 6 additional published trial reports. An array of interventions is available for clinical use, but few have been evaluated adequately in people with SCI. CONCLUSIONS: The effects of most interventions for preventing and treating pressure ulcers in people with spinal cord injury are highly uncertain. Existing evaluations of pressure ulcer interventions include very few participants with spinal cord injury. Subsequently, there is still a need for high-quality randomised trials of such interventions in this patient population.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1801
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:In-Data-Review
[do] DOI:10.1038/s41393-017-0054-y


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