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1
Borille, Denise. "Dressing Wounds: Considerations on Trauma Theory and Life Writing in Vera Brittain’s Testament of Youth." Journal of English Language and Literature 3, no. 2 (April 30, 2015): 259–62. http://dx.doi.org/10.17722/jell.v3i2.55.
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This paper aims at analyzing how the trauma inflicted by the First World War is described by Vera Brittain in her autobiographical novel Testament of Youth (1933). The author, who shares many features in common with Virginia Woolf – regarding witnessing and writing about trauma – also lost her loved ones to the War: her fiancé, Roland Leighton, her brother, Edward Brittain, and her friend, Victor Richardson.For Vera Brittain and some of her contemporaries, nursing became a woman‟s experience of taking part in the male-dominated realm of the First War. From treating wounds to listening to injured soldiers‟ talks, First War nurses grasped the geographies of men‟s bodies and minds, something regarded as “improper” by most parents whose daughters were born between the late Victorian and early Edwardian ages. Nursing was the closest a woman could get to the battleground in those days; in Brittain‟s case, for instance, the only safe way to see Roland again. V.A.D. nursing also allowed many women to evolve from tactile experience to the subjective activity of writing about the War, and Brittain‟s Testament of Youth may be regarded as one of its best examples.What may account for the title Testament of Youth is the thought Brittain kept that writing about the distress she and her contemporaries felt due to war would probably have an impact on coming generations. She leaves a “testament” of a terrible incident that would more likely recede; yet, she acknowledges that, whatever may happen, it would never surpass the impact that the First War had on her generation of young women, who were deprived of the innocence of their youth.
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Menack, Michael, Kerry Thibodeaux, Carlos Trabanco, and Michael Sabolinski. "Effectiveness of Type I Collagen Matrix Plus Polyhexamethylene Biguanide Antimicrobial for the Treatment of Pressure Injuries." Wounds: a compendium of clinical research and practice 34, no. 6 (2022): 159–64. http://dx.doi.org/10.25270/wnds/2022.159164.
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Introduction. The first prospective noninterventional registry study (RESPOND) evaluated the clinical effectiveness of a native type I collagen matrix plus polyhexamethylene biguanide antimicrobial barrier (PCMP) in various nonhealing wounds. This product is intended for the management of partial- and full-thickness wounds and acts as an effective barrier to reduce microbes penetrating through the dressing. The RESPOND study demonstrated that PCMP has clinically meaningful benefits in managing a variety of wounds. Objective. The authors describe the effects of PCMP in the subgroup of patients with pressure injuries (PIs) from the RESPOND registry. Materials and Methods. The prospective, noninterventional study was designed to collect information regarding the use of PCMP in a real-world situation. Eligibility included male and female patients aged 18 years and older with target wounds (partial- or full-thickness) suitable for the use of PCMP. Enrolled patients were followed approximately weekly for up to 32 weeks. All wounds and the subgroups were analyzed to determine the frequency and median time to wound closure using Kaplan-Meier methods. Results. The patients with PIs were older adults with a mean age of 69 years and a mean BMI of 27 kg/m2. At baseline, the mean measured wound length was 3 cm, the mean depth was 8.0 mm, the mean volume was 12.6 cm3, and the mean area was 10.5 cm2. Complete wound closures were evident in 5% of patients (n = 2) at week 4, and were achieved in 39% of patients (n = 18) by week 16, in 49% (n = 22) by week 24, and in 62% (n = 28) by week 32. The median time to wound closure was 32 weeks. For all 45 PIs managed with PCMP, the incidence of achieving greater than 60% reduction in baseline area and depth was 78% (n = 35) and 64% (n = 29), respectively, with approximately 82% (n = 37) of wounds showing a reduction in volume greater than 75%. Conclusions. It appears that PCMP is a useful adjunct in managing chronic deep wounds such as PIs.
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Al Mousa, Rami, Brandon Bosque, and Shane Dowling. "Use of Ovine Forestomach Matrix in the Treatment of Facial Thermal Burns." Wounds: a compendium of clinical research and practice 34, no. 4 (2022): e17-e21. http://dx.doi.org/10.25270/wnds/2022.e17e21.
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Introduction. Thermal burn injuries are common, devastating medical emergencies that are challenging to manage. Timely and effective treatment is paramount to both short- and long-term patient outcomes. Currently, medical providers and health care facilities worldwide are emphasizing the need for cost-efficient and accessible treatments; such treatments are particularly vital for vulnerable populations with limited access to advanced medical resources. The use of extracellular matrix (ECM) technologies has become widespread in the management of acute and chronic wounds, including burns. Ovine forestomach matrix (OFM) is an ECM bioscaffold isolated from sheep forestomach tissue and has been shown to be effective in soft tissue reconstruction procedures. Case Report. The use of OFM in the treatment of 2 facial thermal burn injuries, including in a pediatric patient, is described. Both patients fully recovered from their facial injuries with satisfactory cosmetic outcomes. Conclusions. Although OFM technology is widely used in the management of acute and chronic wounds, the authors believe this to be the first published report of its use to aid healing in burns. Ovine forestomach matrix may provide a valuable additional tool for the management of complex burns.
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Syabariyah, Sitti, Belinda Rizky Amalia, and Nina Gartika. "Effect of Aloe Vera Gel in the Healing of Post Operating Incissions: Evidence Based Nursing." Journal of Health Sciences and Medical Development 1, no. 02 (December 8, 2022): 68–75. http://dx.doi.org/10.56741/hesmed.v1i02.127.
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The incidence of injuries in the world throughout the year is increasing, both acute and chronic wounds. In Indonesia, the prevalence of incisional wounds is 8.2%. Wound healing can be assisted with herbal plants, one of which is aloe vera. The purpose of this evidence-based nursing study was to determine aloe vera's effectiveness in the healing process of incisional wounds. The method used is a literature review. Database searches were conducted through Pubmed, Science Direct, Science Open and Google Scholar. The inclusion criteria of the journal in this study were journals that examined incisions, cuts or surgical wounds given intervention using aloe vera in a quasi-experimental research design, case study, double-blind, controlled trial, journals published in 2016-2021 and used Indonesian or English. This study's results indicate an influence of aloe vera in the wound-healing process, especially in the proliferative phase. This literature study can be used as evidence-based nursing at the level of nursing health services, especially wound care management based on aloe vera.
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Smaropoulos, Eleftherios, and Niels AJ Cremers. "Medical grade honey for the treatment of paediatric abdominal wounds: a case series." Journal of Wound Care 29, no. 2 (February 2, 2020): 94–99. http://dx.doi.org/10.12968/jowc.2020.29.2.94.
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Objective: Children are at high risk of injuries and wounds. The application of medical grade honey is a promising approach to improving the healing of wounds of various origin and severity. However, the use of medical grade honey in young paediatric patients remains limited. The aim of this study is to show the safety, efficacy and usefulness of medical grade honey in abdominal wounds, of different causes, in paediatric patients. Method: This was a prospective, observational case series evaluating five young infants with abdominal wounds at the General Hospital in Thessaloniki. All wounds were treated in the same manner with daily medical grade honey applied to the wound area and closely monitored. Results: All treated wounds rapidly presented granulation tissue formation and underwent re-epithelialisation. Peripheral oedema and inflammation decreased upon initial application. Necrotic tissue was effectively debrided when present. Slough was removed and no signs of infection were detected, irrespective of initial wound presentations. Scar formation was minimal and the full range of motion was preserved in all cases. Conclusion: Based on this case study, medical grade honey is safe and effective in treating different abdominal wounds, including infected or dehisced wounds as well as burns. The easy application and broad applicability make medical grade honey recommendable as a first-line treatment in paediatric patients.
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Kapp, Suzanne, and Nick Santamaria. "The effect of self-treatment of wounds on quality of life: a qualitative study." Journal of Wound Care 29, no. 5 (May 2, 2020): 260–68. http://dx.doi.org/10.12968/jowc.2020.29.5.260.
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Objective: Skin wounds, such as leg ulcers and pressure ulcers (PUs), can have a negative effect on quality of life (QoL). This effect has been confirmed among self-treaters of wounds, specifically. The aim of the study was to investigate the effect of self-treatment of wounds on the physical, emotional, lifestyle and financial domains of QoL. The findings of the study may be used to optimise the wellbeing of people who have wounds. Method: A qualitative study was conducted with people who were 18 years of age or older; lived in Victoria, Australia; spoke English; and had a wound that they had self-treated. Participants were interviewed and the data thematically analysed to identify themes that represented the effect of self-treatment on the physical, emotional, lifestyle and financial domains of QoL. Results: The participants (n=25) averaged 71 years of age and the majority (n=20) had leg wounds. Participants described mostly positive effects on QoL that were attributable to self-treatment. Self-treatment improved physical wellbeing because it resulted in better pain management and wound healing; however, it was a physical challenge for some. Self-treatment enhanced emotional wellbeing because it helped to manage worry about infection and resolve dissatisfaction with professional care. Self-treatment lessened the social consequences of the wound by enabling participants to create an acceptable appearance, maintain their lifestyle and minimise time receiving professional care. Self-treatment reduced the financial cost of wound dressings and the expense associated with receiving professional care. Conclusion: As an approach to care, self-treatment of wounds may offer QoL gains that might otherwise be unachievable. The importance of engaging patients in their own management, and the increasing accountability of healthcare providers to report consumer-focused outcomes, are further reasons to consider self-treatment of wounds as an approach to care in the community setting.
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Shetti, Akshaya Narayan, Ishita Deshpande, Bhavika Singla, and Rachita Govind Mustilwar. "To study the incidences of needle stick injury among critical care nurses working in rural tertiary care hospital." Indian Journal of Pharmacy and Pharmacology 9, no. 2 (July 15, 2022): 128–31. http://dx.doi.org/10.18231/j.ijpp.2022.022.
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Needle-stick injuries (NSIs) are a hazard for nursing staff and public health. Nursing workers are at high risk for occupational exposure to blood-borne pathogens via sharp injuries of the needle-stick. Needle-stick injuries (NSIs) are described as penetrating wounds caused by a device that is contaminated with another person’s body fluids. Needle-stick injuries are injuries acquired by needles like -scalp vein needles, hypodermic needles, blood sample collection needles, intracath stylets, lumbar puncture needles used to connect parts of IV delivery systems. Needle-stick injuries (NSIs) form a medium for the transmission of bloodborne infections. Strict use of personnel protective equipment while working in the hospital should be made compulsory. To study incidences of needle stick injury among nurses working in Rural tertiary care Unit, Loni. Ethical approval for this study was obtained from the Institutional Ethical Committee. Seventy-six nurses, who fulfilled inclusion criteria were included and data was obtained through survey. This study involves 76 nursing staff. Of them all, 27(35.5%) nursing staff experienced NSIsThe administration of medication was common action that caused most of needle-stick injuries mentioned by 14 (18.4%) nursing staff. IV cannula was the device that caused many needle-stick injuries reported by 17 (21.1%) nursing staff. Thenursing professionals are the main key players in both elective and emergency situations. There is a quite higher incidence of needle stick injury among critical care nurses. This might be due to handling of emergency cases and attempting to secure the intravenous line or to deliver the medications. Creating awareness and training appropriately is mandatory for critical care nurses.
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Paolini, Guido, Michail Sorotos, Guido Firmani, Gianluca Gravili, Diego Ceci, and Fabio Santanelli di Pompeo. "Low-vacuum negative pressure wound therapy protocol for complex wounds with exposed vessels." Journal of Wound Care 31, no. 1 (January 2, 2022): 78–85. http://dx.doi.org/10.12968/jowc.2022.31.1.78.
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Objective: Treating high-risk surgical patients with complex wounds over exposed blood vessels is a challenge. Guided wound healing may be the only treatment possible. Negative pressure wound therapy (NPWT) is not recommended in these cases. The authors challenged these current recommendations and share their preliminary experience. Method: The authors adapted a NPWT protocol that uses low-vacuum continuous pressure (−80mmHg) with a silicone sheath and gauze/foam dressing between the wound bed and the device. They monitored the clinical features of patients' wounds to detect bleeding/ischaemia early on. Dressings were changed every 72–96 hours. Results: This protocol was followed in five male patients (aged 23–68 years) with complex wounds over exposed vessels. Two cases were foot crush injuries, one midfoot amputation, one hand self-subamputation and one vascular bypass infection. Comorbidities included monoarterial limbs/stump, severe arteriopathy and psychiatric disorder. The exposed vessels were femoral, radial and ulnar, anterior and posterior tibial arteries and veins. Mean treatment lasted 37 days (range 20–61 days). No episodes of severe bleeding/ischaemia of the extremities were observed. Treatment was discontinued once debridement was complete and granulation tissue allowed spontaneous closure/grafting. All wounds appeared stable at 1-year follow-up. Conclusion: The low-vacuum NPWT protocol was successful in solving five difficult cases. This regimen reduces risks associated with NPWT use on wounds with exposed vessels. The authors believe further validation is required to strengthen the evidence. However, preliminary data are encouraging and might help to change future NPWT recommendations by extending the indications for its use to exposed vessels.
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Netto, Fernando AC Spencer, Mariana J. Becker, Ayessa Bertoldi, Henriqué S. Shiroma, Hemanuelli Barreto, and Marcelo Augusto Fontenelle Ribeiro. "Combined use of progressive tension suture and negative pressure wound therapy in large torso degloving wounds." Journal of Wound Care 31, no. 4 (April 2, 2022): 304–8. http://dx.doi.org/10.12968/jowc.2022.31.4.304.
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Objective: To demonstrate the associated use of progressive tension sutures (PTS) with negative pressure wound therapy (NPWT) in large torso degloving wounds. Methods: This is a case report of two patients with large torso degloving wounds caused by trauma, both of whom were treated with combined PTS and NPWT. Statistics related to wound treatment responses are presented. Results: Initial wound area for Patient 1 was 2400cm2 and 900cm2 for Patient 2. Within 21 and 12 days, respectively, using the combined method, the following data were observed: wound reduction of 94% and 99%, respectively; a closing speed rate of 98cm2/day and 75cm2/day, respectively; and a closing percentage of 4.45% per day and 8.25% per day, respectively. Conclusion: The use of combined PTS and NPWT techniques may be useful in the treatment of traumatic degloving injuries, reducing the wound area and facilitating reconstruction.
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Boyar, Vita. "Successful Management of Moisture-, Friction-, and Trauma-associated Skin Damage in the Pediatric and Neonatal Population Using Cyanoacrylate Skin Protectant." Wounds : a compendium of clinical research and practice 34, no. 3 (March 10, 2022): 83–89. http://dx.doi.org/10.25270/wnds/2022.8389.
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Introduction. Moisture-associated skin damage occurs in 4% to 37% of the pediatric population. Commonly described treatments can be challenging to apply to small neonatal wounds, and concerns exist about absorption, cutaneous side effects, and use in certain populations (eg, preterm neonates). Objective. This single-center, retrospective case series evaluated the use of cyanoacrylate liquid skin protectant (CSP) to manage moisture-, friction-, and trauma-associated pediatric and neonatal wounds. Materials and Methods. Fifteen pediatric and neonatal patients with wounds of various etiologies were treated with 1 to 3 applications of CSP. The product is a purple-colored liquid that comes in a small-sized and large-sized applicator and immediately adheres to the skin, taking approximately 1 minute to dry. One to 2 coats were applied to the affected area. Subsequent applications were prescribed as needed, depending on the skin condition. Before CSP application, some patients underwent different treatments deemed necessary by the treating practitioners. Results. There were 7 neonate patients (age range, 4 days–3 weeks), with a gestational age of 25 weeks to full term. Wounds included incontinence-associated dermatitis; peristomal, gastrostomy-associated, and tracheostomy-associated dermatitis; and skin tears. In the 8 older patients (age, 1–5 months; 10 years; 12 years; 16 years), wounds included gastrostomy and tracheostomy-associated dermatitis and granulation tissue, epidermal stripping from adhesive dressing removal, intertriginous dermatitis, and lesions resulting from graft-versus-host disease. Application of CSP facilitated the healing of dermatitis and peristomal excoriations as well as facilitated skin dryness, leading to increased wear time of a peristomal appliance. Peristomal dryness contributed to less friction and likely was the reason for granulation tissue recession. Conclusions. Cyanoacrylate liquid skin protectant can be considered in the management of pediatric moisture- and friction-associated cutaneous injuries, skin tears, and exudative wounds. It can be used as a stand-alone therapy or in combination with standard of care.
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Mello, Daniel. "Dermal Regeneration Matrix in the Treatment of Acute Complex Wounds." Wounds: a compendium of clinical research and practice 34, no. 6 (2022): 154–58. http://dx.doi.org/10.25270/wnds/2022.154158.
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Introduction. Dermal regeneration matrices (DRMs) represent a significant advance in wound treatment, but their use remains limited because of high associated costs. Used correctly, DRMs help improve aesthetic and functional results of skin-grafted areas. Objective. This case series reports the use of a DRM of 1-mm and 2-mm thickness in the management of acute complex wounds. Materials and Methods. This is a retrospective analysis of a cohort of patients treated between 2015 and 2018. Complex wounds were defined as those with extensive loss of skin and subcutaneous tissue, or as those in critical areas, that required sequential and specialized treatment. Management of acute wounds involved debridement of devitalized tissue, wound bed preparation, DRM implantation, and split-thickness skin grafting (STSG). Negative pressure wound therapy (NPWT) was used in all cases preoperatively, after DRM implantation, and after STSG. Results of integration of DRM and skin grafts were subjectively evaluated. The Vancouver Scar Scale was used to evaluate results 12 months postoperatively. Results. Traumatic injuries were the most common etiology, and the extension of the treated wounds varied between 4 cm × 5 cm to 42 cm × 28 cm, in the greatest dimensions. A 2-mm–thick matrix was used in 14 cases, with skin grafting after 7 to 9 days. In 6 cases, a 1-mm–thick matrix was used, immediately followed by skin grafting. Negative pressure wound therapy was used in all cases. Dermal regeneration matrices and skin graft integration rates of almost 100% were achieved in all cases. No complications occurred. Conclusions. The results showed use of DRM and NPWT was a good reconstructive option in the management of acute complex wounds that required STSG. With proper patient selection, such treatment is an important tool in the armamentarium of reconstructive procedures.
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Kalinich, John F., Elizabeth A. Vane, Jose A. Centeno, Joanna M. Gaitens, Katherine S. Squibb, Melissa A. McDiarmid, and Christine E. Kasper. "Embedded Metal Fragments." Annual Review of Nursing Research 32, no. 1 (October 2014): 63–78. http://dx.doi.org/10.1891/0739-6686.32.63.
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The continued evolution of military munitions and armor on the battlefield, as well as the insurgent use of improvised explosive devices, has led to embedded fragment wounds containing metal and metal mixtures whose long-term toxicologic and carcinogenic properties are not as yet known. Advances in medical care have greatly increased the survival from these types of injuries. Standard surgical guidelines suggest leaving embedded fragments in place, thus individuals may carry these retained metal fragments for the rest of their lives. Nursing professionals will be at the forefront in caring for these wounded individuals, both immediately after the trauma and during the healing and rehabilitation process. Therefore, an understanding of the potential health effects of embedded metal fragment wounds is essential. This review will explore the history of embedded fragment wounds, current research in the field, and Department of Defense and Department of Veterans Affairs guidelines for the identification and long-term monitoring of individuals with embedded fragments.
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Gonzalez, Gilberto A., Christopher Castagno, Jordan Carter, Brinda Chellappan, and Philippe Taupin. "Negative pressure wound therapy on complex extremity wounds requiring coverage with a meshed bilayer wound matrix: a retrospective analysis." Journal of Wound Care 31, Sup9 (September 1, 2022): S8—S15. http://dx.doi.org/10.12968/jowc.2022.31.sup9.s8.
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Objective: The treatment of complex extremity wounds is technically challenging. In this 5-year retrospective review, we compared the use of Integra Meshed Bilayer Wound Matrix (IMBWM; Integra LifeSciences, US) followed by a split-thickness skin graft (STSG) combined with negative pressure wound therapy (NPWT) versus IMBWM followed by STSG alone for the management of these wounds. Method: Data from patients undergoing management using IMBWM for a complex extremity wound coverage were collected. Results: Among the 109 patients studied, the wounds of 62 patients were managed using IMBWM and NPWT, and 47 were managed using IMBWM alone. The most common aetiology of these injuries was trauma. Wound size and location were similar for each group, ranging in size from 2–30cm2 and being primarily on the forearm, followed by the leg and arm. There was a significantly greater take of the IMBWM+STSG with NPWT (96.8%) compared to without NPWT (85.1%, p=0.03). There were significantly fewer reapplications of the dermal matrix required in the NPWT group (3.2%) versus the non-NPWT group (14.9%, p=0.03). There were significantly fewer postoperative complications, prior to STSG, in the NPWT group (3.2%) versus the non-NPWT group (14.9%, p=0.03). Conclusion: The combination of IMBWM with NPWT leads to a higher success rate, and can reduce the number of dermal matrix reapplications and postoperative complications, in the setting of complex extremity wounds. The use of IMBWM in combination with NPWT has the potential to improve both surgical procedures and patient outcomes in this setting.
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Handayani, Estrin, and Robiul Fitri Masithoh. "A small-scale re-evaluation of the efficacy of silver sulfadiazine for burns." British Journal of Community Nursing 25, Sup12 (December 1, 2020): S34—S38. http://dx.doi.org/10.12968/bjcn.2020.25.sup12.s34.
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Burns remain one of the most common injuries contributing to an increase in trauma incidence in hospitals, particularly in developing countries. Therefore, it is essential to identify the appropriate care for these wounds. Silver sulfadiazine has been widely used for the treatment of burns, but its efficacy has not been re-evaluated in recent years. Therefore, this small-scale study aimed at re-evaluating the use of silver sulfadiazine in patients with burns at a hospital in Magelang, Indonesia. A total of seven patients with second- and third-degree burns were involved and received silver sulfadiazine for 5 months (March to July 2020). Data on their wounds were collected three times and evaluated by using the Nursing Outcomes Classification (NOC) observation method. Wound outcomes were evaluated using on the basis of wound healing by secondary intention. Silver sulfadiazine was found to be effective; 85.7% of the wound area showed granulation tissue, and 75–100% of the wound area showed epithelialisation. However, patients complained of pain during silver sulfadiazine treatment. Therefore, additional nursing interventions seem to be needed to manage burns.
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Boyar, Vita. "Successful Management of Complex Pediatric and Neonatal Wounds With Methylene Blue and Gentian Violet Foam Dressings." Wounds : a compendium of clinical research and practice 33, no. 10 (October 10, 2021): 253–59. http://dx.doi.org/10.25270/wnds/2021.253259.
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Introduction. Topical antimicrobial treatment of wounds in pediatric, and especially neonatal, patients can be challenging due to increased systemic absorption, damaging inflammatory cytokines, and oxygen radicals released by bacterial death. A product combining all wound bed preparation principles is desired. Methylene blue and gentian violet (MB/GV) foam dressings can keep wound beds moist, decrease ongoing inflammation, provide antibacterial coverage, and promote healthy wound edges. Objective. This article examines the use of MB/GV antibacterial foams in pediatric patients. Cases included infants with giant omphalocele epidermal stripping, dehisced abdominal wounds, peristomal dermatitis, and peripheral intravenous extravasations and adolescents with stage 4 pressure injuries. The treatment goals were to optimize the wound bed through debridement, elimination of bioburden, providing moisture balance, and enhancement of granulation tissue growth. Materials and Methods. Eight patients (6 infants and 2 adolescents) received MB/GV foam dressings every 2 to 3 days along with standard of care (SOC) management. Results. Effective debridement, bioburden elimination, moisture balance, and edge enhancement were achieved in all wounds. All wound beds were well-prepared to receive other SOC products as needed. Three cases were considered for negative pressure wound therapy (NPWT), but NPWT was not used because of challenging clinical characteristics and wound locations. Instead, MB/GV polyvinyl alcohol foam provided capillary wicking action that enhanced wound closure without NPWT. No side effects were observed. Conclusions. Methylene blue and gentian violet foam dressings appear to be a safe clinical option for antibacterial coverage, moisture management, and debridement in neonatal and pediatric patients.
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Swoboda, Laura. "A Retrospective Analysis of Clinical Use and Outcomes Using Viable Placental Membrane Allografts in Chronic Wounds." Wounds : a compendium of clinical research and practice 33, no. 12 (December 10, 2021): 329–33. http://dx.doi.org/10.25270/wnds/2021.329333.
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Introduction. Viable placental membrane (vPM) has been shown to decrease time to healing, adverse wound events, and wound-related infections. Wound research exclusion criteria commonly exclude wound types other than diabetic foot ulcers and venous leg ulcers (VLUs), comorbidities including peripheral arterial disease (PAD) and uncontrolled diabetes mellitus (DM), and wounds with exposed bone or tendon. Objective. This retrospective research study evaluated the clinical use and outcomes of the vPM with living mesenchymal stem cells used in chronic wound management in the community hospital outpatient department setting with the goal of comparing real-world use and outcomes of the product with use and outcomes described in the chronic wound literature. Materials and Methods. A retrospective analysis on vPM treatments at a Wisconsin academic health system’s community hospitals. Participants included all patients who received vPM therapy between July 1, 2016, and August 21, 2019. Results. A total of 89 patients received vPM treatment during the study period (mean age, 70 years; 69% male [n = 61], 31% female [n = 28]). Wound types were 54% diabetic or neuropathic foot ulcers (n = 48), 17% VLUs (n = 15), 7% pressure injuries (n = 6), and 22% atypical wounds (n = 20). The average wound duration prior to vPM initiation was 104 days. Average wound size at presentation was 6.9 cm2. Of study participants 54% had PAD (n = 48), 63% had DM (n = 56), 33.7% had DM and PAD (n = 30), and 17% had exposed bone or tendon (n = 15). Average adjusted time to healing after initiation of vPM was 81.2 days. The percentage of wounds healed 12 weeks after initiation of vPM treatment was 57%. Conclusions. Effectiveness of vPM observed in controlled trials also was observed in this real-world study on vPM for multiple wound types, patients with comorbidities including PAD and uncontrolled DM, and wounds with exposed bone or tendon. Results of this study were not statistically different from those reported in the literature. More randomized controlled trials are needed to explore the efficacy of vPM on patient presentations common to wound healing centers.
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McNamara, Stephanie A., Penelope A. Hirt, Maximillian A. Weigelt, Sonali Nanda, Valeria de Bedout, Robert S. Kirsner, and Lawrence A. Schachner. "Traditional and advanced therapeutic modalities for wounds in the paediatric population: an evidence-based review." Journal of Wound Care 29, no. 6 (June 2, 2020): 321–34. http://dx.doi.org/10.12968/jowc.2020.29.6.321.
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Objective: Children can have non-healing wounds due to a wide range of pathologies, including epidermolysis bullosa (EB), pilonidal disease and Stevens-Johnson syndrome, with some causes being iatrogenic, including extravasation injuries and medical device-related hospital-acquired pressure ulcers. Furthermore, paediatric wounds are vastly different from adult wounds and therefore require a different treatment approach. While there are numerous types of dressings, topical remedies, and matrices with high-tier evidence to support their use in adults, evidence is scarce in the neonatal and paediatric age groups. The purpose of this review is to discuss the basic principles in paediatric wound management, as well as to present new treatment findings published in the literature to date. The benefits and risks of using different types of debridement are discussed in this review. Various topical formulations are also described, including the need to use antibiotics judiciously. Method: Databases were searched for relevant sources including Pubmed, Embase, Web of Science and DynaMed. Search terms used included ‘wound care’, ‘wound management’, ‘paediatrics’, ‘children’, ‘skin substitutes’, and ‘grafts’. Additionally, each treatment and disease entity was searched for relevant sources, including, for example: ‘Apligraf’, ‘dermagraft’, ‘Manuka honey’, ‘antibiotic’, ‘timolol’, and ‘negative pressure wound therapy’ (NPWT). Results: Amniotic membrane living skin equivalent is a cellular matrix that has been reportedly successful in treating paediatrics wounds and is currently under investigation in randomised clinical trials. Helicoll is an acellular matrix, which shows promise in children with recessive dystrophic EB. NPWT may be used as a tool to accelerate wound closure in children; however, caution must be taken due to limited evidence to support its safety and efficacy in the paediatric patient population. Integra has been reported as a useful adjunctive treatment to NPWT as both may act synergistically. Hospitalised children and neonates frequently have pressure ulcers, which is why prevention in this type of wound is paramount. Conclusion: Advancements in wound care are rapidly expanding. Various treatments for non-healing wounds in paediatric and neonatal patients have been reported, but high tier evidence in these populations is scarce. We hope to shed light on existing evidence regarding the different therapeutic modalities, from debridement techniques and dressing types to tissue substitutes and topical remedies. There have been promising results in many studies to date, but RCTs involving larger sample sizes are necessary, in order to determine the specific role these innovative agents play in paediatric wounds and to identify true safety and efficacy.
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Júnior, Edmar Maciel Lima, Manoel Odorico de Moraes Filho, Bruno Almeida Costa, Ana Paula Negreiros Nunes Alves, Maria Elisabete Amaral de Moraes, Alex Marques do Nascimento Uchôa, Camila Barroso Martins, et al. "Lyophilised tilapia skin as a xenograft for superficial partial thickness burns: a novel preparation and storage technique." Journal of Wound Care 29, no. 10 (October 2, 2020): 598–602. http://dx.doi.org/10.12968/jowc.2020.29.10.598.
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Despite a considerable decrease in its incidence worldwide, burns remain the fourth most common type of trauma. The majority of burns are small, with 75% of injuries treated on an outpatient basis. Tilapia skin, as a biological material, has been suggested as an option for the management of burn wounds. After good results were obtained with the use of a glycerolised version of tilapia skin in burned children and adults, it was hypothesised that similar outcomes could be achieved with the use of a lyophilised version of tilapia skin. We report the case of a 33-year-old female patient with scalds to the upper abdomen, and both breasts, arms and forearms. Involvement of 10% of total body surface area with superficial partial thickness burns was calculated. The good adherence of tilapia skin to the wound bed, a 10-day period for complete re-epithelialisation of the wounds and the absence of side effects suggested that the lyophilised version of tilapia skin is effective for burn treatment. Compared with glycerolisation, lyophilisation is thought to permit extended storage of sterile tissue and decreased costs related to distribution and transport, but further studies are needed to confirm this.
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Abou Arbid, Samer A., Rana H. Bachir, and Mazen J. El Sayed. "Association between Mode of Transportation and Survival in Adult Trauma Patients with Penetrating Injuries: Matched Cohort Study between Police and Ground Ambulance Transport." Prehospital and Disaster Medicine 37, no. 2 (March 8, 2022): 171–78. http://dx.doi.org/10.1017/s1049023x22000346.
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AbstractIntroduction:Police transport (PT) of penetrating trauma patients has the potential to improve survival rates. There are no well-established guidelines for PT of penetrating trauma patients.Study Objective:This study examines the association between survival rate to hospital discharge of adult penetrating trauma patients and mode of transport (PT versus ground ambulance [GA]).Methods:A retrospective, matched cohort study was conducted using the United States (US) National Trauma Data Bank (NTDB). All adult penetrating injury patients transported by police to trauma centers were identified and matched (one-to-four) to patients transported by GA for analysis. Descriptive analysis was carried out. The patients’ demographic and clinical characteristics were tabulated and stratified by the transport mode.Results:Out of the 733 patients with penetrating injuries, ground Emergency Medical Services (EMS) transported 513 patients and police transported 220 patients. Most patients were 16-64 years of age with a male (95.6%) and Black/African American race (79.0%) predominance. Firearm-related injuries (68.8%) were the most common mechanism of injury with the majority of injuries involving the body extremities (62.9%). Open wounds were the most common nature of injury (75.7%). The overall survival rate to hospital discharge was similar for patients transported by GA and by police (94.5% versus 92.7%; P = .343).Conclusion:In this study, patients with penetrating trauma transported by police had similar outcomes to those transported by GA. As such, PT in penetrating trauma appears to be effective. Detailed protocols should be developed to further improve resource utilization and outcomes.
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Al-Gharibi, Koukab A., Sajana Sharstha, and Maria A. Al-Faras. "Cost-Effectiveness of Wound Care: A concept analysis." Sultan Qaboos University Medical Journal [SQUMJ] 18, no. 4 (March 28, 2019): 433. http://dx.doi.org/10.18295/squmj.2018.18.04.002.
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This review aimed to analyse the concept of cost-effectiveness within the context of chronic wound care using Walker and Avant’s approach. The Cumulative Index to Nursing and Allied Health Literature® (EBSCO Information Services, Ipswich, Massachusetts, USA), MEDLINE® (National Library of Medicine, Bethesda, Maryland, USA) and Nursing & Allied Health® (ProQuest LLC, Ann Arbor, Michigan, USA) databases were searched using a combination of keywords. A total of 18 peer-reviewed articles were identified. In wound care, defining attributes for the concept of cost-effectiveness encompassed treatments which were both effective and economical. Four antecedents were identified, including the type of wound, care setting, type of dressing and patient-related characteristics. The consequences of cost-effective wound care were patient prognosis, quality of life, the economic burden on the patient and healthcare system and cost-savings. These findings will hopefully help to standardise cost-effectiveness terminology among nursing professionals in various healthcare settings.Keywords: Cost Effectiveness; Wounds and Injuries; Healthcare Costs; Nursing; Concept Formation.
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Gupta, Vivek, and Arnab Chanda. "Expansion potential of skin grafts with novel I-shaped auxetic incisions." Biomedical Physics & Engineering Express 8, no. 1 (December 7, 2021): 015016. http://dx.doi.org/10.1088/2057-1976/ac3b72.
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Abstract Severe burn injures lead to millions of fatalities every year due to lack of skin replacements. While skin is a very limited and expensive entity, split thickness skin grafting, which involves the projection of a parallel incision pattern on a small section of healthy excised skin, is typically employed to increase the expansion and cover a larger burn site. To date, the real expansion capacity of such grafts are low (<3 times) and insufficient for treatment of severe burn injuries. In this study, novel I-shaped auxetic incision patterns, which are known to exhibit high negative Poisson’s ratios, have been tested on the skin to investigate their expansion potential. Fourteen two-layer skin graft models with varying incision pattern parameters (i.e., length, spacing, and orientation) were developed using finite element modelling and tested under uniaxial and biaxial tensile loads. The Poisson’s ratio, meshing ratios, and induced stresses were quantified across all models. Graft models tested uniaxially along the orthogonal directions indicated opposite trends in generated Poisson’s ratios, as the length of the I-shape incisions were increased. Biaxially, with a symmetric and closely spaced I-shape pattern, graft meshing ratios up to 15.65 were achieved without overstressing the skin. Overall, the findings from the study indicated that expansion potentials much higher than that of traditional skin grafts can be achieved with novel I-shaped auxetic skin grafts, which would be indispensable for covering large wounds in severe burn injuries.
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Díaz-Herrera, Miguel Ángel, José Ramón Martínez-Riera, José Verdú-Soriano, Raúl Miguel Capillas-Pérez, Carme Pont-García, Silvia Tenllado-Pérez, Oriol Cunillera-Puértolas, Miriam Berenguer-Pérez, and Vicente Gea-Caballero. "Multicentre Study of Chronic Wounds Point Prevalence in Primary Health Care in the Southern Metropolitan Area of Barcelona." Journal of Clinical Medicine 10, no. 4 (February 16, 2021): 797. http://dx.doi.org/10.3390/jcm10040797.
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Background: Chronic wounds give rise to major costs and resource consumption in health care systems, due to their protracted healing time. Incidence and prevalence data are scarce or nonexistent in community settings. Objective: The aim of the present epidemiological study was to analyse and determine the prevalence of chronic wounds in the community in the south of the province of Barcelona (Spain). Design: A cross-sectional, multicentre secondary data analysis study was conducted in the community (excluding nursing homes) in Barcelona between 16 April and 13 June 2013. It included 52 primary care centres that serve a total population of 1,217,564 inhabitants. Results: The observed prevalence was 0.11%. Venous ulcers presented the highest prevalence, at 0.04%, followed by pressure injuries, at 0.03%. The >74 age group presented the highest frequency of chronic wounds, accounting for 69.4% of cases. Conclusion: The results obtained are consistent with those reported in previous similar studies conducted in Spain and elsewhere. As with most studies that adjusted their variables for age and sex, we found that the prevalence of ulcers increased with age and was higher in women, except in the case of diabetic foot ulcers and ischaemic ulcers, which were more frequent in men.
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Daneshfar, Cy, Joash Suryavanshi, Hillary Powers Wall, Cameron Cox, and Brendan MacKay. "Palmar Resurfacing of the Hand With Porcine Urinary Bladder Extracellular Matrix Following Traumatic Injury." Wounds : a compendium of clinical research and practice 33, no. 7 (July 10, 2021): E46—E42. http://dx.doi.org/10.25270/wnds/2021.e4652.
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Introduction. Complex wounds of the hand often result in soft tissue defects that are not amenable to primary closure, vacuum-assisted closure, or tissue expansion. Injuries presenting with large defects involving multiple levels of tissue must be addressed by using techniques at higher rungs on the reconstructive ladder, such as split-thickness grafting, pedicled flaps, or free flaps. When repairing palmar tissue, these techniques fall short due to their failure to approximate structure and function of specialized skin. More recently, dermal substitutes containing a decellularized extracellular matrix (ECM) have been used in reconstruction of soft tissue defects, acting as a structural scaffold for the regrowth of native cells. Extracellular matrix products have been shown to improve functional and sensory outcomes in areas requiring highly specialized skin. Urinary bladder matrix (UBM), a porcine ECM scaffold, is unique in that it contains an intact epithelial basement membrane that promotes more organized regrowth through layered structure. Case Report. This case presents a novel use of this product in resurfacing 80% of a palm after postoperative necrosis following a table saw injury to the right volar palm at the distal crease. The patient had intact sensation and near normal functional outcomes at most recent follow up. Conclusions. The UBM may be a valuable adjunct to achieve soft tissue coverage in large, complex hand wounds, particularly those involving the palmar surfaces.
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Mancino, Anne, Alison Acott, and Kathryn Brinegar. "Injection of Cryopreserved Amniotic Membrane and Umbilical Cord Particulate for Pressure Injuries: A Retrospective Case Series." Wounds: a compendium of clinical research and practice 34, no. 9 (2022): e85-e90. http://dx.doi.org/10.25270/wnds/21041.
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Introduction. PI poses a significant burden to society. Cryopreserved AMUC has potential benefits in managing complex wounds owing to its anti-inflammatory, anti-scarring, and proregenerative properties. AMUC grafts are commonly in sheets, but also come as morselized powders that can be sprinkled or injected. The authors initially used AMUC injection in chronic PIs in March 2017. Materials and Methods. This is a single-center, retrospective review of patients with nonhealing PIs treated with AMUC particulate between March 2017 and November 2018. Incidence of wound healing (zero wound volume with complete reepithelialization) was measured at 12, 24, 36, and 52 weeks. Results. Review included 26 PIs (21 patients); of which, 85% were stage 4 PIs, per the NPIAP staging system. After AMUC injection, 14 PIs (54%) achieved complete wound closure at a median of 12.4 weeks (range, 5–52 weeks). Complete wound closure was observed in 7 patients (27%) at 12 weeks, 10 patients (38%) at 24 weeks, 13 patients (50%) at 36 weeks, and 14 patients (54%) at 52 weeks. One patient with vascular issues required amputation; however, no treatment-related adverse events or complications were observed. Conclusions. These preliminary results suggest that injection of AMUC particulate may be a safe and promising treatment in promoting wound closure of difficult-to-treat PIs.
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Santika, Mona, and Siska Iskandar. "ASUHAN KEPERAWATAN NYERI AKUT PADA PASIEN POST OPERASI SECTIO CAESAREA DENGAN TERAPI RELAKSASI AUTOGENIK." JURNAL KEPERAWATAN MUHAMMADIYAH BENGKULU 9, no. 1 (April 17, 2021): 17–22. http://dx.doi.org/10.36085/jkmb.v9i1.1462.
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Sectio Caesarea is a fragmented tissue or skin that stimulates the sensory area and stimulates the safety of sensory areas, resulting in and other neurological injuries can be a risk of infection if the opening of tissues and lack of treatment cause bacteria to enter through operating wounds. The purpose of the research aims to illustrate the acute nursing care of a post section Caesarea with autogenic relaxation therapy. Methodelogythis research is deductive with a qualitative approach and case study design with acute pain disorders in post section cesarean with autogenic relaxation therapy. The result is maternal screening indicates a scale of 3 pain, acute pain like gangstas, pain scale 3, pain that is felt constantly on the move and is impeded by mobility, activity interrupted. Vital Sign is within normal limits, the action done by performing an autogenic relaxation to treat post pain, after three days of nursing and treatment of the subject data has cooled down on both sides.Keywords: Sectio-Caesarea, nursing care, pain disorder
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Zuliani, Zuliani, Mohammad Alfin Kurniawan, and Nurul Khoirun Nisa. "NURSING CARE IN POST OP CRURIS FRACTURE CLIENTS WITH ACUTE PAIN NURSING PROBLEMS (STUDY OF LITERATURE)." Well Being 6, no. 1 (July 2021): 56–65. http://dx.doi.org/10.51898/wb.v6i1.95.
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Post op fracture of the cruris is a break in the tibia and fibula. Clinically, it can be an open fracture if it is accompanied by damage to the soft tissues muscle, skin, nerve tissue, and blood vessels, allowing the connection between the broken bone fragments with the outside air and the closed fracture. The impact that trauma can have on a fracture is limited to activity, may have the change in the damaged part of the body an the anxiety that may result from pain and pain. This research method used a literature study with a case study of nursing care in post op cruris fracture patients with acute pain problems in the Asoka Pavilion of Jombang Hospital which was carried out in the 2017-2019 period. The results of the literature study show that the priority problem for post op client cruris fracture is acute pain. The literature study of 4 clients showed that there were similar factors causing pain in the post op wound fracture of the cruris which resulted in decreased muscle strength, swelling, dan CRT> 2 seconds. Surgery will produce damaged cells with the consequence that it will release autanoid chemicals that can cause pain. Efforts to cope with injuries from post op cruris fracture by performing techniques in the greeting relaxation activities and listening to music and pain medication. In order to recover wounds from post op fracture, the cruris fracture should be treated routinely and increase their nutritional intake
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de Castro, Diana Lima Villela, Evellyn Lima da Silva, Lilian Sayuri Onaga, Paula Cristina Nogueira, Priscilla Cidade Furlan, and Vera Lúcia Conceição de Gouveia Santos. "The prevalence of skin lesions and associated factors in hospitalised adult patients with cancer." Journal of Wound Care 31, no. 8 (August 2, 2022): 660–68. http://dx.doi.org/10.12968/jowc.2022.31.8.660.
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Objective: To assess the prevalence of skin lesions and evaluate the clinical and sociodemographic factors associated with their presence in hospitalised patients. Method: This descriptive, cross-sectional, correlational study was performed in inpatient units and intensive care units of a cancer hospital in São Paulo, Brazil, after approval by the Institutional Research Ethics Committee. Data from hospitalised adult patients with cancer were collected during physical examinations and from medical records. A Chi-squared test, univariate analysis, a logistic regression model with results expressed as odds ratio (OR) and 95% confidence intervals (CI), and Classification and Regression Tree (CART) analysis were used to evaluate the data. Results: Of 341 patients, 80 had skin lesions, equating to an overall prevalence of 23.5%. The skin lesions included pressure injuries (10%), incontinence-associated dermatitis (6.7%), skin tears (6.5%), malignant wounds (3.8%) and complicated surgical wounds (3.2%). The factors associated with skin lesions in cancer patients were the use of disposable nappies (OR: 4.436) and age (59.1±15.1 years), according to the CART analysis, and the wearing of nappies (OR: 4.466, p<0.001), presence of ecchymosis (OR: 2.532, p<0.001) and infection (OR: 6.449, p=0.040), according to multiple regression analysis. Conclusion: This study contributed to knowledge about prevalence and associated factors of skin lesions in hospitalised patients with cancer, allowing the implementation of preventive measures.
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Monteiro Vasconcelos, Felipe, Carolina Cabral Pereira da Costa, Ellen Peres, Robson Souza Leão, Helena Ferraz Gomes, Priscila Silva Thiengo de Andrade, Ariane Silva Pires, Cristiene Faria, Ana Paula Oliveira Motta, and Bruna Ferreira Barreto Pires. "Microorganisms in Pressure Injuries After the Use of Polyhexamethylene Biguanide: A Series of Fourteen Cases." Wounds : a compendium of clinical research and practice 34, no. 2 (February 10, 2022): 51–56. http://dx.doi.org/10.25270/wnds/2022.5156.
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Introduction. Colonization of a pressure injury with microorganisms can negatively affect wound healing. Thus, it is necessary to evaluate which products best facilitate wound healing. Objective. This case series evaluated the effectiveness of the antimicrobial polyhexamethylene biguanide (PHMB) on microorganisms in pressure injuries. Materials and Methods. Fourteen patients (14 wounds) were treated with PHMB in the hospital setting after collection of a wound swab sample for microbiological analysis and determination of the risk profile using the disk diffusion method. Results. Thirteen lesions (92.9%) were positive for 1 or more bacterial strains, the most prevalent of which were Staphylococcus aureus and Pseudomonas aeruginosa. Two strains of methicillin-resistant S aureus (MRSA) were also identified. Klebsiella pneumoniae demonstrated 100% resistance to the tested antibiotics, with Acinetobacter demonstrating 90% resistance, P aeruginosa 88.9%, Citrobacter freundii 87.5%, S aureus 66.7%, and MRSA 57.1%. Only Serratia marcescens demonstrated no resistance to any antibiotic tested. Polyhexamethylene biguanide was effective only against strains of S marcescens, which were not present in the second wound swab sample collected (after the application of PHMB); other microorganisms were present in the second wound swab sample collected. Conclusions. Polyhexamethylene biguanide has an immediate antimicrobial effect on S marcescens. However, it had no qualitative effect on the other microorganisms. Studies with larger populations and randomized clinical trial methodologies are necessary to elucidate additional findings concerning the effectiveness of PHMB in managing microorganisms in pressure injuries.
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Rippon, Mark G., Jan Forster, and Alan A. Rogers. "Hydro-responsive wound dressings for treating hard-to-heal wounds: a narrative review of the clinical evidence—part 2." Journal of Wound Care 31, no. 4 (April 2, 2022): 330–38. http://dx.doi.org/10.12968/jowc.2022.31.4.330.
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This narrative clinical review summarises the key evidence in support for the use of a hydro-responsive wound dressing, HydroTac (HRWD-2, PAUL HARTMANN AG, Germany) to address key aspects associated with the treatment of both acute and hard-to-heal wounds. This review demonstrates how HRWD-2 can be used in general to address the challenges presented by a wide range of wound types and skin injuries. It highlights the ability of HRWD-2 to regulate an optimal moist wound environment that promotes wound progression and healing. Key aspects covered in this review include the dressing's ability to: promote certain phases of the wound healing response (for example, re-epithelialisation) address the concepts and needs for wound progression as set out in the TIME wound management framework provide an optimal hydration level reduce tissue trauma and pain at dressing change.
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Silva-Filho, Gilvan Vilarinho, Adriana Moreno Morgan-Kanada, and Niro Kasahara. "Predictive values of the Pediatric Penetrating Ocular Trauma Score and the Toddler/Infant Ocular Trauma Score in Brazilian children with open globe injury." Clinical and Experimental Emergency Medicine 9, no. 1 (March 31, 2022): 41–46. http://dx.doi.org/10.15441/ceem.21.092.
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Objective This study compared the prognostic value of the Pediatric Penetrating Ocular Trauma Score (POTS) with the Toddler/Infant Ocular Trauma Score (TOTS) in a cohort of Brazilian children with open-globe injuries.Methods This retrospective, observational case series included consecutive children with open-globe injuries seen at the Santa Casa de Sao Paulo Eye Emergency Service. The medical records of all patients were reviewed for data analysis, including the circumstance and time of injury, type of penetrating injury, initial and final visual acuity (VA), time of surgery, and associated eye diseases. The test characteristics of POTS and TOTS for VA were calculated and compared by the McNemar test.Results Thirty patients were included. The mean age was 3.9 ± 1.6 years; 20 were male patients and 10 were female patients. Most wounds were limited to the anterior segment (93.3%). The sensitivity for the POTS was higher than that of the TOTS (100%; 95% confidence interval [CI], 75.3–100 vs. 61.5%; 95% CI, 31.6–86.1; P = 0.014). The specificity was not significantly different (14.3%; 95% CI, 0.4–57.8 vs. 0%; 95% CI, 0–41.0; P = 0.563). The accuracy for the POTS was higher than the TOTS (70.0%; 95% CI, 45.7–88.1 vs. 40.0%; 95% CI, 19.1–63.9; P = 0.001).Conclusion In this cohort of Brazilian children with open-globe injuries, the POTS had better accuracy than did the TOTS in predicting VA after treatment.
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Davini, Giulia, Valentina Dini, Agata Janowska, Michela Macchia, Bruno Gualtieri, Giammarco Granieri, and Marco Romanelli. "Wound Dehiscence After Achilles Tendon Trauma and Repair: Treatment With Ultraportable Negative Pressure Wound Therapy and Compression Therapy." Wounds : a compendium of clinical research and practice 34, no. 1 (January 10, 2021): E93—E98. http://dx.doi.org/10.25270/wnds/2021.e93e98.
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Introduction. Achilles tendon rupture is a common injury requiring surgical repair. Re-ruptures, infections, delayed wound healing, and hematomas have been reported postoperatively. Objective. This case series described the use of ultraportable negative pressure wound therapy (NPWT) and compression bandaging following postoperative dehiscence of Achilles tendon repair. Materials and Methods. Retrospective records were reviewed to identify patients who underwent wound management for Achilles tendon dehiscence between January 2014 and January 2018. Patient demographics, wound size at first and last visit, number of visits, and previous treatment data were extracted. Wound management included wound irrigation, surgical debridement, and application of silver dressings, as needed. Therapy was transitioned to ultraportable NPWT with twice-weekly dressing changes. When possible, patients with an ankle-brachial index greater than 0.8 received multilayer, multicomponent compression. Treatment response was evaluated using a wound imaging system at 2-week to 4-week intervals for a total of 24 weeks. Results. Nine male patients with a mean age of 69.7 years presented for care. One patient sustained injury during sports activities, and the other 8 patients sustained injuries resulting from household accidents. Six patients achieved complete wound closure. Three patients achieved a mean 90% wound closure. No adverse effects were observed during treatment with NPWT and compression therapy. Conclusions. In the current study, ultraportable NPWT and compression bandaging were found to be effective in the management of wounds with critical local vascularity. Larger, randomized controlled studies are necessary to fully assess the potential clinical benefit of NPWT and compression therapy in the management of postoperative wounds of the Achilles tendon.
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Osborn, Suzanne C., David Addison, Claudia Islas, Karen Richey, and Kevin N. Foster. "110 Does Discharge to a Post-acute Facility Predispose Burn Patients to a Deterioration of Their Wounds?" Journal of Burn Care & Research 43, Supplement_1 (March 23, 2022): S72. http://dx.doi.org/10.1093/jbcr/irac012.113.
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Abstract Introduction The care of burn injuries requiring hospitalization is complex and highly specialized. In-hospital treatment results in discharging patients with stabilized, but unhealed wounds with the need for ongoing care. The expectation is that wounds continue to heal without complication. For patient who are unable to be discharged home, disposition is frequently dictated by finance and payor source. Post-acute facilities such as Skilled Nursing facilities (SNF), Acute Rehabilitation Centers (ARC) and Long-term Acute Care facilities (LTAC) are utilized. The purpose of this study was to evaluate the wound healing in patients being sent to SNF and ARC. Methods A retrospective chart review of patients discharged to a SNF or ARC over a one-year period was performed. Photographic review was done comparing photos from the first clinic visit to those from hospital discharge. Wounds were designated as “Improved” (IM) or “Worsened/No Change” (W/NC) by a single burn surgeon. Results Of the 963 charts reviewed, 719 patients suffered burn injuries, and of these 127 were discharged to post-acute facilities, 54 were either discharged to a LTAC or did not have photos available for review at their first clinic visit. Thus 73 were evaluable. The majority, 51% (n=37) worsened or showed no change (W/NC) and 49% (n=36) improved (IM). All patients returned to clinic within the first 2 weeks of discharge. There were no significance differences for age, gender, BMI, comorbidities, substance abuse, living situation, ICU days, ventilator days, length of stay, number of surgeries, payor source or facility type (SNF vs ARC). Mean TBSA was greater in IM 13.99% vs W/NC 8.31% (p=0.018). There were no significant differences between groups for mechanism, although IM was more likely to have suffered a flame/flash injury (n=20) and W/NC contact burns (n=21). A total of 30 different facilities were utilized for discharge. Conclusions Despite having smaller burn injuries, the majority of patients worsened if discharged to a post-acute facility. No patient factors were identified that were associated with worsening/no change in wound status at the first clinic visit post discharge. Given the number of discharge facilities utilized, we were unable to analyze the relationship between specific facilities and outcomes. The magnitude of the problem warrants further investigation. A Quality Improvement project is being developed to further identify areas for intervention.
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Yoksa, Daniel T., Yusuf Abba, Bala U. Shamaki, and Ngamarju A. Satumari. "Effects of resveratrol topical ointment on wound healing of full-thickness cutaneous burns in albino rats." Journal of Wound Care 31, no. 9 (September 2, 2022): 780–91. http://dx.doi.org/10.12968/jowc.2022.31.9.780.
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Objective: In this study, the effects of resveratrol topical ointment on wound contraction and histopathology of full-thickness cutaneous burn wounds were evaluated. Method: Adult albino rats were grouped into four equal-sized groups of 15 rats each, as follows: Group A—no wound, no treatment (control); Group B—1% silver sulphadiazine; Group C—5% resveratrol, and Group D—wound without treatment (control). A burn wound measuring 23.5mm was created on the skin at the dorsum of all rats in groups B—D after shaving. The percentage of wound contraction was measured using a digital Vernier Caliper on days 1, 3, 5, 7, 10, 14, 16, 18 and 21, post-wounding. From each group, five rats were then euthanised and tissue samples of the skin, liver and kidney were collected in 10% buffered formalin for histopathology. Results: The percentage of wound contraction was significant (p<0.05) on 7, 14 and 18 days post treatment. Histopathologically, 5% resveratrol topical ointment application resulted in a thicker epidermis with neovascularisation and an increased collagen distribution. Resveratrol topical ointment ameliorated the extent of hepatocellular and nephrotubular injuries following burn-induced hepatocellular and acute kidney injuries. Conclusion: In this study, topical application of 5% resveratrol ointment appeared to enhance burn wound healing by increasing the rate of wound contraction through collagen fibre synthesis, granulation tissue formation and epithelial regeneration.
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Souza, Vitor Latorre. "Intervenção percutânea coronária e curativos por lesões de pele em sítio de punção: revisão integrativa." Revista Feridas, no. 42 (June 1, 2020): 1524–29. http://dx.doi.org/10.36489/feridas.2020v8i42p1524-1529.
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Objetivo: Identificar literaturas sobre lesões de pele por curativo pós intervenção coronária percutânea (IPC). Método: Revisão integrativa, seguindo as etapas: estabelecimento da questão de pesquisa, definição dos critérios de inclusão e exclusão, categorização e avaliação dos estudos, interpretação dos resultados e síntese do conhecimento. Utilizando os descritores Wounds and Injuries; Angioplasty, Balloon, Coronary; Nursing Care; Cardiovascular Nursing; Compression Bandages; Percutaneous Coronary Intervention nas bases Medline, LiLaCS e BDENF. Incluiu artigos primários, de revisão, na integra, todos idiomas, excluindo duplicadas e não relacionados ao tema. Resultado: Do total de 91 artigos, 17 estudos foram selecionados e destes 4 atenderam aos critérios. De 4 artigos, 2 foram publicados nos Estados Unidos, 1 na Dinamarca e 1 na Suíça, no período entre 2002 e 2009. Conclusão: Concluímos que existe a necessidade de estudos sobre a incidência dessas lesões e também que enfermeiros construam protocolos para pautar suas atribuições técnicas no momento de avaliar a pele, para definir o material e técnica de curativo pós IPC.
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Karatan, Berrak, and Kamil Yamak. "Use of single-layer artificial dermal template in patients with trauma and burns." Journal of Wound Care 31, Sup4 (April 1, 2022): S16—S23. http://dx.doi.org/10.12968/jowc.2022.31.sup4.s16.
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Objective: Artificial dermal templates (ADTs), were designed initially to provide extracellular matrix and skin substitute for extensive burn injuries. Use of ADTs in a variety of other indications, has also been described in the literature. In this study, we describe our experience of using ADTs for different indications in burn contractures and wound coverage. Method: In this retrospective study, patients requiring burn scar contracture release, permanent wound coverage for acute traumatic wounds and temporary wound coverage to prepare for complex reconstructions, and where the ADT Pelnac (Gunze Ltd., Japan) was applied, were evaluated. Data regarding patient sex, age, type and location of injury, comorbidities, operations and complications were recorded. Results: A total of 24 patients were included in the study, of whom 12 patients were operated on for burn contractures. ADTs were used with split-thickness skin grafts (STSGs) or Z-plasties in a single-stage procedure. In six patients, ADT and STSGs were used to cover defects with exposed bone or tendon. Of the patients, six had their wounds covered temporarily while they were stabilised for complex reconstructions or were awaiting definitive histopathological results. Revisional surgeries due to graft failures or insufficient contracture releases were required by 12 patients. All temporary wound coverage patients had successful flap reconstructions after stabilisation of their general status, had tumour-free margins in the histopathological examination, and no necrosis or infection was seen on follow-up. Conclusion: In this study, ADTs had positive effects on selected patients, but comprehensive and comparative clinical studies are needed for different indications to choose between these templates.
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Cunha, João Batista da, Rosimar Aparecida Alves Dutra, Geraldo Magela Salomé, and Lydia Masako Ferreira. "Sistema computacional aplicado à tecnologia móvel para avaliação e tratamento de feridas." Revista de Enfermagem UFPE on line 12, no. 5 (May 1, 2018): 1263. http://dx.doi.org/10.5205/1981-8963-v12i5a230677p1263-1272-2018.
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RESUMOObjetivo: descrever o desenvolvimento de um aplicativo móvel para a avaliação e tratamento de feridas. Método: estudo metodológico. Foi feita a pesquisa da literatura com os descritores: ferimentos e lesões; bandagens; cicatrização. Foram realizados o planejamento do conteúdo, a seleção das ferramentas do aplicativo, a definição da configuração de ambientes, ferramentas e recursos educacionais, a construção do ambiente na Internet para download e instalação do aplicativo no dispositivo móvel. Resultados: quinze artigos foram selecionados através da pesquisa da literatura. O aplicativo criado possui uma interface gráfica de fácil uso, armazena as características sociodemográficas do paciente, permite a avaliação da ferida e de fatores de risco e recomenda procedimentos terapêuticos. Conclusão: o aplicativo desenvolvido pode ter grande utilidade na prática clínica, ajudando a selecionar intervenções de enfermagem para a prevenção e tratamento de feridas, bem como na educação em enfermagem. Descritores: Aplicativos Móveis; Software; Lasers; Ferimentos e Lesões; Algortimos; Cuidados de enfermagem. ABSTRACT Objective: to describe the development of a mobile application for evaluation and treatment of wounds. Method: methodological study. Literature search was carried out with the descriptors: wounds and injuries; dressings; cicatrization. The following steps were followed: planning of content; selection of application tools; configuration of environments, tools and educational resources; building the Internet environment for downloading and installing the application on mobile devices. Results: fifteen articles were selected through literature search. The application has an easy-to-use graphical interface. It stores the patient's sociodemographic characteristics, allows assessment of the wound and risk factors and recommends therapeutic procedures. Conclusion: the application developed may be very useful in clinical practice, helping to select nursing interventions for wound prevention and treatment, as well as in nursing education. Descriptors: Mobile Applications; Software; Lasers; Wounds and injuries; Algorithms; Nursing care.RESUMENObjetivo: describir el desarrollo de un aplicativo móvil para la evaluación y tratamiento de heridas. Método: estudio metodológico. Fue hecha la investigación de la literatura con los descriptores: heridas y lesiones; vendajes; cicatrización. Fueron realizados el planeamiento del contenido, la selección de las herramientas del aplicativo, la definición de la configuración de ambientes, herramientas y recursos educacionales, la construcción del ambiente en Internet para download e instalación del aplicativo en el dispositivo móvil. Resultados: quince artículos fueron seleccionados a través de la investigación de la literatura. El aplicativo creado posee una interface gráfica de fácil uso, almacena las características sociodemográficas del paciente, permite la evaluación de la herida y de factores de riesgo y recomienda procedimientos terapéuticos. Conclusión: el aplicativo desarrollado puede tener grande utilidad en la práctica clínica, ayudando a seleccionar intervenciones de enfermería para la prevención y tratamiento de heridas, así como en la educación en enfermería. Descriptores: Aplicaciones Móviles; Programas Informáticos; Heridas y Lesiones; Evaluación.
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Levin, Pamela F., Jeanne Beauchamp Hewitt, and Susan Terry Misner. "Workplace Violence." AAOHN Journal 44, no. 7 (July 1996): 326–31. http://dx.doi.org/10.1177/216507999604400703.
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Homicide is the leading cause of fatal occupational injuries for women and accounts for 39% of all fatal injuries for women at work. Using medical examiner and coroner reports, this study analyzed female workplace homicides in three counties within metropolitan Chicago from 1984 to 1990. These workplace homicides were compared to non-workplace homicides of women. There were 1,354 female homicides; of the 17 workplace homicides, all occurred in Cook County. The annual rate of female occupational homicides was higher (1.5/105) for Cook County, while for the metropolitan Chicago area (Cook, DuPage, and Lake counties) it was 1.19/105. Black women experienced a higher workplace homicide rate (2.3/105) than white women (1.2/105). Most of these occupational homicides occurred in retail trade, predominately in eating and drinking establishments; robbery was a frequent occurrence, and the women often worked alone. Only three medical examiner reports cited a known assailant. The leading cause of death was from gunshot wounds. Workplace homicides were similar to non-workplace homicides in relation to age, race, and cause of death. Identified risk factors associated with workplace homicides, as well as non-fatal assaults, should be used to develop effective preventive measures. A national standard for general workplace security also is needed.
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De Freitas Martins, Thalyta Cássia, Poliana Miranda, Samanta Cristina De Almeida Pereira, and Matheus Gomes de Souza. "Tratamento Tópico para o Sangramento em Feridas Tumorais: Uma Revisão Integrativa." Saúde Coletiva (Barueri) 11, no. 66 (June 29, 2021): 6571–86. http://dx.doi.org/10.36489/saudecoletiva.2021v11i66p6571-6586.
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Objetivo: realizar uma revisão integrativa da literatura, focada na identificação e avaliação de estudos primários objetivando o controle tópico do sangramento em feridas tumorais. Métodos: foi feita pesquisa bibliográfica no período de dezembro de 2020 a janeiro de 2021 nas bases de dados Scopus, Cinahl, PubMed e Web of Science e usados os descritores wounds and injuries, hemorrhage, neoplasms e nursing e as palavras chaves symptom management, bleeding e therapeutics. Resultados: A amostra final foi composta por 06 estudos. Os delineamentos mais frequentes foram série de casos/relato de caso, com cinco estudos (83,3%), e um estudo de coorte (16,7%). Portanto, cinco estudos (83,3%) apresentaram nível de evidência 6 (fraca) e um (16,7%), nível de evidência 4 (moderada). Conclusão: recomenda-se que estudos posteriores com melhor delineamento metodológico sejam conduzidos a fim de produzir evidências mais concretas.
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Tatomir, Jovanka. "Procedure zdravstvene nege pacijenta sa opekotinskom traumom / Procedures health care of the patient with burns trauma." SESTRINSKI ŽURNAL 3, no. 1 (November 1, 2016): 48. http://dx.doi.org/10.7251/sez0116048t.
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The burns are tissue damage caused under the influence of pathogenic amounts of heat, chemicals, electricity or radiation of different bodies.Etiological factors generally can be divided into four groups: thermal, chemical, electrical and radiation burns.Tissue damage is directly related to high temperature and length of exposure to harmful agents. The higher the temperature and longer works, the damage was more severe. Etiologic agents can cause minor injuries in the form of erythema of the skin, and severe destruction of body parts or the whole organism. System changes occur and are particularly pronounced in severely burned patients. These are patients with more than 25% body surface area burned, regardless of the depth, electrical burns, subdermal burns over 10% of body surface area burned with associated lung injuries, fractures, contusions, wounds, diseases previously. The burns are the most serious violations of the organism due to the involvement of almost all organs and systems. Extensive burns are therefore called and burns disease.The treatment of burned patients conducted team with a multidisciplinary approach. The nurse is an integral part of the team. The treatment of burns consists of first aid, general medical and surgical treatment. Prophylactic antibiotic therapy is applied in extensive burns. The main aim of local treatment of the disposal of burned area.Nursing care of the patient with burns trauma is of particular importance for the outcome of the treatment and prevention of complications. Nursing process involves numerous and complex medical-technical intervention, such as: continuous monitoring of vital functions; daily dressing wounds, with the absolute application of the principles of aseptic techniques; taking laboratory analysis; placement of a urinary catheter connected to a closed drainage system, to be followed hour diuresis; placement central venous catheter, peripheral venous catheters; taking blood cultures and urine culture with the aim of diagnosis of septic states.
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Siedlecki, Zygmunt, and Maciej Śniegocki. "Minimally Invasive (Percutaneous) Pedicle Srews as the Treatment of Choice in Thoracolumbar Spine Fractures." Journal of Neurological and Neurosurgical Nursing 11, no. 1 (March 28, 2022): 3–7. http://dx.doi.org/10.15225/pnn.2022.11.1.1.
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Introduction. Minimally invasive techniques of transpedicular fusion have become very common and seem to displace classical open techniques. Pedicle screws fusion is the procedure of choice in unstable traumatic lumbar and thoracic spine fractures of.Aim. The aim of the study was to answer whether open techniques are still used in injuries or whether they have been completely replaced by MISS.Material and Methods. The manuscript presents an analysis of patients treated in 2017–2021 in the Department of Neurosurgery, Neurotraumatology and Pediatric Neurosurgery of Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University.Results. Based on the analysis of medical documentation, it was found that every case of traumatic thoracolumbar spine fracture in 2017–2021 was treated using minimally invasive techniques. According to the documentation, the last case of using open surgical technique in the case of trauma was in 2016. It was noted that percutaneous techniques dominated the surgical treatment of thoracolumbar spine fractures and replaced the classic techniques in our department, which are used only, in some cases, in treatment of non-traumatic spondylolisthesis.Conclusions. Therefore, percutaneous techniques are currently the procedure of choice in spine injuries fusion in our hospital. The use of percutaneous techniques reduces the surgical traumatization of tissues (it is important to avoid additional traumatization and blood loss in traumatic patients). It has been pointed out that these procedures are performed by neurosurgeons who, in teaching process, used percutaneous techniques often and now prefer this method. The use of percutaneous techniques has important aspect in the field of neurosurgical nursing, because care of the operated area consists in observing few (4–16) smaller wounds, not one long wound (as in classic techniques), and these wounds are located directly above the titanium screw tips, which must under neurosurgical nurse care. (JNNN 2022;11(1):3–7)
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Soares, Raquel De Souza, Daianny Arrais de Oliveira da Cunha, and Patricia Dos Santos Claro Fuly. "Cuidados de enfermagem com feridas neoplásicas." Revista de Enfermagem UFPE on line 12, no. 12 (December 2, 2018): 3456. http://dx.doi.org/10.5205/1981-8963-v12i12a236438p3456-3463-2018.
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RESUMO Objetivo: discutir os cuidados de Enfermagem relacionados às feridas neoplásicas nos pacientes em cuidados paliativos. Método: trata-se de um estudo bibliográfico, tipo revisão integrativa, com buscas nas bases de dados Cochrane, LILACS, MEDLINE, BVS e Portal CAPES, em publicações nos idiomas português, espanhol e inglês, com recorte temporal de 2012 a 2017, selecionou-se 7 artigos para a análise descritiva. Resultados: encontraram-se nos artigos selecionados as seguintes categorias de acordo com a sintomatologia abordada: Controle da dor; Controle do odor; Prevenção de hemorragias; Controle de exsudato e Aspectos psicossociais. Conclusão: norteiam-se, pelos cuidados de Enfermagem encontrados, as condutas do enfermeiro ao realizar os curativos das feridas neoplásicas. Destaca-se, no entanto, um importante aspecto que evidencia o comprometimento psicossocial que envolve o paciente com ferida neoplásica, considerando este, também, um cuidado de Enfermagem a ser realizado. Descritores: Enfermagem; Cuidados Paliativos; Ferimentos e Lesões; Neoplasias; Enfermagem Oncológica; Cuidados de Enfermagem.ABSTRACT Objective: to discuss nursing care related to neoplastic wounds in patients in palliative care. Method: this is a bibliographical study, type integrative, with searches in the databases Cochrane, LILACS, MEDLINE, VHL and Portal CAPES, in Portuguese, Spanish and English publications, with a temporal cut from 2012 to 2017, seleciounou 7 articles for the descriptive analysis. Results: the following categories were found in the selected articles according to the symptomatology: Pain control; Odor control; Prevention of bleeding; Control of exudate and psychosocial aspects. Conclusion: Nursing care is guided by nursing care when performing the dressing of neoplastic wounds. However, it is important to emphasize the psychosocial impairment that involves the patient with neoplastic wound, considering also a Nursing care to be performed. Descriptors: Nursing; Palliative Care; Wounds and Injuries; Neoplasms; Oncology Nursing; Nursing Care.RESUMEN Objetivo: discutir los cuidados de enfermería relacionados con las heridas neoplásicas en los pacientes en cuidados paliativos. Método: se trata de un estudio bibliográfico, revisión de tipo integrador, para buscar las bases de datos Cochrane, Lilacs, Medline, BVS y Portal CAPES, en publicaciones en portugués, español e Inglés, con el marco de tiempo de 2012 a 2017, seleccionado - siete artículos para el análisis descriptivo. Resultados: se encontraron en los artículos seleccionados las siguientes categorías de acuerdo con la sintomatología abordada: Control del dolor; Control del olor; Prevención de hemorragias; Control de exudado y Aspectos psicosociales. Conclusión: se orientan, por los cuidados de Enfermería encontrados, las conductas del enfermero al realizar los vendajes de las heridas neoplásicas. Se destaca, sin embargo, un importante aspecto que evidencia el compromiso psicosocial que envuelve al paciente con herida neoplásica, considerando este, también, un cuidado de Enfermería a ser realizado. Descriptores: Enfermería; Cuidados Paliativos; Heridas y Lesiones; Neoplasias; Enfermería Oncológica; Atención de Enfermería.
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Ewanowski, Kathleen M., Caitlin Bramble, Walter R. Anyan, Irma D. Fleming, Ronda Hopkins, Stephen E. Morris, Callie M. Thompson, and Giavonni M. Lewis. "608 Utilization of Phase-Based Guidelines For Patient Care After Application of Cultured Epithelial Autograft." Journal of Burn Care & Research 43, Supplement_1 (March 23, 2022): S143—S144. http://dx.doi.org/10.1093/jbcr/irac012.236.
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Abstract Introduction Cultured epithelial autografts (CEA) have been clinically utilized since 1981 & can be a lifesaving procedure in patients with extensive full thickness burns. CEA is more susceptible to bacterial contamination & complete graft loss than traditional split-thickness autografts, yet no standard of practice exists for the postoperative care of these grafts to minimize infection & maximize graft take. Prior to 2019, care of CEA patients at our institution was not standardized & instead varied upon the attending surgeon’s practice. With the input of interdisciplinary team members, CEA patient care was standardized via phase-based guidelines (PBGs), leading to improved team communication & improved patient outcomes. Methods PBGs were created via interdisciplinary collaboration among surgeons, APCs, nursing staff, PT/OT, & psychosocial providers. Team members agreed upon 3 facets of patient care: Wound Care/Airing Out, Restrictions/Visitors, & Burn Therapy (Figure 1). As wounds progressed postoperatively, patient phases were advanced, liberalizing them from rigorous infection-prevention techniques to strict unit standards for non-CEA burn patients. In 2019, the utilization of patient-specific CEA care plans ceased in favor of standardized PBGs. A retrospective chart review was conducted on all patients from 2018-2021 who received CEA & survived their injuries. Some patients underwent a single CEA application while others underwent multiple operations. CEA graft take was assessed on all wounds from each surgery. Results CEA was rarely used at our institution. Beginning in 2018, seven patients received CEA & survived their injuries, ranging in age from 4-59 yrs (mean 24) & %TBSA from 38-80 (mean 53) (Table 1). Implementation of PBGs correlated with subjective improvement in team communication & increased mean percentages of CEA graft take from < 35% to >75%. Conclusions PBGs have standardized care for our CEA patients, eliminated communication errors among team members, & increased CEA graft take. Further research is needed to determine efficacy in decreasing infection, antibiotic use, hospital stay length, & mortality in these patients.
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Chimed-Ochir, Odgerel, Yui Yumiya, Akihiro Taji, Eisaku Kishita, Hisayoshi Kondo, Akinori Wakai, Kouki Akahoshi, et al. "Emergency Medical Teams’ Responses during the West Japan Heavy Rain 2018: J-SPEED Data Analysis." Prehospital and Disaster Medicine 37, no. 2 (February 28, 2022): 205–11. http://dx.doi.org/10.1017/s1049023x22000231.
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AbstractIntroduction:Rainfall-induced floods and landslides accounted for 20.7% of all disaster events in Japan from 1985 through 2018 and caused a variety of health problems, both directly and indirectly, including injuries, infectious diseases, exacerbation of pre-existing medical conditions, and psychological issues. More evidence of health problems caused by floods or heavy rain is needed to improve preparedness and preventive measures; however, collecting health data surrounding disaster events is a major challenge due to environmental hazards, logistical constraints, political and economic issues, difficulties in communication among stakeholders, and cultural barriers. In response to the West Japan Heavy Rain in July 2018, Emergency Medical Teams (EMTs) used Japan - Surveillance in Post-Extreme Emergencies and Disasters (J-SPEED) as a daily reporting template, collecting data on the number and type of patients they treated and sending it to an EMT coordination cell (EMTCC) during the response.Study Objective:The aim of the study was to conduct a descriptive epidemiology study using J-SPEED data to better understand the health problems during floods and heavy rain disasters.Methods:The number and types of health problems treated by EMTs in accordance with the J-SPEED (Ver 1.0) form were reported daily by 85 EMTs to an EMTCC, where data were compiled during the West Japan Heavy Rain from July 8 through September 11, 2018. Reported items in the J-SPEED form were analyzed by age, gender, area (prefecture), and time period.Results:The analysis of J-SPEED data from the West Japan Heavy Rain 2018 revealed the characteristics of a total of 3,617 consultations with the highest number of consultations (2,579; 71.3%) occurring between Day 5 and Day 12 of the 65-day EMT response. During the response period, skin disease was the most frequently reported health event (17.3%), followed by wounds (14.3%), disaster stress-related symptoms (10.0%), conjunctivitis (6.3%), and acute respiratory infections (ARI; 5.4%).Conclusion:During the response period, skin disease was the most frequently reported health event, followed by wounds, stress, conjunctivitis, and ARIs. The health impacts of a natural disaster are determined by a variety of factors, and the current study’s findings are highly context dependent; however, it is expected that as more data are gathered, the consistency of finding will increase.
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Ho, Weiguang, Christopher D. Jones, Daniel Widdowson, and Hilal Bahia. "Bromelain-based enzymatic debridement of e-cigarette burns: a single unit experience." Journal of Wound Care 28, no. 11 (November 2, 2019): 758–61. http://dx.doi.org/10.12968/jowc.2019.28.11.758.
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Objective: It is widely accepted that the early debridement of burns improves outcome. There is increasing evidence that enzymatic debridement is an effective technique for removal of full-thickness and deep-dermal burns, reducing blood loss and often the need for autologous skin grafting by avoiding over excision of the burn. We aim to highlight the potential use of this form of debridement as an alternative to surgical management in patients with electronic cigarette (e-cigarette)-associated flame burn injuries. Methods: This case series presents the use of Nexobrid (MediWound Ltd, Israel), a non-surgical, bromelain-based enzymatic debridement technique, in patients with deep partial-thickness burns (range: 1–3% total body surface area), avoiding the need for autologous skin grafting. Results: Burn wounds in two patients healed within 14 days without complications or the need for further surgical intervention. Another patient required further dressings after discharge but failed to attend follow-up appointments. These results are comparable with those reported by others using conservative management of e-cigarette burns. Conclusion: The authors wish to raise awareness of the potential for a combination of thermal and chemical burns related to e-cigarette explosions. Chemical burns should be excluded by pH testing of the burn wound. From our experience, small e-cigarette-associated flame burns can be considered for management with enzymatic debridement.
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Ranse, J., and S. Lenson. "(A111) Role, Resources, and Clinical and Educational Backgrounds of Nurses Who Participated in the Prehospital Response to the 2009 Bushfires in Victoria, Australia." Prehospital and Disaster Medicine 26, S1 (May 2011): s31. http://dx.doi.org/10.1017/s1049023x11001130.
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The bushfires of February 2009 in Victoria, Australia resulted in the deaths of 173 people and caused injuries to 414. Furthermore, > 2,030 houses and 3,500 structures were destroyed. The role and experience of nurses in this environment are not well understood, and little is known about the clinical and education background of nurses in this setting. This presentation will provide an overview of the bushfires and report on two research projects. The aims of these projects were to explore participant demographics and various aspects of nursing activities in the prehospital environment. These projects used volunteer nursing members of St John Ambulance Australia who responded to the Victorian fires. The first project used a retrospective, descriptive postal survey, and the second was descriptive and exploratory, using semi-structured interviews as a means of data collection. The survey highlighted that nurses had varying clinical and educational backgrounds. Males were overrepresented when compared to the national average of nurses. Most participants had taken disaster-related education, however, this varied in type and duration. Similarly, most had participated in training or mock disasters; however this usually was not related to bushfire emergencies. The qualitative findings identified two main themes having expansive roles and being prepared. These highlighted that nurses maintained a variety of roles, such as clinicians, emotional supporters, coordinators and problem solvers, and they were well prepared for these roles. This research provided insight into the characteristics and level of preparedness of nurses who responded to the 2009 Victorian bushfires in the prehospital environment. Additionally, it highlights the need for more structured education and training for nurse that is aligned with their role and deployment environment.
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Wang, Jian, Bo Yang, Xiu-Hang Zhang, Shu-Han Liu, and Wei Wu. "The Effectiveness of Silver-containing Hydrofiber Dressing Compared With Topical Silver Sulfadiazine Cream in Pediatric Patients With Deep Partial-Thickness Burns: A Retrospective Review." Wound Management & Prevention 68, no. 3 (March 1, 2022): 29–36. http://dx.doi.org/10.25270/wmp.2022.3.2936.
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BACKGROUND: Deep partial-thickness (DPT) burns are a common pediatric burn injury and involve the limbs and trunk. Initial management of a pediatric burn is conservative and consists of wound dressings and creams to optimize the environment for reepithelialization. Silver-containing Hydrofiber dressings (SHDs) and silver sulfadiazine (SS) cream are used widely to treat burn wounds. However, the effectiveness of the 2 methods when applied to pediatric DPT burn wounds is unclear. PURPOSE: This study was performed to compare the effectiveness of SHD versus SS cream in pediatric patients with DPT burns. METHODS: The authors conducted a retrospective review of data collected from 92 pediatric patients (mean age, 51.44 months; range, 2 months to 18 years) with DPT burns to the limbs and trunk involving 5% to 10% of total body surface area who were admitted to a burn center from January 2018 through January 2020; more than 75% of these burns were scald injuries. Of the patients included in this analysis, 40 were treated with topical SS cream, whereas SHDs were used in 52 patients. Outcomes included time to complete healing, number of dressing changes, nursing care time, hospitalization expenses, complications, and patient primary caregiver satisfaction score using a 4-point Likert scale. RESULTS: The complete healing time was significantly shorter in the SHD group compared with the SS group (18.98 ± 2.21 days vs 22.45 ± 2.25 days, respectively; P < .05). There were fewer dressing changes in the SHD group than in the SS group (4 ± 0.74 vs 11.55 ± 0.88, P < .05). Overall, caregivers of patients in the SHD group reported better satisfaction than caregivers in the SS group. CONCLUSION: When compared with SS cream, the use of SHD was found to be a safe, effective, and economical therapeutic method for treating DPT burns in the pediatric patients included in this study.
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Rodrigues dos Santos, Antonio Adriano, Ana Beatriz De Almeida Medeiros, Maria Julia Guimarães de Oliveira Soares, and Marta Miriam Lopes Costa. "Observation of dressing technique performed by professionals of nursing in a public hospital." Revista de Enfermagem UFPE on line 4, no. 3 (June 30, 2010): 1357. http://dx.doi.org/10.5205/reuol.928-8485-2-le.0403201003.
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ABSTRACTObjectives: to know how professionals of nursing are performing the dressing technique, to observe the use of technical principles in the accomplishment of the procedure and to identify the use of materials appropriated for execution of the technical procedure. Method: this is about an exploratory study, from quantitative approach, with a sample composed by 14 professionals. Data had been collected through a half-structuralized questionnaire. Is has been approved by the Ethics Commitee from Health Sciences Center of Federal University of Paraíba/UFPB and by the Ethics Commitee of the Lauro Wanderley University Hospital, under the protocol number 011/09, considering the Resolution 196/96 of the National Research Ethics Committee with human. Results: the most participants were female and they had less than five years of performance in the treatment of wounds; the practical of hygienic cleaning of the hands is not made in the correct way for the majority of them; the materials and coverings had been used in adequate way. Conclusion: the dressing technique is not made, for the majority of the nursing professionals, in agreement with what studied literature recommend. Descriptors: nursing; wounds and injuries; therapeutics.RESUMOObjetivos: conhecer como profissionais de enfermagem estão realizando a técnica de curativo, observar a utilização dos princípios técnicos na realização do procedimento e identificar a utilização de materiais adequados para execução do procedimento técnico. Método: trata-se de um estudo exploratório, de abordagem quantitativa, com amostra de 14 profissionais de enfermagem. Os dados foram coletados com um roteiro semi-estruturado, após aprovação pelo Comitê de Ética do Centro de Ciências da Saúde da Universidade Federal da Paraíba/UFPB, Campus I e pelo Comitê de Ética do Hospital Universitário Lauro Wanderley, sob protocolo 011/09, considerando a Resolução 196/96 da Comissão Nacional de Ética em Pesquisa com Seres Humanos. Resultados: a maioria dos participantes era do sexo feminino e tinham menos de cinco anos de atuação no tratamento de feridas; a prática de higienização das mãos não é feita da maneira correta pela maioria deles; os materiais e coberturas foram utilizados de maneira adequada. Conclusão: a técnica de curativo não é feita, pela maioria dos profissionais de enfermagem, em concordância com o que a literatura pesquisada recomenda. Descritores: enfermagem; ferimentos e lesões; terapêutica.RESUMENObjetivos: conocer cómo las enfermeras están haciendo la técnica de curativo, observar el uso de los principios técnicos en la realización del procedimiento e identificar el uso de materiales adecuados para la aplicación del procedimiento técnico. Método: estudio exploratório, enfoque cuantitativo con una muestra de 14 profesionales. Los datos fueron recogidos entre marzo y junio 2009 a través de un cuestionario semi-estructurado. Este estudio fue aprobado por el Comité de Ética del Centro de Ciencias de la Salud, Universidad Federal de Paraíba, y por el Comité de Ética del Hospital Universitario Lauro Wanderley, con el número de protocolo siguiente: 011/09, teniendo en cuenta la resolución 196/96 de la Comisión Nacional de Ética en Pesquisa. Resultados: la mayoría de los participantes eran mujeres y tenían menos de cinco años de experiencia en el cuidado de heridas; la práctica de lavarse las manos no se hace de la manera correcta por la mayoría de ellos; los materiales y coberturas fueran usados correctamente. Conclusión: la técnica de curativo no se hace por la mayoría de los profesionales de enfermería, de acuerdo con lo que la literatura recomienda. Descriptores: enfermería; heridas y lesiones; terapéutica.
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Renemann, Horst H. "Rescue Mission Following the Hi-Jacking of the Lufthansa 737, “Landshut”." Journal of the World Association for Emergency and Disaster Medicine 1, no. 2 (1985): 199–200. http://dx.doi.org/10.1017/s1049023x00065584.
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At 15:15 hrs on 17 October 1977, the Lufthansa Medical Service in Frankfurt was notified about the hijacking of a 737 Boeing aircraft. At 15:30 hrs the Crisis Management Staff (CMS) asked me if I would accompany a stand-by crew on the rescue mission. The intention of the CMS was to come to an agreement with the hijackers to exchange the crew of the hijacked plane for a stand-by crew accompanied by an airline physician. I agreed. Medicines and medical equipment for the treatment of injured and sick passengers were packed by medical assistants. At 16:30 hrs highly confidential information was received from CMS—GSG 9 that the Border Patrol Special Commando led by Commander Wegner would accompany the rescue mission which would henceforth be termed “Special Mission”. The hijacked plane was to be followed and seized. It was likely that in the course of this operation an unpredictable number of burns, gunshot wounds and other serious injuries could occur. In a very short time, medical assistants packed further huge crates full of first-aid packs, Macrodex infusions, analgesics, and so forth. I asked Dr. Straub, a medical colleague, and Mr. Reiser, a nursing assistant, both employees of the Lufthansa Medical Service, to accompany me as volunteers, and they agreed. At 16:45 hrs the CMS approved the medical team and the medical equipment.
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Graneiro, Thaiz Souza, Cristiane Rodrigues da Rocha, and Lara Raquel Dias Carvalho. "Tratamento de feridas usando laser de baixa intensidade como terapia adjuvante: uma revisão integrativa da literatura." Research, Society and Development 11, no. 11 (August 16, 2022): e83111133276. http://dx.doi.org/10.33448/rsd-v11i11.33276.
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Trata-se de uma revisão integrativa de literatura com abordagem qualitativa. O objetivo deste artigo é avaliar os parâmetros relacionados à dosimetria do laser de baixa intensidade no tratamento de lesões por pressão e úlceras diabéticas mais utilizados nas evidências científicas. Dados foram coletados nas bases Literatura Latino-Americana e do Caribe em Ciências da Saúde e Base de Dados de Enfermagem, pela Biblioteca Virtual em Saúde; Medical Literature Analysis and Retrieval System Online, pela PubMed; Web of Science; Cumulative Index of Nursing and Allied Health e EMBASE, utilizando-se o filtro temporal de 2016 a 2022. Foram usados os seguintes descritores controlados e não controlados: low level light therapy; LLLT; laser biostimulation; laser therapy; photobiomodulation; wounds and injuries; wound healing; diabetic foot; pressure ulcer. Resultados: Foram analisados 14 estudos a partir de duas categorias temáticas para avaliação dos parâmetros do laser de baixa intensidade utilizados nas lesões com as seguintes etiologias: ferida diabética e lesão por pressão. Conclusão: Todos os estudos encontraram desfecho positivo com uso de laser de baixa intensidade no tratamento de lesões por pressão ou úlceras diabéticas. A maioria recomendou comprimento de onda na faixa do vermelho (658 nm – 660 nm). Houve grande discrepância quanto à energia aplicada, porém a maioria dos trabalhos apresentou uma janela de 3 J/cm2 a 6 J/cm2. A categoria que analisou os estudos com úlcera diabética teve potência de 30 mW na maioria dos artigos. A categoria de lesões por pressão obteve bons resultados com potências de 3,6 mW a 100 mW.
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Medeiros, Ana Beatriz de Almeida, Maria Julia Guimarães de Oliveira Soares, Marta Miriam Lopes Costa, Antonio Adriano Rodrigues dos Santos, Gilson De Vasconcelos Torres, and Felismina Rosa Parreira Mendes. "Dressing techniques: practice of nursing academics an institution of higher education." Revista de Enfermagem UFPE on line 5, no. 2 (March 26, 2011): 379. http://dx.doi.org/10.5205/reuol.1718-11976-1-le.05spe201110.
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ABSTRACTObjectives: to know how academics of nursing are performing the dressing technique, to observe the use of technical principles in the accomplishment of the procedure and to identify the use of materials appropriated for execution of the technical procedure. Method: exploratory study, from quantitative approach, with a sample composed by 24 academics. Data had been collected through a half-structuralized questionnaire. Is has been approved by the Ethics Commitee from Health Sciences Center of Federal University of Paraíba and by the Ethics Commitee from Lauro Wanderley University Hospital, under the protocol number 011/09, considering the resolution 196/96 of the National Research Ethics Commitee. Results: the most participants were female; the practical of hygienic cleaning of the hands is not made in the correct way for the majority of them; the materials and coverings had been used in adequate way. Conclusion: the dressing technique is not made, for the majority of the nursing academics, in agreement with what studied literature recommend. Descriptors: nursing; wounds and injuries; therapeutics.RESUMOObjetivos: conhecer como acadêmicos de enfermagem estão realizando a técnica de curativo, observar a utilização dos princípios técnicos na realização do procedimento e identificar a utilização de materiais adequados para execução do procedimento técnico. Método: estudo exploratório, abordagem quantitativa, com amostra composta por 24 acadêmicos. Os dados foram coletados através de um roteiro semi-estruturado. Estudo aprovado pelo Comitê de Ética do Centro de Ciências da Saúde da Universidade Federal da Paraíba e pelo Comitê de Ética do Hospital Universitário Lauro Wanderley, sob o seguinte número de protocolo: 011/09. Considerando a Resolução 196/96 da Comissão Nacional de Ética em Pesquisa. Resultados: a maioria dos participantes era do sexo feminino; a prática de higienização das mãos é feita da maneira correta pela maioria deles; os materiais e coberturas foram utilizados de maneira adequada. Conclusão: a técnica de curativo é feita, pela maioria dos acadêmicos de enfermagem, em concordância com o que a literatura pesquisada recomenda. Descritores: enfermagem; ferimentos e lesões; terapêutica.RESUMENObjetivos: conocer cómo las académicos están haciendo la técnica de curativo, observar el uso de los principios técnicos en la realización del procedimiento e identificar el uso de materiales adecuados para la aplicación del procedimiento técnico. Método: estudio exploratório, enfoque cuantitativo con una muestra de 24 académicos. Los datos fueron recogidos através de un cuestionario semi-estructurado. Este estudio fue aprobado por el Comité de Ética del Centro de Ciencias de la Salud, Universidad Federal de Paraíba, y por el Comité de Ética del Hospital Universitario Lauro Wanderley, con el número de protocolo siguiente: 011/09, teniendo en cuenta la resolución 196/96 de la Comisión Nacional de Ética en Pesquisa. Resultados: la mayoría de los participantes eran mujeres; la práctica de lavarse las manos se hace de la manera correcta por la mayoría de ellos; los materiales y coberturas fueran usados correctamente. Conclusión: la técnica de curativo se hace por la mayoría de los académicos de enfermería, de acuerdo con lo que la literatura recomienda. Descriptores: enfermería; heridas y lesiones; terapêutica.