The Art of Dressing Selection: A Consensus Statement on Skin Tears and Best Practice.

PURPOSE: To provide information about product selection for the management of skin tears. TARGET AUDIENCE: This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. OBJECTIVES: After participating in this educational activity, the participant should be better able to:1. Explain skin tear (ST) risk factors and assessment guidelines.2. Identify best practice treatments for STs, including the appropriate dressings for each ST type. ABSTRACT: To aid healthcare professionals in product selection specific for skin tears, the International Skin Tear Advisory Panel conducted a systematic literature review and 3-phase Delphi consensus with a panel of international reviewers to provide the best available evidence for product selection related to the treatment of skin tears.

International Skin Tear Advisory Panel: a tool kit to aid in the prevention, assessment, and treatment of skin tears using a Simplified Classification System ©.

PURPOSE: To enhance the learner's competence with knowledge regarding utilization of a tool kit to aid in the prevention, assessment, and treatment of skin tears. TARGET AUDIENCE: This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. OBJECTIVES: After participating in this educational activity, the participant should be better able to:1. Demonstrate knowledge of skin tear prevention and classification as presented in the International Skin Tear Advisory Panel's tool kit.2. Apply information from the skin tear tool kit to patient care scenarios. ABSTRACT: The International Skin Tear Advisory Panel has created a tool kit for the prevention, identification, and treatment of skin tears. The tool kit is based on extensive literature reviews, international input from healthcare professionals, and on expert opinion. It has undergone a modified Delphi process.

Prevalence of skin tears in a long-term care facility.

PURPOSE: The purpose of this study was to collect baseline data of the prevalence of skin tears in a Canadian long-term care (LTC) facility. SUBJECTS AND SETTING: The research setting was a 114-bed long-term care facility located in Eastern Ontario, Canada. The sample population comprised 113 residents from the facility. DESIGN: A cross-sectional, quantitative study design was used to gather baseline data on the prevalence of skin tears in the Canadian population living in LTC. METHODS: Residents were assessed for presence of skin tears, the number of skin tears, and location. Skin tears were categorized according to the validated Payne Martin Classification system. Data were collected using a predetermined data collection sheet developed for this study. A certified enterostomal therapy nurse with previous experience with the assessment of skin tears collected the data along with 1 nurse employed by the facility. Data were collected on a single day over a 6-hour period. RESULTS: Twenty-five of the 113 participating residents in the LTC facility had skin tears, yielding a prevalence of 22%. Category I accounted for 51% of skin tears, 16% were category II, and 33% were category III. Individuals who were found to have more than 1 skin tear had at least 1 category III skin tear. The most common anatomical locations were arms (48%), lower legs (40%), and hands (12%). Possible etiologic factors included blunt trauma such as banging into objects (44%), trauma associated with activities of daily living (20%), and falls (12%); 24% were categorized as idiopathic. CONCLUSION: Study findings highlight gaps in our knowledge of skin tears and the need for additional studies to more clearly define their epidemiology.

Evidence-based practice standards for the use of topical pressurised oxygen therapy.

Whenever a new therapy enters the wound care arena it is mandatory to deliver the best evidence to clinicians, healthcare administrators and policy makers to support integration of the technology into clinical practice. While this can often be problematic when novel therapies lack a large body of supporting evidence, methods that incorporate the use of expert opinion do exist to evaluate existing evidence and create consensus statements that can help guide decisions. Topical pressurised oxygen therapy is a method of delivering pressurised and humidified oxygen directly to the wound bed to support the healing of chronic and hypoxic wounds. This article will present the process by which the evidence was identified and evaluated as well as present standards based on the evidence related to topical pressurised oxygen therapy. We will show, through the use of the evidence, how this therapy can be a non invasive safe approach for wound management for selected patients in all clinical care settings.

Physiology of continuous-flow pumps.

The use of mechanical pumps for circulatory support started in the mid-1950s. The evolution of these devices has led to the present-day use of continuous-flow pumps to take over the function of a patient's failing heart. The physiology associated with rotary blood pump use is quite different from normal cardiovascular physiology. Clinicians caring for patients who are supported by rotary blood pumps must have an understanding of the differences in physiology, monitoring methods, and unique complications associated with the use of these pumps.

Extreme heart makeover: understanding mechanical circulatory support.

Learn about ventricular assist devices and total artificial hearts and how they affect patient care.

Report of the first U.S. patient successfully supported long term with the LionHeart completely implantable left ventricular assist device system.

We report our first successful long-term survivor in the United States with the LionHeart (Arrow International, Inc., Reading, PA) completely implantable left ventricular assist device system. The patient was initially deemed a poor candidate for cardiac transplantation and had inotrope-dependent, end-stage cardiac failure. The patient was supported for 13 months with this system. During this period of support, the patient returned to independent living and derived obvious benefits toward his daily activities with the completely implanted system. The device proved to be reliable during this period of support. Through lifestyle modification, the patient was ultimately deemed an appropriate candidate for heart transplantation and ultimately received successful transplantation.

Addressing the challenge of providing nursing care for elderly men suffering from urethral erosion.

Urethral erosion in the male patient with a long-term indwelling catheter is a known but poorly documented sequelae of catheter injury. It is a difficult and challenging problem for staff, the patient, and his family. Urethral erosion affects not only the complexity of the patient's care but also the patient's quality of life. In recent months, 3 elderly gentlemen who were living in 3 different long-term care facilities were referred to us for assistance with their wounds, which were a direct result of catheter-related urethral erosion. In an attempt to find a solution for these difficult-to-manage wounds, the authors conducted a review of the literature. It quickly became evident that although literature is available describing urethral erosion and its relationship to indwelling urethral catheters, there is no literature available that describes the treatment and management of wounds caused by urethral erosion. Realizing that a solution to the problem or treatment of urethral erosion could not be found in the literature, the authors developed a treatment option for the management of urethral erosion. This article describes the plan of care devised to treat these 3 male patients with urethral erosion. Through the use of soft silicone foam and soft silicone tape, a treatment plan was devised that removed the pressure, decreased catheter movement, and provided a moist wound healing environment.

Managing heart failure: what you need to know.

Find out more about this common disorder, from assessing symptoms to answering your patient's questions about the newest treatments.