Complementary and alternative therapies in perinatal populations: a selected review of the current literature.

Complementary and alternative therapies have been accepted and used in perinatal nursing and midwifery practice for decades. Many authors describe a need for scientific scrutiny of these modalities to determine their efficacy and usefulness in patient care and to create some comparability among studies. The article presents a selective review of the current and readily available English literature about complementary and alternative therapies in perinatal care. Although there is a substantial amount of information published about these modalities in perinatal care, much of it is anecdotal. With the advent of definitions, descriptions, and funding in the United States and abroad, it is likely that additional research of improved design and comparability will be forthcoming.

Myocutaneous flaps. Surgical treatment of severe pressure ulcers.

Surgical treatment of pressure ulcers using the myocutaneous flap procedure is a relatively new approach for patients with spinal injuries. First, the pressure ulcers are treated conservatively; however, if they become large or infected, surgery is considered. We have performed approximately 1,500 of these surgeries in the past five years. Only 5% of the cases have developed complications. The primary complication experienced was small wound dehiscence, which we attributed to mechanical interference with wound healing. We attribute the overall success of these surgeries to the rigid protocol and interdisciplinary approach to management.

Ilizarov external fixation. Surgical principles, nursing implications.

The role of the perioperative nurse in caring for a patient with an innovative procedure such as the Ilizarov device is challenging. Because of the problem fracture, the patient usually has had multiple unsuccessful surgical experiences and may express considerable concern and anxiety. As perioperative patient advocates, nurses must encourage patients to be their own spokespersons and to ask questions when they do not understand. The patient advocacy role becomes even more important when the patient undergoes a new procedure. It is our experience with this procedure that both patients and professional staff have many questions during the postoperative period. It is essential that the perioperative nurse establish a communication climate among the patient and members of the interdisciplinary team that promotes collaboration and problem solving on behalf of the patient undergoing this unique surgical procedure.