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1.
Texto & contexto enferm ; 29: e20180371, Jan.-Dec. 2020. tab, graf
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: biblio-1059139

RESUMO

ABSTRACT Objective: to identify factors associated with medical-device-related pressure injury. Method: an integrative review of published articles on the subject related to the adult population in the databases of PUBMED, Scopus, MEDLINE, Latin American and Caribbean Health Sciences Literature (Literatura Latino-Americana e do Caribe em Ciências da Saúde, LILACS), Web of Science and Nursing Database (Banco de Dados em Enfermagem, BDENF), between 2013 and 2018. Results: medical-device-related pressure injuries were common in adults, especially in the elderly, due to capillary fragility, among other changes. Other observed factors were length of stay, critically ill patients or those requiring any type of medical device. Numerous medical devices have been associated with skin lesions; among the most frequent were breathing, feeding, and orthopedic devices, tubes, oximeters, neck collars, patches and nasogastric tubes. Conclusion: the first step towards prevention is exploration in terms of identifying the types of injury-causing devices and evidence-based interventions, and disseminating information to the entire multidisciplinary team.


RESUMEN Objetivo: identificar factores asociados con las lesiones por presión relacionadas a dispositivos médicos. Método: revisión integradora de artículos publicados sobre el tema relacionado a la población adultas en las siguientes bases de datos: PUBMED, Scopus, MEDLINE, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Web of Science y Banco de Dados em Enfermagem (BDENF), entre 2013 y 2018. Resultados: las lesiones por presión relacionadas con dispositivos médicos fueron comunes en adultos, principalmente en ancianos, debido a la fragilidad capilar, entre otras alteraciones. También se observaron otros factores como tiempo de permanencia, pacientes críticos o que necesitaban cualquier tipo de dispositivo médico. Se asoció un sinnúmero de dispositivos médicos a las lesiones de piel; entre los más frecuentes se pueden mencionar los dispositivos respiratorios, de alimentación y ortopédicos, los tubos, los oxímetros, los collares cervicales, los adhesivos y las sondas nasogástricas. Conclusión: el primer paso para la prevención es la exploración, en términos de identificar los tipos de dispositivos que causan la lesión y las intervenciones basadas en evidencias científicas, además de divulgar la información a todo el equipo multiprofesional.


RESUMO Objetivo: identificar fatores associados à lesão por pressão relacionada a dispositivo médico. Método: revisão integrativa de artigos publicados sobre o tema relacionado à população adulta nas bases de dados da PUBMED, Scopus, MEDLINE, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Web of Science e Banco de Dados em Enfermagem (BDENF), entre 2013 e 2018. Resultados: lesões por pressão relacionadas a dispositivo médico foram comuns em adultos, principalmente em idosos, devido à fragilidade capilar, entre outras alterações. Outros fatores observados foram tempo de permanência, pacientes críticos ou que necessitassem de qualquer tipo de dispositivo médico. Inúmeros dispositivos médicos foram associados às lesões de pele; entre os mais frequentes estiveram dispositivos respiratórios, de alimentação, ortopédicos, tubos, oxímetros, colares cervicais, adesivos e sondas nasogástricas. Conclusão: o primeiro passo para a prevenção é a exploração, em termos de identificação dos tipos de dispositivos que causam a lesão e intervenções baseadas em evidências científicas, além da divulgação das informações para toda a equipe multiprofissional.


Assuntos
Humanos , Adulto , Ferimentos e Lesões , Lesão por Pressão , Enfermagem , Adulto , Equipamentos e Provisões , Segurança de Equipamentos
2.
Rev. enferm. UERJ ; 28: e35054, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1117622

RESUMO

Objetivo: avaliar a mobilidade do cliente com dermatose imunobolhosa antes e após aplicação do curativo com gaze vaselinada. Método: estudo quase experimental, interinstitucional, com clientes com dermatoses imunobolhosas hospitalizados em um hospital estadual e um hospital federal do Estado do Rio de Janeiro e uma instituição do Mato Grosso do Sul. Utilizou-se a lógica fuzzy para classificar a mobilidade dos sujeitos antes, 24 horas após e uma semana após aplicação do curativo. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa. Resultados: Incluídos 14 participantes, sendo nove com pênfigo vulgar, dois com pênfigo foliáceo e três com penfigóide bolhoso, entre 27 e 82 anos, predominando 11 mulheres. Após 24 horas, nenhum participante se considerou com baixa mobilidade, sete passaram a mobilidade média, e sete, alta, o que foi mantido uma semana após aplicação do curativo. Conclusão: constatou-se significativo aumento da mobilidade logo nas primeiras 24 horas após aplicação do curativo.


Objective: to assess the mobility of clients with immunobullous dermatoses, before and after applying vaseline gauze dressings. Method: in this quasi-experimental, interinstitutional study of inpatients with immunobullous dermatoses at a state hospital and a federal hospital in Rio de Janeiro State and an institution in Mato Grosso do Sul (Brazil), patient mobility before, 24 hours after, and one week after applying the dressing was classified using fuzzy logic. The study was approved by the research ethics committee. Results: 14 participants, nine with pemphigus vulgaris, two with pemphigus foliaceus, and three with bullous pemphigoid, aged between 27 and 82 years old, and predominantly (11) women. After 24 hours, none of the participants considered their mobility to be poor, seven began to be moderately mobile, and seven were highly mobile, and continued so one week after applying the dressing. Conclusion: mobility increased significant in the first 24 hours after applying the dressing.


Objetivo: evaluar la movilidad de clientes con dermatosis inmunobullosa, antes y después de la aplicación de apósitos de gasa con vaselina. Método: en este estudio cuasi-experimental, interinstitucional de pacientes hospitalizados con dermatosis inmunobullosa en un hospital estatal y un hospital federal en el estado de Río de Janeiro y una institución en Mato Grosso do Sul (Brazil), la movilidad del paciente antes, 24 horas después y una semana después la aplicación del apósito se clasificó mediante lógica difusa. El estudio fue aprobado por el comité de ética en investigación. Resultados: se incluyeron 14 participantes, nueve con pénfigo vulgar, dos con pénfigo foliáceo y tres con penfigoide ampolloso, con edades comprendidas entre 27 y 82 años, y predominantemente mujeres (n=11). Después de 24 horas, ninguno de los participantes consideró que su movilidad fuera pobre, siete comenzaron a ser moderadamente móviles y siete eran altamente móviles, y así continuaron una semana después de la aplicación del apósito. Conclusión: la movilidad aumentó significativamente en las primeras 24 horas después de la aplicación del apósitoconsideraba con baja movilidad, siete comenzaron a tener movilidad media y siete, alta, que se mantuvo una semana después de aplicar el apósito. Conclusión: hubo un aumento significativo en la movilidad en las primeras 24 horas después de aplicar el apósito.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Vaselina/uso terapêutico , Bandagens , Dermatopatias Vesiculobolhosas/terapia , Penfigoide Bolhoso/terapia , Pênfigo/terapia , Limitação da Mobilidade , Brasil , Lógica Fuzzy , Lesão por Pressão/prevenção & controle , Prevenção Secundária , Ensaios Clínicos Controlados não Aleatórios como Assunto , Hospitais Públicos , Pacientes Internados , Cuidados de Enfermagem
3.
Estima (Online) ; 18(1): e1120, jan.-dez. 2020.
Artigo em Português | BDENF - Enfermagem | ID: biblio-1103092

RESUMO

Objectives: To correlate the incidence of pressure injury (PI) with the average time of nursing care in an intensive care unit (ICU). Method: Epidemiological, observational, retrospective study, carried out in the ICU of a university hospital. Data were collected by consulting the PI incidence and the average nursing care time from ICU databases between 2010 and 2014. Measures of central tendency and variability, and Pearson's correlation coefficient were used for data analysis. Results: The average incidence of PI between 2010 and 2014 was 10.83% (SD = 2.87) and the average time spent in nursing care for patients admitted to the ICU was 15 hours (SD = 0.94). There was no statistically significant correlation between the incidence of PI and the nursing care time (r = -0.17; p = 0.199), however, the results suggested an overload on the nursing team. Conclusion: This study confirms the importance of implementing and reassessing the effectiveness of preventive care protocols for PI, in addition to warning about the work overload of nursing in assisting critically ill patients.


Assuntos
Incidência , Carga de Trabalho , Lesão por Pressão , Unidades de Terapia Intensiva , Cuidados de Enfermagem
4.
Estima (Online) ; 18(1): e1020, jan.-dez. 2020.
Artigo em Português | BDENF - Enfermagem | ID: biblio-1100027

RESUMO

Objetivo: Identificar na literatura as estratégias utilizadas pela equipe de enfermagem para prevenção de lesão por pressão em pacientes cirúrgicos. Métodos: Revisão integrativa, utilizando a estratégia PICo, tendo como questão norteadora: "quais as estratégias utilizadas pela equipe de enfermagem para prevenção de lesão por pressão em pacientes cirúrgicos?" As buscas foram realizadas nas bases de dados Web of Science, MEDLINE via PubMed, CINAHL, Cochrane, Scopus e no índice bibliográfico LILACS via BVS, sendo analisados 12 estudos. Resultados: O Brasil se destacou com quatro publicações e os estudos de coorte, com nível de evidência IV, prevaleceram em seis artigos. As intervenções tecnológicas para prevenção de lesão por pressão no centro cirúrgico foram colchões para distribuição de pressão, dispositivo para redução de pressão no calcâneo, instrumentos validados específicos para a classificação do risco de lesão por pressão em pacientes cirúrgicos, além de superfícies de apoio contendo polímero viscoelástico e outros utensílios para alívio da pressão decorrente do peso e de dispositivos médicos. Com relação às intervenções educativas, destacaram-se os protocolos, os treinamentos e a simulação realística. Conclusão: Observou-se que essas estratégias reduziram a incidência de lesão por pressão, além de diminuírem os custos e garantirem a satisfação dos pacientes.


Assuntos
Enfermagem , Lesão por Pressão , Posicionamento do Paciente , Período Perioperatório , Período Intraoperatório
5.
Medicine (Baltimore) ; 99(41): e22699, 2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33031342

RESUMO

BACKGROUND: Pressure ulcer (PU) is defined as a lesion or trauma to the skin and underlying tissue resulting from unrelieved pressure, shear, friction, moisture, or a combination of all these, usually appearing over a bony prominence. We aim to evaluate the credibility of systematic reviews and meta-analyses that assess the effectiveness, safety, and economy of the dressing treatments for PU through an overview. METHODS: We searched the following electronic bibliographic databases: PubMed, Embase, Cochrane Library, CINAHL Complete, PsycARTICLES, PsycINFO, DynaMed Plus, as well as the Chinese databases without any language restriction. We will include meta-analyses that dressings treatments in the management of PUs. For each meta-analysis, we will estimate the effect size of a treatment through the random-effect model and the fixed-effect model, and we will evaluate between-study heterogeneity (Cochrane's Q and I statistics) and small-study effect (Egger's test); we will also estimate the evidence of excess significance bias. Methodological quality of each meta-analysis will be evaluated by using Assessment of Multiple Systematic Reviews 2. RESULTS: This study is ongoing and the results will be submitted to a peer-reviewed journal for publication. ETHICS AND DISSEMINATION: Ethical approval is not applicable, since this is an overview based on published articles. PROTOCOL REGISTRATION NUMBER: The protocol has been registered on PROSPERO under the number CRD42020161232.


Assuntos
Bandagens , Lesão por Pressão/terapia , Humanos , Metanálise como Assunto , Revisões Sistemáticas como Assunto
6.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 5073-5076, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019127

RESUMO

This study developed a sensor system that measures electrical impedance with a surrounding electrode array that is located around the wound and estimates the depth and classifies the difference in tissues of small regions in the area using tomography combined with spectroscopy method. The system is designed to integrate into the dressing to reduce unnecessary removal of dressings. In the human trial, moisturizer applied area was detected using Random Forest classifier (94.4% accuracy) and differences between every 10 minutes were significant in moisturizer applied area (p<; 0.05). The study confirmed the proof of concept that the system can monitor the change in human skin without attaching the sensor to the target area and indicate the skin area that had changed.


Assuntos
Lesão por Pressão , Espectroscopia Dielétrica , Impedância Elétrica , Humanos , Lesão por Pressão/diagnóstico , Tomografia , Tomografia Computadorizada por Raios X
8.
J Wound Ostomy Continence Nurs ; 47(5): 430-434, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32868735

RESUMO

BACKGROUND: Medical device-related pressure injuries (MDRPIs) account for more than 30% of all hospital-acquired pressure injuries. The COVID-19 pandemic introduced a large population of patients at risk for MDRPIs due to prolonged intubation and prone positioning. We reviewed our experience with MDRPIs during the 2020 COVID-19 pandemic at an Academic Medical Center. CASES: We evaluated 30 cases of MDRPIs acquired during the peak of our pandemic, April 1 to May 31, 2020, and compared these to injuries seen over a similar time period prior to the pandemic. CONCLUSIONS: Our experiences with MDRPIs during this time has led the WOC team to begin development of a quality improvement project aimed at improving management of high-risk respiratory illness patients requiring intubation and prone positioning.


Assuntos
Betacoronavirus , Infecções por Coronavirus/terapia , Equipamentos e Provisões/efeitos adversos , Pneumonia Viral/terapia , Lesão por Pressão/etiologia , Lesão por Pressão/patologia , Decúbito Ventral , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Posicionamento do Paciente , Pneumonia Viral/complicações , Lesão por Pressão/prevenção & controle , Melhoria de Qualidade , Respiração Artificial/efeitos adversos , Respiração Artificial/instrumentação , Estudos Retrospectivos , Adulto Jovem
9.
J Wound Ostomy Continence Nurs ; 47(5): 435-438, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32868736

RESUMO

Patients admitted to the intensive care unit (ICU) are at a high risk for developing pressure injuries. A patient requiring multiorgan support is at a higher risk for pressure injuries related to immobility, sedation, vasopressors, and hypoxia. To mitigate pressure injuries, our hospital utilizes a bundle approach to prevent skin injury. However, despite efforts to prevent pressure injuries, we found our patients in the ICU with the diagnosis of COVID-19 went on to develop significant pressure and mucosal injuries. This is a case report of 4 patients diagnosed with COVID-19 who developed significant skin and mucosal injuries during their ICU admissions in the month of March 2020. We found that patients developed skin conditions that were initially thought to be deep-tissue injuries (DTIs) early in the admission. The DTIs progressed over the course of the admission in the ICU and evolved to thick adherent eschar that appeared to be unstageable pressure injuries, which extended beyond the soft tissue directly over the bony prominence. We also found that skin damage to the mucosa of the nares, tongue, lips, and urethra presented first as inflammation and then progressed to thick eschar. Despite maximum pressure relief with the use of a pressure-relieving turn and position system, bordered foam dressings, fluidized positioners, specialty beds, and leadership support for twice-a-week skin checks, our patients diagnosed with COVID-19 developed extensive skin damage across the fleshy portion of the buttocks and on the mucosa of the nares, tongue, lips, and urethra during minimal exposure to pressure. Although the initial presentation of the skin damage appeared to be related to pressure, the extent of the skin damage suggests a vascular inflammatory process beyond skin damage related to pressure.


Assuntos
Betacoronavirus , Infecções por Coronavirus/terapia , Equipamentos e Provisões/efeitos adversos , Membrana Mucosa/lesões , Pneumonia Viral/terapia , Lesão por Pressão/etiologia , Lesão por Pressão/patologia , Adulto , Idoso , Infecções por Coronavirus/complicações , Feminino , Humanos , Masculino , Pandemias , Pneumonia Viral/complicações , Lesão por Pressão/prevenção & controle , Respiração Artificial/efeitos adversos , Respiração Artificial/instrumentação
10.
J Wound Ostomy Continence Nurs ; 47(5): 450-455, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32970030

RESUMO

BACKGROUND: Managing patients during the coronavirus disease-2019 (COVID-19) pandemic, and the associated severe acute respiratory syndrome-related coronavirus-2 (SARS-CoV-2) in particular, required the nimble responsiveness for which WOC nurses are known. Problem-solving skills were needed to continue the level of WOC nursing services expected by patients, families, and professional colleagues, while reducing the hours we were physically present at our clinical facility. In order to respond to these demands, our team realized it must create an innovative approach to provide efficient, cost-effective consultations during this global crisis. This Challenges in Practice article summarizes our experience with use of telemedicine technologies to perform remote consultations within the acute care setting. CASES: Case 1 was a 52-year-old woman with a history of paraplegia. She had several pressure injuries but had not received topical care for these wounds prior to admission. A consultation for the WOC nurse was requested and performed via telehealth services on a day our team was working off-site. This case illustrates the process our team used to perform a virtual consultation and demonstrates how the use of images placed in the electronic medical record aided in developing an effective plan of care. Case 2 was a 48-year-old man who tested positive for COVID-19. He developed bilateral unstageable pressure injuries on his cheeks after being placed in the prone position for a prolonged period while critically ill. This case describes multiple technologic platforms used for telemedicine consults in a patient with COVID-19 requiring isolation. CONCLUSIONS: Remote consultation by WOC nurses was possible in our healthcare system because of previous experience using telemedicine technology and well-established collaborative relationships with providers and bedside nurses. By expanding our use of telemedicine technology, we were able to provide ongoing care to a patient without COVID-19 who had WOC consultation needs, and a patient with strict isolation demands due to COVID-19.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Lesão por Pressão/terapia , Consulta Remota/organização & administração , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Lesão por Pressão/etiologia , Lesão por Pressão/patologia
11.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(6): 722-732, 2020 Jun 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-32879131

RESUMO

OBJECTIVES: To investigate the status and the related factors of nursing behaviors for pressure injury, and to provide the evidence for standardizing pressure injury management. METHODS: A total of 1 039 clinical nursing staff from 4 general hospitals in Changsha from December 1 to 30, 2017 were selected by a stratified random sampling procedure. Nurses' demographic information such as age, gender, title, educational attainment, and department were collected. We investigated the status of nursing behaviors on pressure injury by a self-designed questionnaire, assessed nurses' knowledge of pressure injury and nurses' attitude of pressure injury using the Pressure Ulcer Knowledge Test and Attitude towards Pressure Ulcer Prevention Instrument, respectively, compared the nursing behaviors on pressure injury with different backgrounds, used multiple linear regression to analyze the influential factors for nursing behaviors on pressure injury, and conducted the Pearson correlation analysis for nurses' knowledge, attitude, and behaviors on the pressure injury. RESULTS: The overall nursing behaviors score on pressure injury was 155.96±17.29. The 5 dimensional scores from high to low were: risk assessment (4.42±0.49), prevention actions (4.40±0.50), risk understanding (4.35±0.52), injury assessment and interventions (4.27±0.55), and health education (4.25±0.63). A significant difference was found in the nursing behavior scores of pressure injury among ages, lengths of service, education, and training times (all P˂0.05). There was no correlation between nurses' knowledge and behaviors (P=0.606). The nurses' attitude was positively correlated with their behaviors (r=0.307, P˂0.001), and the nurses' knowledge was also positively correlated with their attitudes (r=0.212, P˂0.001). The results of multiple linear regression showed that the length of service (≤5 years), training times (1-2 times), education (diploma or below), the scores of nurses' knowledge, and the scores of nurses' attitude were independent influencial factors of nurses' behaviors on pressure injury. CONCLUSIONS: The nursing staff in the general hospital of Changsha has a high level of nursing behaviors on pressure injury, and they has good sense of responsibility and confidence. However, personal competence in pressure injury is insufficient and still needs to be improved. The nursing managers should focus on the nurses' attitude and training frequency, increasing the experience in nursing the pressure injury and practical level, and arouse the highly educated nurses' enthusiasm and sense of accomplishment to prevent pressure injury, thus reducing the incidence of pressure injury.


Assuntos
Recursos Humanos de Enfermagem no Hospital , Lesão por Pressão/epidemiologia , Lesão por Pressão/etiologia , Atitude do Pessoal de Saúde , China/epidemiologia , Estudos Transversais , Conhecimentos, Atitudes e Prática em Saúde , Hospitais Gerais , Humanos , Inquéritos e Questionários
13.
Rev Lat Am Enfermagem ; 28: e3357, 2020 Sep 07.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-32901770

RESUMO

OBJECTIVE: to evaluate the use of realistic simulation as a strategy to promote teaching about pressure injuries. METHOD: This is a quasi-experimental study. A modified and translated version of the Pieper Pressure Ulcer knowledge test was applied. Kappa statistical analysis was used to assess the professionals' knowledge in the realistic simulation using the SPSS software. A p-value <0.05 was considered significant. RESULTS: Seventy-seven nursing professionals participated in the realistic simulation, the majority (72.7%) being nursing technicians. Regarding the knowledge of primary and secondary coverage techniques, the Kappa index went from 0.56 (p=0.002) in the pre-test to 0.87 (p=0.001) in the post-test. As for the sterile dressing technique, there was a variation from 0.55 (p=0.002) in the pre-test to 0.91 (p=0.001) in the post-test. Regarding the cleaning of pressure injuries, there was a variation from 0.81 (CI: 0.62-0.84) in the pre-test to 0.91 (0.85-0.97) in the post-test. The knowledge about the use of a sterile spatula to distribute the dressing in the wound increased from an agreement index from regular to good. CONCLUSION: The introduction of the realistic simulation in the clinical practice has created quality assessment indicators for the prevention and treatment of pressure injuries.


Assuntos
Competência Clínica , Lesão por Pressão/prevenção & controle , Bandagens , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Tradução
17.
Zhonghua Shao Shang Za Zhi ; 36(8): 726-729, 2020 Aug 20.
Artigo em Chinês | MEDLINE | ID: mdl-32829613

RESUMO

Objective: To investigate the clinical effects of superior gluteal artery perforator " buddy flap" in repairing pressure ulcer in sacrococcygeal region. Methods: From January 2017 to December 2018, 13 patients (8 males and 5 females) aged 24-79 years with stage 4 pressure ulcers in sacrococcygeal region were admitted to the First Affiliated Hospital of Zhengzhou University, with wound area from 5 cm×4 cm to 12 cm×10 cm. After thorough debridement and vacuum sealing drainage, the superior gluteal artery perforator " buddy flap" was designed to repair the pressure ulcer in sacrococcygeal region. The pressure ulcer was repaired by the main flap with area from 7.0 cm×5.0 cm to 18.0 cm×12.0 cm; the main flap's donor area was covered by the auxiliary flap with area from 5.0 cm×3.0 cm to 11.0 cm×7.0 cm; the auxiliary flap's donor area was covered by the connecting flap between the main flap and the auxiliary flap. The remaining wound without covering was directly closed by suturing. The postoperative flap survival and complications were observed. The appearance and function of flaps and the recurrence of pressure ulcer were followed up. Results: The flaps of 12 patients survived after operation without complications of infection, fat liquefaction, or poor flap survival. A small area of superficial necrotic skin at the distal end of flap was observed in one case, which was healed after dressing change. All the patients were followed up for 6 months without recurrence of pressure ulcer, and the operation area was naturally full in appearance, which was pressure and wear resistant. Conclusions: Superior gluteal artery perforator " buddy flap" is an effective method for the treatment of pressure ulcer in sacrococcygeal region. The effect of tension-free repair of the pressure ulcer and main flap donor area can be achieved in one operation. The operation is simple, the curative effect is accurate, and it has certain clinical value.


Assuntos
Retalho Perfurante , Lesão por Pressão , Procedimentos Cirúrgicos Reconstrutivos , Região Sacrococcígea , Lesões dos Tecidos Moles , Adulto , Idoso , Artérias , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transplante de Pele , Resultado do Tratamento , Adulto Jovem
18.
Georgian Med News ; (303): 7-12, 2020 Jun.
Artigo em Russo | MEDLINE | ID: mdl-32841173

RESUMO

Aim - to improve the results of treatment of pressure sores using low-energy laser technology. The authors performed a comparative analysis of the effectiveness of the use of low-energy laser irradiation in the complex treatment of pressure ulcers of 2-3 degrees in 35 patients with severe brain damage for the period from 2017-2019. The contact laser was used with the following parameters: wave length - 904 nm, frequency - 5000 Hz, irradiation mode - pulsed, power - 13.5mWt/cm2, exposure - on average 2 minutes per zone. The results were compared with those in 41 people treated according to the traditional methodology. The demographic criteria, localization and length of the process did not have significant intergroup differences. The use of low-energy laser technology in combination with other conservative methods made it possible to accelerate the healing of pressure sores by 1.3-1.4 times, and to reduce the degree of microbial contamination of the focus in earlier periods (p<0.05). At the same time, both the duration of the inpatient rehabilitation phase and the overall treatment costs are reduced. An integrated approach using low-energy laser technology as an additional physical factor can significantly improve the results of the treatment of pressure sores in people with severe brain damage.


Assuntos
Lesão por Pressão , Encéfalo , Humanos , Lasers , Luz , Cicatrização
19.
Zhonghua Shao Shang Za Zhi ; 36(7): 540-546, 2020 Jul 20.
Artigo em Chinês | MEDLINE | ID: mdl-32842400

RESUMO

Objective: To investigate the effect of modified double negative-pressure wound therapy combined with debridement and tension-reduced suture in treatment of stage 4 pressure sores and infection in sacrococcygeal region and its surrounding area. Methods: From January 2015 to June 2019, 20 patients with stage 4 pressure sores and infection in sacrococcygeal region and its surrounding area were admitted to Department of Burns and Plastic Surgery and Cosmetology of Linyi People's Hospital. Among them, there were 11 males and 9 females, aged 48 to 88 years. The wounds of 13 patients were located in the sacrococcygeal region, and 8 of them had exposed sacrococcyx. The wounds of 4 patients were located in the greater trochanter area of femur, and the wounds of 3 patients were located in the ischial tuberosity area. All the patients had fever in different degree, bacterial infection, hypoproteinemia, and electrolyte imbalance, etc. at admission. After thorough debridement and dressing change, routine negative-pressure wound therapy with negative pressure value of -16.6 kPa was performed according to the scope of lesions in period Ⅰ. When granulation tissue was fresh with less exudate and without residual necrotic tissue, modified double negative-pressure wound therapy in combination with debridement and tension-reduced suture was performed immediately in period Ⅱ. Modified double negative-pressure wound therapy were persistently performed through negative pressure drainage tube inserted into deep part of wounds and negative pressure drainage tube on surface at the same time, with superficial negative pressure value of -19.9 kPa. Meanwhile, systemic anti-infection and nutritional supports were given. The wounds were monitored for the grade of wound healing and whether skin necrosis, split, or fluid accumulation develop at the suture site. The patients were followed up for 1 to 6 months after discharge to monitor wound healing. Length of hospital stay, infection condition before and after the debridement and tension-reduced suture, and complications during treatment were recorded. Results: All wounds achieved first grade healing, with the skin at the suture site healed without split, fluid accumulation, or necrosis. The patients were followed up for 1 to 6 months after discharge, with good shape of surgical incision, little pigmentation on the skin, no hypertrophic scar or contracture, and no recurrence of pressure sores. Length of hospital stay of patients was 24 to 33 d, with an average of 28.5 d. Before debridement and tension-reduced suture, 2 cases were infected with Pseudomonas aeruginosa, 1 case was infected with Escherichia coli and Staphylococcus aureus, and 1 case was infected with Proteus mirabilis. The results of bacterial culture were all negative after debridement and tension-reduced suture. During the treatment, all patients were not complicated with bone or joint infection, necrotizing fasciitis, septicemia, etc. Conclusions: Modified double negative-pressure wound therapy combined with debridement and tension-reduced suture for treatment of patients with stage 4 pressure sores and infection in sacrococcygeal region and its surrounding area is easy to operate with minimal injury, easy for patients to accept with a very high level of satisfaction, and is suitable to popularize and applicate for primary hospitals.


Assuntos
Infecções , Tratamento de Ferimentos com Pressão Negativa , Lesão por Pressão , Idoso , Idoso de 80 Anos ou mais , Desbridamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Lesão por Pressão/terapia , Região Sacrococcígea , Transplante de Pele , Suturas , Resultado do Tratamento
20.
Zhonghua Shao Shang Za Zhi ; 36(7): 596-599, 2020 Jul 20.
Artigo em Chinês | MEDLINE | ID: mdl-32842408

RESUMO

From June 2017 to October 2018, 7 patients with pressure ulcers were admitted to Taiyuan Ninth People's Hospital, including 3 males and 4 females, aged 75-86 years. There were totally 10 stage 4 pressure ulcer wounds without bone exposure, with wound area ranging from 6 cm×4 cm to 11 cm×9 cm. Three wounds were accompanied by latent cavity, with surface projection area of the latent space ranging from 5 cm×3 cm to 12 cm×8 cm. After admission, conservative debridement was performed continuously until the granulation tissue in the skin defect area was bright red, prone to bleeding, with basically flat base. The split-thickness skin of 1/4-1/2 of the wound area size was taken from the front side of the thigh on the hospital bed, and rectangular small skin with a side length of 1-3 mm and/or microskin were made and transplanted to the granulation wound. Conservative treatment was continued after the operation. Seven wounds healed 3-6 weeks after one transplantation. The sinus tract remained in the latent area of one wound 6 weeks after the first grafting, and the patient was discharged from hospital. One wound was grafted twice and healed 8 weeks after the first operation. One patient (one wound) died of underlying disease. This treatment method is suitable for stage 4 pressure ulcer wounds without bone exposure which cannot be operated on routinely, with small trauma, low risk, and being simple, and it can be performed on the hospital bed.


Assuntos
Lesão por Pressão , Idoso , Idoso de 80 Anos ou mais , Desbridamento , Feminino , Humanos , Masculino , Pele , Transplante de Pele , Cicatrização
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