Acta Medica Croatica最新文献

{"title":"[THE ROLE OF PRESSURE ULCER SURROUNDING SKIN PREPARATION PRIOR TO THE APPLICATION OF WOUND DRESSING].","authors":"S Marinović Kulišić","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Pressure ulcer develops as a result of many factors, primarily pressure, tensile forces and ischemia with immobility and\u0000incontinence. Targeted and properly designed preventive measures reduce the incidence and complications of pressure\u0000ulcers, among which the most common are infections. An important preventive measure is protection of the surrounding\u0000skin before the application of wound dressings. Skin changes dictate the use of emollients and topical therapy according to\u0000dermatological status.</p>","PeriodicalId":35756,"journal":{"name":"Acta Medica Croatica","volume":"70 Suppl 1 ","pages":"39-43"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35209831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[CHARACTERISTIC FEATURES OF PRESSURE ULCER INFECTION].","authors":"N Kučišec-Tepeš","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Pressure ulcer is a localized injury of the skin and/or adjacent tissue, usually above bone protrusions. It is a result of pressure\u0000or pressure combined with shear stress, friction and humidity. With regard to long life and delayed healing, it is a chronic\u0000wound. Pressure ulcer appears as a consequence of a combination of micro-embolism, ischemia and myonecrosis. These\u0000pathophysiological processes provide an ideal medium for proliferation of microorganisms, predominantly bacteria, and development\u0000of infection. Progression in the development of pressure ulcer is a dynamic process manifesting in phases, each\u0000of which is characterized by its own physiological-anatomical peculiarities and microbiological status. An open lesion without\u0000protective barrier becomes contaminated immediately, and, shortly afterwards, colonized by physiological microflora of the\u0000host and microbes from the environment. In the absence of preventive measures, the wound becomes critically colonized\u0000and infected. The characteristic of chronic wound/pressure ulcer is that it is colonized, and the infection develops depending\u0000on various factors in 5% to 80% of cases. The ability of microbes to cause infection depends on a number of factors,\u0000which include the pathogen and the host. The number and quantity of virulent factors, microbes, determines the virulence\u0000coefficient, which is responsible for overcoming the host’s immune system and development of infection. In the development\u0000of pressure ulcer infection, two essential microbial factors predominate, i.e. the presence of adhesin and association with\u0000biofilm. Thus, pressure ulcer infection as a chronic wound is characterized by a polymicrobial and heterogeneous population\u0000of microbes, domination of biofilm phenotype as a primary factor of virulence present in 90% of cases, phenotype hypervariability\u0000of species, and resistance or tolerance of the etiological agents to all types of biocides. The most significant virulence\u0000factor is biofilm. It is a corporative community of microbes with a clear architecture managed by quorum sensing molecules.\u0000It is through them that the communication between species takes place, the phenotype and virulence change, and resistance\u0000develops at the level of genome. The formation of biofilm takes place in several stages, and the speed is measured in hours.\u0000Microorganisms in the biofilm are protected from the action of the host’s immune system and, likewise, they are tolerant or\u0000resistant to antibiotics, antiseptics, and stress. Bacteria causing pressure ulcer infection are characterized as opportunistic,\u0000but also primarily pathogenic. The dominance and combination of species depend on the duration, localization and stage\u0000of pressure ulcer. The predominant etiological agents are Staphylococcus aureus, Streptococcus pyogenes, Pseudomonas\u0000aeruginosa and Peptostreptococcus spp. Nowadays, multiple-resistant strains predominate, such as MRSA, Acinetobacter\u0000spp. and Pseudomonas spp. A chronic wound such","PeriodicalId":35756,"journal":{"name":"Acta Medica Croatica","volume":"70 Suppl 1 ","pages":"45-51"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35209832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[PERSONALIZED APPROACH TO PATIENT WITH CHRONIC WOUND IN FAMILY MEDICINE].","authors":"T Sinožić,&nbsp;M Katić,&nbsp;J Kovačević","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>It can be said that the occurrence and development of wounds, healing, delayed healing, and the notion of chronic wound\u0000are some of the basic characteristics of all living beings. When it comes to people, there are a number of processes that take\u0000place during wound healing, and even under ideal circumstances, they create a functionally less valuable skin tissue, along\u0000with structural and functional changes. Fibrosis in the form of hypertrophic scars and keloids, contractures and adhesions\u0000are examples of excessive healing. Microcirculation is significantly different from healthy skin circulation with consequential\u0000formation of local hypoxia and stagnation in lymph flow with edema. Poor functionality of the scar tissue, particularly in the\u0000areas exposed to stronger forces, can cause forming of wounds. Such wounds are hard to heal despite the inexistence of\u0000other possible reasons for delayed healing, precisely because of their poor functionality and placement. The presence of\u0000wound requiring long-term treatment affects all areas of patient life and leads to decline in the quality of life. Exemplified by\u0000case presentation of a patient with post-traumatic wound in the scar area, in our office we showed a model of care based\u0000on the principle of overall personalized care with the biopsychosocial approach. Diagnostic and therapeutic procedures included\u0000wound assessment, biofilm and lymphedema detection, assessment of the patient’s psychosocial status, risk factors\u0000for wound healing, vascular ultrasound diagnostics, carboxytherapy as specialized adjuvant therapy, use of modern wound\u0000dressings, and compression therapy. Supportive psychotherapy was conducted in positive communication environment\u0000during treatment. In this way, in an atmosphere of cooperation with the patient, it was possible not only to influence the\u0000process of wound healing as the primary objective, but also to improve the quality of the patient’s life, as well as to influence\u0000our professional satisfaction with the results achieved. Family doctors are involved in the care of chronic wound patients\u0000as part of the multidisciplinary team of experts. Additional specific knowledge and skills are required for such care in order\u0000to ensure overall quality care as a supplement of the existing knowledge, skills and working experience in family medicine.</p>","PeriodicalId":35756,"journal":{"name":"Acta Medica Croatica","volume":"70 Suppl 1 ","pages":"105-10"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35209843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Proposition of algorhythm for treatment with hyperbaric oxygenation Hyperbaric oxygenation in Rijeka Clinical Hospital Center].","authors":"M Marinović,&nbsp;N Fumić,&nbsp;B Reinić,&nbsp;I Barković,&nbsp;E Marcucci,&nbsp;J Brusić,&nbsp;B Bakota","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":35756,"journal":{"name":"Acta Medica Croatica","volume":"70 Suppl 1 ","pages":"83-91"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35209838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PRESSURE ULCER PREVENTION: FUNDAMENTALS FOR BEST PRACTICE.","authors":"Mark Collier","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This introduction has highlighted both the complex nature of the aetiology of pressure ulcer development and the complex\u0000nature of the assessment process intended to identify those patients who are or might be at an enhanced risk of pressure\u0000ulcer development. The latter statement assumes that all patients cared for in any healthcare setting are vulnerable to\u0000pressure ulcer development. Whilst it is acknowledged that the use of a risk assessment tool can be important in an overall\u0000pressure ulcer prevention strategy, it is important that the limitations of these tools are acknowledged and that they are not\u0000an finite assessment in themselves and that they should be used by a practitioner with a fundamental breadth of relevant\u0000knowledge and an appreciation of the range of appropriate preventative equipment/techniques available and the role of the\u0000multi-disciplinary team in the prevention of all avoidable pressure ulcers.</p>","PeriodicalId":35756,"journal":{"name":"Acta Medica Croatica","volume":"70 Suppl 1 ","pages":"3-10"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35508200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[PRESSURE ULCER AS THE PRINCIPAL INDICATOR OF HEALTH CARE QUALITY AT NEUROLOGY DEPARTMENT].","authors":"V Belas Horvat,&nbsp;M Kos","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>According to the European Pressure Ulcer Advisory Panel (EPUAP) definition, pressure ulcer is a local skin or subcutaneous\u0000tissue damage due to the force of pressure or friction or their combination. Pressure ulcers have accompanied humans\u0000since the beginning and respective descriptions are found in the 19th century literature. Pressure ulcer is a major medical,\u0000social and health-economic problem because it is associated with a number of complications that require multidisciplinary\u0000approach in care and treatment. In affected patients, pressure ulcer causes quality of life reduction, discomforts, pain, emotional\u0000problems and social isolation. If the process of tissue decay is not halted, tissue damage will spread involving deep and\u0000wider structures, thus seriously compromising the patient general condition. Pressure ulcer usually develops at the sites of\u0000protrusions formed by lumbar spine, ischium, hip, ankle, knee or elbow, as well as in the areas with less developed adipose\u0000tissue. Any temporary or permanent immobility should be perceived as a milieu favoring the onset of pressure ulcer. Advances\u0000in medicine and standards of living in general have prolonged life expectancy, thus also increasing the population at risk\u0000of chronic diseases including pressure ulcer. The aim of the study was to determine the relationship between the length of\u0000bed-ridden condition and the occurrence of pressure ulcers in patients treated at Department of Cerebrovascular Diseases\u0000and Intensive Neurology from January 1, 2012 until December 31, 2015. The study included patients with pressure ulcer\u0000verified on admission and those having developed pressure ulcer during hospital stay. Clinical picture of severe stroke predominated\u0000in the majority of study patients. Patients were divided into groups according to health care requirements as classified\u0000by the Croatian Chamber of Nurses. Preliminary results indicated the length of bed-ridden condition to be associated\u0000with the occurrence of chronic wounds, and thus with increased cost and length of hospital treatment. Therefore, health care\u0000methods and procedures should be focused on reduction of pressure ulcer development, quality health care, implementation\u0000of preventive measures, and continuous education of health care professionals.</p>","PeriodicalId":35756,"journal":{"name":"Acta Medica Croatica","volume":"70 Suppl 1 ","pages":"17-24"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35508207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[PRESSURE ULCER TREATMENT EXPERIENCE AT CLINICAL DEPARTMENT OF PLASTIC, RECONSTRUCTIVE AND AESTHETIC\u0000SURGERY, DUBRAVA UNIVERSITY HOSPITAL: COMPARISON OF RESULTS RECORDED IN THE 2011-2016 AND 2003-2008\u0000PERIOD].","authors":"S Budi,&nbsp;R Žic,&nbsp;K Martić,&nbsp;F Rudman,&nbsp;Z Vlajčić,&nbsp;R Milanović,&nbsp;Z Roje,&nbsp;A Munjiza,&nbsp;I Rajković,&nbsp;B Gorjanc,&nbsp;R Held,&nbsp;A Maletić,&nbsp;H Tucaković,&nbsp;Z Stanec","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Results of this clinical study on surgical treatment of pressure ulcers at Department of Plastic, Reconstructive and Aesthetic\u0000Surgery, Dubrava University Hospital showed that there was no difference between the 2011-2016 and 2003-2008 periods,\u0000indicating continuation of good surgical treatment planning and appropriate postoperative care. Despite the smaller number\u0000of hospitalized patients in the 2011-2016 period (31 patients and 42 reconstructive procedures), the number of reconstructive\u0000procedure was similar to the recent 2003-2008 period (47 patients and 57 reconstructive procedures). The best\u0000results of reconstruction of sacral region pressure ulcer were achieved with fasciocutaneous and musculocutaneous flaps.\u0000Whenever possible, depending on the extent of the defect, musculocutaneous flaps should be preferred for reconstruction.\u0000It is especially suitable for pressure ulcer recurrence. For ischial region reconstruction, good results can be obtained by mobilizing\u0000the semimembranosus and/or semitendinosus in defect gap. For trochanteric region, the tensor fascia lata flap is a\u0000good choice. For maximal functional and reconstructive results, a multidisciplinary approach in pressure ulcer treatment has\u0000the leading role in the modern concept of wound healing. Surgical treatment should always include radical debridement, ostectomy\u0000and well planned defect reconstruction. Conservative treatment should be support to surgical treatment with a focus\u0000on patient health care and high hygiene measures. In recent years (2011-2016), the usage of better conservative treatment\u0000led to reduction of patient hospital stay and surgical treatment of pressure ulcer. Further ‘wound care’ nurses training in\u0000Croatia can lead the trend towards advanced practice nursing in pressure ulcer prevention and conservative treatment.</p>","PeriodicalId":35756,"journal":{"name":"Acta Medica Croatica","volume":"70 Suppl 1 ","pages":"11-6"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35508206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[POSITIONING OF IMMOBALE NEUROLOGIC PATIENT].","authors":"Z Maček,&nbsp;M Mandić","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Damage to the central nervous system leads to the loss of motor control, loss of consciousness, sensory, cognitive and\u0000perceptive dysfunction. Patients are immobile in the early phase of recovery, therefore therapeutic approach demands\u0000appropriate methods of patient positioning in bed. The positioning has to ensure conditions that will stimulate and promote\u0000functional rehabilitation and prevent complications of immobility. The positioning has to rely on functional assessment of\u0000the patient problem, while it should also be therapeutic and individually adjusted to the patient needs. In the methods of\u0000positioning an immobile patient, all medical team members take part, especially nurses, physical therapists and occupational\u0000therapists. Results of positioning are better if mobilization and integration of the abilities regained by the patient are included.</p>","PeriodicalId":35756,"journal":{"name":"Acta Medica Croatica","volume":"70 Suppl 1 ","pages":"59-63"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35209834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[CHARACTERISTIC FEATURES OF PRESSURE ULCER INFECTION].","authors":"Ku","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":35756,"journal":{"name":"Acta Medica Croatica","volume":"70 Suppl 1 ","pages":"45-51"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35209842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[MALNUTRITION SCREENING TOOLS FOR ELDERLY IN GENERAL PRACTICE].","authors":"D Vrdoljak","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Malnutrition of elderly is an unrecognized condition, which can be effectively treated. It is associated with increased morbidity,\u0000hospitalizations, lower quality of life, increased mortality and significant costs. Body mass index (BMI) is not a sufficient measure\u0000of nutritional status of the elderly as it does not take into account changes in body structure and composition caused by aging.\u0000Various validated screening tools are recommended to use in elderly. General practitioner (GP) provides health care for all the\u0000elderly living in the community and therefore has an ideal opportunity to screen them for malnutrition. The objective of the article\u0000is to show malnutrition screening tools for elderly, with an emphasis on those with sufficient sensitivity and specificity, applicable\u0000in family medicine. We searched databases Medline, Library of Congress and the Web of Science using selected keywords. The\u0000search was limited to articles published in the last 20 years, with no language restrictions. We found 37 articles: in initial screening\u0000we excluded 20 and 17 articles remained. After retrieving all 17 full texts, one more was excluded so that the final number\u0000of analyzed articles was 16. Among reviewed studies, following malnutrition screening tools were used for elderly: Geriatric\u0000Nutritional Risk Index (GNRI), Malnutrition Screening Tool (MST), Mini Nutritional Assessment-Short Form (MNA-SF), Nutritional\u0000Risk Screening 2002 (NRS 2002), Malnutrition Universal Screening Tool (MUST), Short Nutritional Assessment Questionnaire 65+\u0000(SNAQ(65+)) and Australian Nutrition Screening Initiative (ANSI). The most frequently used tool (in nine articles) was MNA-SF, for its\u0000convenience, simplicity, sufficient sensitivity and specificity. Screening for malnutrition is the first step in nutritional care for the elderly.\u0000For the purpose of screening, GP has many tools available and should choose a simple one with sufficient sensitivity and specificity and easy to\u0000incorporate in the course of consultation with an elderly patient. It seems that such a tool for GP is MNA-SF.</p>","PeriodicalId":35756,"journal":{"name":"Acta Medica Croatica","volume":"69 4","pages":"339-45"},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35650209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}