Advances in Skin & Wound Care最新文献

{"title":"The Direct Effects of Norepinephrine Administration on Pressure Injuries in Intensive Care Patients: A Retrospective Cohort Study.","authors":"Graziela Argenti, Gerson Ishikawa, Cristina Berger Fadel","doi":"10.1097/ASW.0000000000000027","DOIUrl":"10.1097/ASW.0000000000000027","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the direct effects of norepinephrine administration on pressure injury (PI) incidence in intensive care patients.</p><p><strong>Methods: </strong>This is a secondary and exploratory analysis of a retrospective cohort study of intensive care patients discharged in 2017 to 2018. Observational cases only included patients who received primary PI preventive care during intensive care (N = 479). As a first-choice vasopressor drug, norepinephrine administration was approximated with days of norepinephrine. Linear path models were examined from norepinephrine administration to PI development. The identification of confounding variables and instrumental variables was grounded on directed acyclic graph theory. Direct effects were estimated with instrumental variables to overcome bias from unobserved variables. As models were re-specified with data analysis, the robustness of path identification was improved by requiring graph invariance with sample split.</p><p><strong>Results: </strong>Norepinephrine caused PI development from one stage to another after 4.0 to 6.3 days of administration in this cohort as a total effect (90% CI). The direct effect was estimated to advance the stage of PI at a rate of 0.140 per day of norepinephrine administered (standard error, 0.029; P < .001). The direct effect accounted for about 70% of the total effect on PI development.</p><p><strong>Conclusions: </strong>Estimations with instrumental variables and structural equation modeling showed that norepinephrine administration directly and substantially affected hospital-acquired PI incidence in intensive care patients in this cohort.</p>","PeriodicalId":7489,"journal":{"name":"Advances in Skin & Wound Care","volume":"36 9","pages":"1-12"},"PeriodicalIF":2.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10041511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of Pressure Injuries Associated with Urethrocutaneous Fistula.","authors":"Serge Zogheib, Nour Khalil, Georges Mjaess, Charbel Feghaly, Bechara Daou, Cyril Hanna, Marwan Nasr","doi":"10.1097/ASW.0000000000000023","DOIUrl":"10.1097/ASW.0000000000000023","url":null,"abstract":"<p><strong>Objective: </strong>To review the literature about combined urologic and reconstructive management of pressure injuries (PIs) with urethral fistulas.</p><p><strong>Data sources: </strong>Authors searched the PubMed, MEDLINE, EMBASE, and Cochrane databases using the following keywords: \"Perineum\" or \"Perineal\" and \"Pressure Ulcers\" or '' Pressure Injury'' and \"Urethral Fistula.\"</p><p><strong>Study selection: </strong>The search yielded a total of 95 articles. Study selection followed the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) statement, and the study was designed according to the PICOS (Population, Intervention, Comparison, Outcomes, Study) guidelines. Congress abstracts, letters to the editor, and editorial comments were excluded. After screening, a total of 9 studies (30 patients) were included in the review.</p><p><strong>Data extraction: </strong>Included patients received treatment for a perineal or ischial PI associated with a urinary fistula. The outcomes were recovery, complications, treatment failure, recurrence, and illness-related death.</p><p><strong>Data synthesis: </strong>Pressure injuries were mainly ischiatic (50%) and perineal (43%). Forty-six percent of patients had spinal cord injuries, and at least 40% reported voiding dysfunction. Sixteen percent had previous ischiectomy. Flaps such as posterior thigh flap, biceps femoris flap, and inferiorly based transverse rectus abdominal muscle flap had 88% to 100% success rates when used with urinary diversion techniques. Suprapubic cystostomy, the simplest method of urinary diversion, was successful in 47% of cases when performed alone and in 100% when combined with a pedicled omental flap or a transverse rectus abdominal muscle flap.</p><p><strong>Conclusions: </strong>Prevention and wound care are essential for PI management, but when combined with a urinary fistula, surgical management is unavoidable. Urinary diversion is essential before undergoing any type of ulcer reconstruction. Urethral reconstruction showed favorable results, further strengthened when combined with a musculocutaneous flap.</p>","PeriodicalId":7489,"journal":{"name":"Advances in Skin & Wound Care","volume":"36 9","pages":"1-8"},"PeriodicalIF":2.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10041512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Soap Scrap\" Technique: A Tissue-Preserving Approach to Treating Wounds with Undermining or Pockets.","authors":"Igor Melnychuk, Julia Juriga","doi":"10.1097/ASW.0000000000000008","DOIUrl":"10.1097/ASW.0000000000000008","url":null,"abstract":"<p><strong>Abstract: </strong>This retrospective case series introduces a tissue-preserving approach to treat complicated wounds with undermined edges or wounds with pockets. Wounds with undermining or pockets are commonly encountered in clinical practice and can be difficult to manage when trying to achieve wound closure. Traditionally, epibolic edges need to be resected or cauterized with silver nitrate, whereas wound undermining or pockets need to be resected or unroofed. The method described herein consists of three components: sharp debridement of all undermined areas or inside walls of wound pockets, compression, and immobilization. Compression can be performed using multilayered compression alone, modified negative-pressure therapy, or both. Immobilization of all wound layers can be achieved using a brace, removable Cam Walker, or a cast.This article reports on 11 patients who had unfavorable upper and lower extremity wounds with undermined areas or wound pockets who were treated using this methodology. The average patient age was 73 years, and the average wound depth was 1.12 cm. The average undermined area was 1.7 (range, 0.2-5.0) cm. Wounds healed in an average of 9.1 weeks; all wounds healed between 3 and 15 weeks. This series demonstrates a novel tissue-preserving approach to treating wounds with undermining or wounds with pockets using debridement, immobilization, and compression.</p>","PeriodicalId":7489,"journal":{"name":"Advances in Skin & Wound Care","volume":"36 9","pages":"495-501"},"PeriodicalIF":2.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10028374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The 2022 Update on Pressure Injuries: A Review of the Literature.","authors":"Dan Berlowitz, Julia G Forget, Kelley Saindon","doi":"10.1097/ASW.0000000000000025","DOIUrl":"10.1097/ASW.0000000000000025","url":null,"abstract":"<p><strong>General purpose: </strong>To review six articles published in 2022 that provide important new data or change how clinicians may think about pressure injuries.</p><p><strong>Target audience: </strong>This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.</p><p><strong>Learning objectives/outcomes: </strong>After participating in this educational activity, the participant will:1. Identify evidence-based risk factors for the development of pressure injuries (PIs).2. Distinguish the predictors for PI development that prompted intervention.3. Identify inconsistencies in documented stages of PIs.4. Explain the impact of staffing on PI development rates.</p>","PeriodicalId":7489,"journal":{"name":"Advances in Skin & Wound Care","volume":"36 9","pages":"463-469"},"PeriodicalIF":2.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10041510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polylactic Acid-Based Biomaterials in Wound Healing: A Systematic Review.","authors":"Hui Ling Chen, Joanne Wai Yee Chung, Vincent Chun Man Yan, Thomas Kwok Shing Wong","doi":"10.1097/ASW.0000000000000011","DOIUrl":"10.1097/ASW.0000000000000011","url":null,"abstract":"<p><strong>Objective: </strong>To examine (1) the effectiveness of polylactic acid (PLA)-based biomaterials in wound healing, (2) their effects on wound infection prevention, and (3) their safety compared with existing biomaterials.</p><p><strong>Data sources: </strong>Data sources included PubMed, MEDLINE, Cochrane Library, CINAHL (Cumulative Index to Nursing and Allied Health Literature), CNKI (China National Knowledge Infrastructure), WEIPU, and WANFANG databases.</p><p><strong>Study selection: </strong>Investigators included 14 studies discussing the effects of PLA-based biomaterials in cutaneous wound healing published from 2000 to 2021.</p><p><strong>Data extraction: </strong>Authors extracted the following information from the selected studies: general information, study type, type of wound, PLA-based biomaterials and techniques, study period, outcome measures, and results.</p><p><strong>Data synthesis: </strong>Polylactic acid-based biomaterials may promote wound healing through wound area repair, collagen deposition, angiogenesis, and cell activities, which are related to the good biocompatibility, biodegradability, and moisture management properties of PLA. A proper product structure may also help. Both the native PLA materials and PLA blends seem to be antibacterial, although more evidence is needed for the native PLA products. Because there was no severe adverse event or obvious cytotoxicity observed in the included studies, PLA-based biomaterials are likely safe.</p><p><strong>Conclusions: </strong>Polylactic acid-based biomaterials may be good wound dressing materials, although more evidence is needed to support their broader application in wound care.</p>","PeriodicalId":7489,"journal":{"name":"Advances in Skin & Wound Care","volume":"36 9","pages":"1-8"},"PeriodicalIF":2.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10035613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sternal Wound Management in Pediatric Cardiac Surgical Patients: A Novel Strategic Interprofessional Approach: Erratum.","authors":"","doi":"10.1097/ASW.0000000000000031","DOIUrl":"10.1097/ASW.0000000000000031","url":null,"abstract":"","PeriodicalId":7489,"journal":{"name":"Advances in Skin & Wound Care","volume":"36 9","pages":"1"},"PeriodicalIF":1.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10057247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are You Providing and Reporting Principal Care Management?","authors":"Kathleen D Schaum","doi":"10.1097/ASW.0000000000000030","DOIUrl":"10.1097/ASW.0000000000000030","url":null,"abstract":"","PeriodicalId":7489,"journal":{"name":"Advances in Skin & Wound Care","volume":"36 9","pages":"460-462"},"PeriodicalIF":2.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10057248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experts in Vacuum Technology Focus on the Science of Care Across the Patient Spectrum.","authors":"Jeff Castillo","doi":"10.1097/ASW.0000000000000034","DOIUrl":"10.1097/ASW.0000000000000034","url":null,"abstract":"","PeriodicalId":7489,"journal":{"name":"Advances in Skin & Wound Care","volume":"36 9","pages":"457-458"},"PeriodicalIF":2.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10057249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The 2022 Update on Pressure Injuries: A Review of the Literature.","authors":"","doi":"10.1097/ASW.0000000000000029","DOIUrl":"https://doi.org/10.1097/ASW.0000000000000029","url":null,"abstract":"","PeriodicalId":7489,"journal":{"name":"Advances in Skin & Wound Care","volume":"36 9","pages":"1"},"PeriodicalIF":2.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10033005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stoma Perceptions of Adults with an Ostomy: A Metaphor Analysis in a Single Center.","authors":"Nazife Gamze Özer Özlü, Fatma Vural","doi":"10.1097/ASW.0000000000000017","DOIUrl":"10.1097/ASW.0000000000000017","url":null,"abstract":"<p><strong>Objective: </strong>To use metaphor to evaluate stoma perceptions among adults with ostomies to conceptualize and portray their lived experiences using a figurative approach.</p><p><strong>Methods: </strong>A qualitative research design was used. Participants were 27 adults with an ostomy who were followed up in the stoma therapy unit. Individuals were included in the study if they had had a temporary or permanent ostomy for at least 2 months and spoke Turkish. Participants were asked to complete the sentence: \"Stoma is like…/similar to… because….\" The researchers used content analysis to evaluate participants' responses. Interpretation of the metaphors developed by participants was carried out in five phases: coding, example metaphor compilation, theme development, ensuring trustworthiness, and transferring.</p><p><strong>Results: </strong>Participants expressed a total of 17 unique and 10 repeated metaphors for the concept of \"stoma.\" These metaphors were grouped under three different themes: positive (lifesaving), negative (punishment/enemy), and neutral (temporary/necessity for life). The most commonly used metaphors were life, savior, comfort, difficulty, fear, punishment, and necessity.</p><p><strong>Conclusions: </strong>Individuals with an ostomy mostly had negative metaphorical associations with stomas. The authors recommend that hospitals implement multifaceted interventions to bring positive metaphors to individuals with ostomies.</p>","PeriodicalId":7489,"journal":{"name":"Advances in Skin & Wound Care","volume":"36 9","pages":"1-7"},"PeriodicalIF":2.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10041514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}