Surgery for pressure ulcers in spinal cord‐injured patients following a structured treatment programme: a 10‐year follow‐up
Abstract With the aim to improve the outcomes for spinal cord‐injured patients undergoing surgery for pressure ulcers, a structured treatment programme regulating pre‐ and postoperative care and rehabilitation was introduced in 2002 in Stockholm. Fifty‐one consecutive patients operated on between 2002 and 2007 were included in a 10‐year follow‐up to evaluate the programme regarding initial healing results and long‐term ulcer and health status. At one month postoperatively, 49 out of 51 (96%) patients were completely healed. Five patients (5/44, 11%) developed recurrent or new ulcers within 3 years of surgery. Two patients were re‐operated on (2/44, 5%). Between 3 and 10 years after surgery, 9 patients (9/33, 27%) had a history of recurrent ulcers, and 6 (6/33, 18%) had a history of new ulcers, a total of 15 patients (15/33, 45%). Of these, three needed re‐operation (3/33, 9 %). The health status values using a visual analogue rating scale were 70 (median) at 3 and 10 years compared with 30 (median) preoperatively. The good initial healing, the low ulcer recurrence rate and the raise in health status indicate the value of a structured treatment programme, especially for the first few postoperative years.
Are certain factors associated with the development of postoperative pressure ulcer after liver resection?Wounds
AbstractUse of open abdomen (OA) progressively acquired increasing importance with the diffusion of the damage control management of critical patients. The purpose of the present study is to identify the state of the art about the use of OA in Italy, focusing on techniques, critical issues and clinical outcomes. A prospective analysis of adult patients enrolled in the IROA, limited to the Italian participating centres was performed. 375 patients were enrolled. Mean age was 64 ± 16 years old, 56% of the patients were male, mean BMI was 26.9 ± 5.2. Main indications for using OA...
Identify whether incisional (or prophylactic) negative-pressure wound therapy (iNPWT) is associated with reduced wound complications.
Publication date: November 2019Source: European Journal of Surgical Oncology, Volume 45, Issue 11Author(s): Adarsh Shah, Renjit Kurian, Edmund Leung
The objective of this retrospective study in a uniform patient population was to compare the anterior and posterior approaches for 1B-THA in terms of: 1) early mortality rates, 2) early complications, 3) and 90-day re-admission rates, hospital stay lengths, and blood loss.Hypothesis1B-THA in patients younger than 80 years who have an ASA score of 1 or 2 is associated with no early mortality and with low early morbidity rates regardless of whether the anterior or posterior approach is used.Material and methodsA single-centre retrospective comparative design was used to assess 90-day mortality and morbidity rates in consecut...
ConclusionsProphylactic use of NPWT may reduce the incidence of superficial SSI in closed abdominal incisions but has no effect on deep or organ space SSI.
Authors: Namgoong S, Jung SY, Han SK, Kim AR, Dhong ES Abstract Current treatment guidelines for biofilm-associated infections (BAI) recommend repeated sharp/surgical debridement followed by treatment with antimicrobial agents until the wound becomes self-sustaining in terms of a positive wound-healing trajectory. However, complete removal of a biofilm is unlikely, and biofilms reform rapidly. We have treated BAI in patients with chronic diabetic ulcers using a meshed skin graft combined with negative pressure wound therapy (NPWT) immediately after surgical debridement, rather than waiting until the development of ...
Conclusion: The key lessons learned from this experience are being used to develop a new implementation-focused network. Features felt to be especially important for the SCI KMN includes a highly representative governance structure, the use of indicators within an overall evaluation framework and the systematic application of implementation processes with shared learnings supporting each site. PMID: 31573445 [PubMed - in process]
Conditions: Wound Infection; Surgical Site Infection; Surgical Wound; Surgical Incision Interventions: Other: Wound dressings: Conservative dressings; Other: Wound dressings: Prevena dressings; Other: Wound dressings: ciVAC dressings Sponsor: Imperial College London Not yet recruiting
DISCUSSION: The identified preoperative factors and postoperative complications should help guide quality improvement programs. PMID: 31567615 [PubMed - as supplied by publisher]