Repositioning for pressure injury prevention in adults.

CONCLUSIONS: Despite the addition of five trials, the results of this update are consistent with our earlier review, with the evidence judged to be of low or very low certainty. There remains a lack of robust evaluations of repositioning frequency and positioning for PI prevention and uncertainty about their effectiveness. Since all comparisons were underpowered, there is a high level of uncertainty in the evidence base. Given the limited data from economic evaluations, it remains unclear whether repositioning every three hours using the 30° tilt versus "usual care" (90° tilt) or repositioning 3-to-4-hourly versus 2-hourly is less costly relative to nursing time. PMID: 32484259 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research

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We describe the most highly recommended generic and disease-specific PRO tools in SCD and discuss the challenges of incorporating them in clinical practice. EXPERT OPINION: PRO measures are essential to incorporate into SCD clinical trials either as primary or secondary outcomes. The use of PRO measures in SCD facilitates a patient-centered approach, which is likely to lead to improved outcomes. Significant challenges remain in adapting PRO tools to routine clinical use and in developing countries. PMID: 33034214 [PubMed - as supplied by publisher]
Source: Expert Review of Hematology - Category: Hematology Tags: Expert Rev Hematol Source Type: research
CONCLUSIONS: Immunohistochemistry seems to be a promising option not only in clinical recognition, but also in the selection and monitoring of treatment effects. However, these methods have not yet recommended for routine clinical use. PMID: 33032462 [PubMed - as supplied by publisher]
Source: Scandinavian Journal of Gastroenterology - Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research
Currently in fellowship doing bread/butter procedures (MBB, epidurals, PNB, few SCS/PNS trials, etc.) and just interviewed at a private practice spot where they do a lot of procedures that I will have not done any training in prior to graduating (e.g. IT pump, SI fusion, Vertiflex, Kypho, MILD, Discectomy, lots of SCS/PNS trials etc) and significant amount of "OR pain procedures" at a very busy practice seeing 30-40 pts/day - how many of you are commonly performing these procedures and are... private practice concern
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Pain Medicine Source Type: forums
Publication date: October 2020Source: Brain, Behavior, and Immunity, Volume 89Author(s): Fernando Lopes, Fernando A. Vicentini, Nina L. Cluny, Alexander J. Mathews, Benjamin H. Lee, Wagdi A. Almishri, Lateece Griffin, William Gonçalves, Vanessa Pinho, Derek M. McKay, Simon A. Hirota, Mark G. Swain, Quentin J. Pittman, Keith A. Sharkey
Source: Brain, Behavior, and Immunity - Category: Neurology Source Type: research
Shortly after the end of WWII, a British medical officer inspecting a military hospital in Germany observed a treatment for pressure injuries developed by Nazi doctors.  The officer’s name was Captain James Fulton Neil and his case report was published in the British Medical Journal along with a photograph of the unfortunate patient reproduced above.  The treatment employed suspension by wires drilled into pelvic bones, and I discovered Captain Neil’s article while researching the history of wound care. This post is a summary of my paper recently published in Advances in Skin &Wound Care that desc...
Source: Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers - Category: Geriatrics Authors: Tags: Featured Medical Articles Geriatric Medicine Pressure Injuries & Wound Care bedsore bedsores decubiti decubitus ulcer Jeff Levine MD Jeffrey M Levine MD medical history pressure sore pressure sores pressure ulcer pressure ulcers Source Type: blogs
  How do you know if your wound is chronic? The severity of your injury, as well as complications that cause significant delays in healing, are common indicators. There are also certain kinds of wounds that often end up high on the chronic scale. Here are the three most common types of chronic wounds: Infectious wounds, surgical sites and ulcers are among the most common chronic wounds. 1. Infectious wounds When infection causes significant delays in healing, the wound often becomes chronic. According to Wound Care Centers, typical signs of chronic infectious wounds include bad odors, pus drainage, dead ti...
Source: Advanced Tissue - Category: Dermatology Authors: Tags: Wound Care Wound Infection chronic wounds Source Type: news
Authors: Skavinski KA Abstract Pain from pressure ulcers can severely impact a patient's quality of life. Evidence-based treatment of ulcer-related pain typically relies on systemic opioids with limiting side effects. Literature exists on the use of topical ketamine for neuropathic pain, but not for tissue injury in general and for decubitus ulcer pain specifically. Ketamine has a number of actions including blocking of the glutamate NMDA ionophore in the periphery. Preclinical evidence suggests that NMDA receptors located on peripheral sensory afferent terminals may play a role in initiating pain signaling in infl...
Source: Journal of Pain and Palliative Care Pharmacotherapy - Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research
CONCLUSIONS: It is uncertain whether foam dressings are more clinically effective, more acceptable to users, or more cost effective compared to alternative dressings in treating pressure ulcers. It was difficult to make accurate comparisons between foam dressings and other dressings due to the lack of data on reduction of wound size, complete wound healing, treatment costs, or insufficient time-frames. Quality of life and patient (or carer) acceptability/satisfaction associated with foam dressings were not systematically measured in any of the included studies. We assessed the certainty of the evidence in the included tria...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
This article describes oral pharmacologic agents intended to build new tissue and aid in
Source: Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers - Category: Geriatrics Authors: Tags: Publications bedsores decubiti decubitus ulcer medications pharmacology pressure sores pressure ulcers wound care wound healing Source Type: blogs
Dr. Levine was on the advisory panel for revision of this guideline.This updated guideline is evidence based and incorporates the revised federal guidance to surveyors on pressure ulcers (Tag F314) including risk factors, infection, pain management, treatments based on the wound characteristics, and the resident’s rights to refuse one or more aspects of pressure ulcer
Source: Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers - Category: Geriatrics Authors: Tags: Publications amda decubiti decubitus ulcer Jeff Levine MD Jeffrey M Levine MD Long-Term Care medical director pressure sores pressure ulcers wound care wound healing Source Type: blogs
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