Ostomy/wound management
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Ostomy/wound management · Feb 2007
A prospective, descriptive pressure ulcer risk factor and prevalence study at a university hospital in Turkey.
Valid and reliable patient records regarding pressure ulcers and standard procedures to promote pressure ulcer prevention are not generally available in Turkish hospitals. Consequently, information about pressure ulcer prevalence and risk factors is limited and cannot be obtained retrospectively. A prospective, 1-day, cross-sectional descriptive study was conducted among all eligible, hospitalized patients in the adult medical, surgical, and intensive care units of a university hospital in Turkey. ⋯ Patients at risk for pressure ulcer development were found to be male, older, unconscious, and post surgery; additionally, they had a low body mass index and serum albumin as well as other health problems known to be associated with pressure ulcer formation. A significant, negative correlation between hospital length of stay and Braden scale score also was observed. These findings confirm prevalence and risk factor data from studies conducted in other countries and suggest that assessment and prevention efforts in Turkish hospitals must improve in order to decrease the burden of pressure ulcers.
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Ostomy/wound management · Feb 2007
Intraoperatively acquired pressure ulcers: are there common risk factors?
Surgery puts patients at risk for developing pressure ulcers. Studies examining factors most likely associated with intraoperatively acquired pressure ulcers have not resulted in the development of a risk assessment tool specific to the surgical patient population. To ascertain the current national rate and potential risk factors of intraoperatively acquired pressure ulcers, a survey method was used to obtain data from a 1-day descriptive study. ⋯ Most (six patients, 66.7%) had at least one comorbidity and were managed with a warming device and 89% received three or more anesthetic agents. The median operative time for patients developing a pressure ulcer was 4.48 hours. While the external validity of these findings is limited by the current study sample size, the observations confirm previously reported trends and the need for research to improve risk factor identification of surgical patients to improve pressure ulcer prevention efforts.
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Bacterial colonization and infection are important factors in compromised wound healing, particularly in chronic wounds. Although "best practice" for controlling these factors currently is not defined, systemic antibiotics are generally accepted as the preferred choice for treating infection, provided ischemia does not reduce their bioavailability. ⋯ The judicious use of dressings, notably those containing certain antiseptic agents, can be a valuable option to control infection and promote healing. A review of the literature underscores the importance of considering the antiseptic route as part of a concerted approach to wound management and infection control.
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Because it provides greater and more durable weight reduction than behavioral and pharmacological interventions for the morbidly obese, the number of bariatric surgeries is increasing - one such procedure is the Roux-en-Y gastric bypass. A cross-sectional study was conducted to examine incision care knowledge and discharge concerns of patients who had undergone this type of gastric bypass bariatric surgery. Participants (N = 31; 28 women, three men; mean age 45 years), recruited from a bariatric surgery center in a large, urban teaching hospital, had undergone a Roux-en-Y gastric bypass by either the open (n = 29) or laparoscopic (n = 2) method. ⋯ Lower incision care knowledge scores were correlated with a higher fear of incision care (r = .46, P = .008) and patients reporting greater pain had more concerns about discharge (r = .49, P <.005). Little is known about preparing the bariatric surgery patient for discharge home. To improve outcomes, research that examines issues including discharge teaching methods, patient concerns, and information for persons undergoing bariatric surgery is needed.