Ostomy/wound management
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Ostomy/wound management · Jun 2013
The effect of multiple layers of linens on surface interface pressure: results of a laboratory study.
Underpads and layers of linens are frequently placed under patients who are incontinent, have other moisture-related issues, and/or are immobile and cannot reposition independently. Many of these patients are also at risk for pressure ulcers and placed on pressure-redistribution surfaces. The purpose of this study was to measure the effects of linens and incontinence pads on interface pressure. ⋯ The study results illustrate that significant increases in peak interface pressure occur in a laboratory setting when linen layers are added to pressure redistribution surfaces. Results also indicated wetting incontinence pads on a support surface did not significantly increase interface pressure. Although additional preclinical and clinical studies are needed to guide practice, excessive linen usage for patients on therapeutic support surfaces should be discouraged.
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Ostomy/wound management · Apr 2013
ReviewPressure ulcer development and vasopressor agents in adult critical care patients: a literature review.
Critical care units provide technologically sophisticated care to the sickest patients in the healthcare system. The contribution of iatrogenic factors, including administration of pharmacologic agents such as vasopressors, to pressure ulcer (PU) development in adult critical care patients is understudied, thus less understood, but may be an important PU risk factor to consider in the critical care population. Vasopressor agents are potent vasoconstrictors commonly administered to critical care patients to elevate mean arterial pressure to counteract the effects of inadequate tissue perfusion and hypoxia; they have reemerged over the past decade in contemporary intensive care units as important first-line drugs in the treatment of shock states. ⋯ Increased vigilance regarding PU risk in critical care patients receiving vasopressor agents may be warranted. However, studies are needed to examine the effects of individual vasopressor agents and dosage and duration thresholds, as well as empirical investigation regarding the synergistic effect of multiple vasopressor agents administered simultaneously, on PU development in this population. Finally, research is needed to further elucidate vasopressor use as an independent risk factor for PU development in this population.
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Ostomy/wound management · Apr 2013
A retrospective, nonrandomized, beforeand- after study of the effect of linens constructed of synthetic silk-like fabric on pressure ulcer incidence.
A new, synthetic, silk-like fabric was developed for the purpose of providing bedding and patient gowns that manage moisture, friction, and shear when used between the patient and the healthcare support surface that may affect the development of pressure ulcers (PUs). A retrospective study was conducted to compare the incidence of hospital-acquired PUs in patients admitted to Telemetry, Urology, and Intensive Care Units before and after hospital linens were changed from standard to the synthetic (intervention) linens. Patient medical record data were abstracted for a period 12 weeks before (control) and 12 weeks following the linen change (intervention). ⋯ At discharge, 136 PUs were present in the control and 64 were present in the intervention group (P <0.001). The significant differences in the incidence of hospital-acquired PUs between the two groups suggest that linen type affects PU risk. Additional controlled clinical studies in high-risk patient populations are warranted.
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Ostomy/wound management · Nov 2012
An in vitro assessment of MRI issues at 3-Tesla for antimicrobial, silver-containing wound dressings.
Although no reports of adverse events have been published to date, the presence of metallic dressing ingredients may present an magnetic resonance imaging (MRI) safety concern for patients using silver-containing wound dressings. The purpose of this in vitro study was to test magnetic field interactions (ie, translational attraction and torque), heating, artifacts, and conductivity (ie, electrical resistance) when using MRI at 3-Tesla for two (nonborder and border) silver-containing wound dressings. The results indicated the dressings displayed no magnetic field interactions (deflection angle 0˚; no torque), and in each case, MRI-related heating effects were at the same levels as the background temperature increases (ie, <1.8˚C). ⋯ To date, only a hydrofiber silver-containing dressing has been tested for MRI safety. Because of potential variances in material characteristics, MRI test results are specific to the dressings tested and cannot be applied to other products. Future studies to define the level of silver concentration in dressings that may pose a hazard for performing an MRI are warranted.