Ostomy/wound management
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Ostomy/wound management · Oct 2012
Comparative Study Controlled Clinical TrialProspective, nonrandomized controlled trials to compare the effect of a silk-like fabric to standard hospital linens on the rate of hospital-acquired pressure ulcers.
Hospital bedding and gowns influence skin moisture, temperature, friction, and shear, which in turn may affect the development of pressure ulcers. To evaluate the effect of a new silk-like synthetic fabric on the incidence of pressure ulcers in an acute care setting, two consecutive 6-month clinical trials were conducted among 307 consecutively admitted patients in a Medical Renal Unit (August 2008 and March 2010) and in 275 patients admitted to a Surgical Intensive Care Unit (ICU) (September 2009 to March 2010). During the first 8 weeks, all patients used standard hospital bed linens, reusable underpads, and gowns. ⋯ Average length of stay was 4.5 days and 4.33 days in the control and intervention groups, respectively (P = 0.33). The significant differences between the control and intervention group in the rate of pressure ulcer development suggests that the type of linens used affect pressure ulcer risk and that this silk-like synthetic fabric technology may help reduce the incidence of pressure ulcers in high-risk patients. Controlled clinical studies in other patient populations are warranted.
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Ostomy/wound management · Aug 2012
Randomized Controlled TrialQuality of pediatric second-degree burn wound scars following the application of basic fibroblast growth factor: results of a randomized, controlled pilot study .
Pediatric burn wounds present unique challenges. Second-degree burns may increase in size and depth, raising concerns about healing and long-term scarring. Results of a clinical study in adults with second-degree burn wounds suggest that application of basic fibroblast growth factor (bFGF) may reduce time to second-intention healing and result in a more cosmetically acceptable scar. ⋯ After 1 year, scar pigmentation, pliability, height, and vascularity were also significantly different (P <0.01) between the groups. Hypertrophic scars developed in 0 of 10 wounds in the treatment and in three of 10 wounds in the control group, and effective contact coefficient, transepidermal water loss, water content, and scar thickness were significantly greater in control group (P <0.01). Both the short- and long-term results of this treatment in pediatric burn patients are encouraging and warrant further research.
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Ostomy/wound management · Jun 2012
Single-stage reconstruction for soft tissue defects: a case series.
Various techniques for obtaining expedient aesthetic coverage of soft tissue defects with limited donor site morbidity have been developed, including the use of a dermal regeneration template (DRT) as the first step in a two-stage surgical approach. Use of DRT in reconstruction has increased as a result of reports suggesting improved cosmetic results and reduced scarring compared to split-thickness skin grafts (STSG), but this approach requires a return to the operating room. To evaluate outcomes of a single-stage procedure, a prospective evaluation of patients with complicated soft tissue defects measuring <200 cm2 was conducted. ⋯ No wound breakdown, adverse events, or re-operation occurred during follow-up. In this case series, single-stage reconstruction using DRT, STSG, and NPWT was used with good outcomes and second-stage reconstruction surgery was avoided. Prospective, randomized, controlled clinical studies to compare the various surgical and wound care approaches to closing these tissue defects are warranted.
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Ostomy/wound management · Mar 2012
Multicenter StudyExamining the relationship between physician and facility level-of-service coding in outpatient wound centers: results of a multicenter study .
The evaluation and management (E/M) services for the physician and the hospital-based outpatient center ("facility") are calculated using different federal regulations. In addition, patients visiting outpatient wound care centers require different levels of care from the physician than the facility. The purpose of this study was to analyze and compare physician and facility E/M level-of-service coding using the electronic wound registry records from three geographically diverse, hospital-based outpatient wound centers. ⋯ Although facility E/M levels of service followed a normal distribution, physician E/M visits were heavily skewed toward higher levels of care (3 to 5). These findings confirm that, especially during the initial visit, patients presenting at outpatient wound centers require different levels of care from the physician than from the facility. The finding that initial physician level of service coding was higher than facility E/M levels of service for both initial and follow-up visits is not unexpected, considering the high number of comorbidities in many wound patients and the general risk of their presenting problems.
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Ostomy/wound management · Jan 2012
An in vitro comparison of two silver-containing antimicrobial wound dressings .
Preclinical studies have shown that release of silver by different wound dressings varies. The purpose of this in vitro study was to compare the antimicrobial activity of silver alginate (SA) and silver carboxymethylcellulose (SCM) dressings. An- timicrobial activity was tested using nine bacterial strains with log10 reduction and corrected zone of inhibition (CZOI) as- says. ⋯ CLSM showed complete kill of S. aureus after 20 hours for both dressings. The results of this study confirm the broad-spectrum, in vitro activity of some dressings containing ionic silver. The in vitro antimicrobial efficacy of both wound dressings was comparable, but clinical studies comparing the efficacy and effectiveness of silver-containing dressings to nonionic silver-containing dressings are needed.