Wounds
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A Marjolin's ulcer describes malignant degeneration in any chronic wound. The majority of cases arise in burn scars and are often latent for decades. ⋯ Based on observations and a review of the literature, early detection and aggressive management with wide local excision and prompt coverage yield optimal results when treating patients with Marjolin's ulcers.
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Patient repositioning to offload high-pressure areas is an essential component of pressure ulcer prevention for bed-bound patients. In most settings, the quantity and quality of offloading and repositioning are difficult to measure. Real-time continuous bedside pressure mapping (CBPM) offers an opportunity to do so. ⋯ Real-time, ongoing pressure measurement using a pressure-sensing mat may be a useful tool to help care providers effectively reposition patients within the context of existing standardized protocols for the prevention and minimization of pressure ulcers. .
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xBxxaxcxkground. In addition to prevention guidelines already in place, the effectiveness of an antimicrobial dressing on the occurrence of surgical site infections (SSIs) among adult patients undergoing cardiac surgery was evaluated. ⋯ The antimicrobial dressing had a positive effect by reducing the infection rate, especially for leg incisions using conventional open techniques, and could be a worthwhile addition in conjunction with a strategic program. .
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Neutrophilic dermatosis of the dorsal hands (NDDH) is a rare condition often misdiagnosed as a localized cutaneous infection. A type of neutrophilic dermatosis, NDDH is considered to be a subset of Sweet's syndrome and is similar to pyoderma gangrenosum. The authors report 2 cases of male patients who presented with persistent ulcerative skin lesions. ⋯ The clinical presentation, histological features, and excellent response to corticosteroid treatment are consistent with diagnosis of NDDH. Delayed recognition of neutrophilic dermatosis and treatment of secondary infection resulted in delayed treatment. Improved recognition of neutrophilic dermatoses is important for optimal management of NDDH. .
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Background. Outcomes following burn injury have improved considerably in recent years due to early excision and skin grafting. Despite a reduction in late burn complications, up to 70% of patients experience long-term pain at both the injured area and the skin-grafted scar. Current therapies do not ameliorate these symptoms for a majority of these patients. This report presents initial results of a new technique using a bilayer dermal substitute (Integra™, [Integra LifeSciences, Plainsboro, NJ]) for revision of painful scars. ⋯ Scar excision, interval placement of a bilayer dermal matrix, and subsequent skin grafting is a new technique that can improve, and in some cases ameliorate, burn scar related pain. .