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Decubitus Ulcers (decubitu + ulcer)
Selected AbstractsDecubitus ulcers: A review of the literatureINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 10 2005Cheryl Bansal BA Decubitus ulcers are a worldwide health care concern affecting tens of thousands of patients and costing over a billion dollars a year. Susceptibility to pressure ulcers comes from a combination of external factors (pressure, friction, shear force, and moisture), and internal factors (e.g. fever, malnutrition, anaemia, and endothelial dysfunction). Often, enough damage is done to create the basis for a decubitus ulcer after as little as 2 h of immobility, a situation which may be difficult to avoid if the patient must undergo prolonged surgery or remain bedridden. Damage owing to pressure may also occur hours before the patient receives medical attention, especially if the patient falls or becomes immobilized owing to a vascular event. Several classification systems for decubitus ulcers have been described, based on where injury first occurs. The histologic progression of decubitus ulcers is a dynamic process involving several stages, each having characteristic histologic features. A team-focused approach integrating all aspects of care, including pressure relief, infection control, nutrition, and surgery, may improve healing rates. With accurate risk assessment and preventative care, we can hope to minimize complications and mortality owing to decubitus ulcers. [source] Risk assessment scales for pressure ulcer prevention: a systematic reviewJOURNAL OF ADVANCED NURSING, Issue 1 2006Pedro L. Pancorbo-Hidalgo PhD RN Aim., This paper reports a systematic review conducted to determine the effectiveness of the use of risk assessment scales for pressure ulcer prevention in clinical practice, degree of validation of risk assessment scales, and effectiveness of risk assessment scales as indicators of risk of developing a pressure ulcer. Background., Pressure ulcers are an important health problem. The best strategy to avoid them is prevention. There are several risk assessment scales for pressure ulcer prevention which complement nurses' clinical judgement. However, some of these have not undergone proper validation. Method., A systematic bibliographical review was conducted, based on a search of 14 databases in four languages using the keywords pressure ulcer or pressure sore or decubitus ulcer and risk assessment. Reports of clinical trials or prospective studies of validation were included in the review. Findings., Thirty-three studies were included in the review, three on clinical effectiveness and the rest on scale validation. There is no decrease in pressure ulcer incidence was found which might be attributed to use of an assessment scale. However, the use of scales increases the intensity and effectiveness of prevention interventions. The Braden Scale shows optimal validation and the best sensitivity/specificity balance (57·1%/67·5%, respectively); its score is a good pressure ulcer risk predictor (odds ratio = 4·08, CI 95% = 2·56,6·48). The Norton Scale has reasonable scores for sensitivity (46·8%), specificity (61·8%) and risk prediction (OR = 2·16, CI 95% = 1·03,4·54). The Waterlow Scale offers a high sensitivity score (82·4%), but low specificity (27·4%); with a good risk prediction score (OR = 2·05, CI 95% = 1·11,3·76). Nurses' clinical judgement (only considered in three studies) gives moderate scores for sensitivity (50·6%) and specificity (60·1%), but is not a good pressure ulcer risk predictor (OR = 1·69, CI 95% = 0·76,3·75). Conclusion., There is no evidence that the use of risk assessment scales decreases pressure ulcer incidence. The Braden Scale offers the best balance between sensitivity and specificity and the best risk estimate. Both the Braden and Norton Scales are more accurate than nurses' clinical judgement in predicting pressure ulcer risk. [source] Decubitus ulcers: A review of the literatureINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 10 2005Cheryl Bansal BA Decubitus ulcers are a worldwide health care concern affecting tens of thousands of patients and costing over a billion dollars a year. Susceptibility to pressure ulcers comes from a combination of external factors (pressure, friction, shear force, and moisture), and internal factors (e.g. fever, malnutrition, anaemia, and endothelial dysfunction). Often, enough damage is done to create the basis for a decubitus ulcer after as little as 2 h of immobility, a situation which may be difficult to avoid if the patient must undergo prolonged surgery or remain bedridden. Damage owing to pressure may also occur hours before the patient receives medical attention, especially if the patient falls or becomes immobilized owing to a vascular event. Several classification systems for decubitus ulcers have been described, based on where injury first occurs. The histologic progression of decubitus ulcers is a dynamic process involving several stages, each having characteristic histologic features. A team-focused approach integrating all aspects of care, including pressure relief, infection control, nutrition, and surgery, may improve healing rates. With accurate risk assessment and preventative care, we can hope to minimize complications and mortality owing to decubitus ulcers. [source] An investigation into the use of serum albumin in pressure sore predictionJOURNAL OF ADVANCED NURSING, Issue 2 2000Denis Anthony RMN RGN BA MSc PhD AMIEE An investigation into the use of serum albumin, in pressure sore prediction Objectives To ascertain the relevance of serum albumin and serum sodium as predictors of pressure sores in addition to the Waterlow score. Design Observational study of patients at risk of developing decubitus ulcers. Setting Staffordshire, in the midlands of the United Kingdom. Participants 773 elderly hospital in-patients of a district general hospital. Measurements Waterlow scores and serum albumin and sodium. Development of a pressure sore. Results Logistic regression analysis of serum albumin, serum sodium and the Waterlow score showed the Waterlow score and serum albumin were significant predictors of pressure sores. Conclusions Serum albumin may, in this patient group (in-patients over 64 years of age), be a useful predictor of pressure sore occurrence, though further work is needed to establish whether this is the case. Risk assessment of pressure sores can possibly be improved by adding serum albumin to one of the pre-existing tools such as the Waterlow score. [source] Urinary bladder hyperreflexia: A rat animal modelNEUROUROLOGY AND URODYNAMICS, Issue 7 2003Hassan Shaker Abstract In this work, we are presenting a rat animal model for bladder hyperreflexia after suprasacral spinal cord transection. Our aim was to standardize an animal model that can be useful in studying this condition. After standardizing the animal model in a pilot study, 26 female Sprague,Dawley rats were subjected to spinal cord transection at the level of T10 vertebra. Four animals were subjected to cystometrogram (CMG) 24 hr after spinalization and six rats 3 weeks post-spinalization. These CMGs were compared to that of six normal controls. The detailed description of the model presented in this manuscript, is the final result after several modifications. All the animals consistently developed hyperreflexia after an initial period of spinal shock phase. Expressed volume of urine continued to decrease until it reached a plateau after peaking at 1-week post-spinalization. The attrition rate reached 27.3% after several improvements in the animal model and was mostly from self-inflicted injuries. Post-operative complications included hypothermia, decubitus ulcers, hematuria, urinary tract infection in addition to the unexplained death of two animals. In conclusion, we believe that this animal model closely resembles the clinical condition of hyperreflexia and follows similar course. The relative low cost of this animal model and the easy maintenance makes it a valuable tool to study such a condition. Neurourol. Urodynam. 22:693,698, 2003. © 2003 Wiley-Liss, Inc. [source] | ||||||||||