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Secondary Intention (secondary + intention)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

Evaluation of NOC Measures in Home Care Nursing Practice

INTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003
Gail M. Keenan
PURPOSE To evaluate the reliability, validity, usefulness, and sensitivity of 89 NOC outcomes in two Visiting Nurse Associations in Michigan. METHODS Of a total 190 NOC outcomes 89 were assigned for testing. Interrater reliability and criterion validity were assessed a total of 50 times per outcome (on 50 different patients) across the study units. The total number of times the reliability and validity were assessed for each of the 89 measures studied ranged from 5,45. Three RN research assistants (RNRAs) oversaw and participated in data collection with the help of 15 clinicians. Convenience sampling was used to identify subjects. A roster of outcomes to be studied was maintained and matched with patient conditions whenever possible until the quota of outcomes assigned had been evaluated. Clinicians and RNRAs independently rated the outcomes and indicators applicable to the patient. NANDA diagnoses, NIC interventions, and medical diagnoses were recorded. FINDINGS A total of 258 patients (mean age 62) enrolled; 60% were women, 23% were from minority groups, and 78% had no college degree. Thirty-six of the 89 NOC measures were designated "clinically useful." The 10 outcomes with the highest interrater reliability were Caregiver Home Care Readiness; Caregiver Stressors; Caregiving Endurance Potential; Infection Status; Mobility Level; Safety Status: Physical Injury; Self-Care: Activities of Daily Living; Self-Care: Bathing; Self-Care: Hygiene; and Wound Healing: Secondary Intention. Criterion measurement and repeated ratings provided evidence to support the validity and sensitivity of the NOC outcomes. Evidence also suggested that NOC label level ratings could be a feasible, reliable, and valid method of evaluating nursing outcomes under actual use. For some measures, adjustments in the scales and anchors are needed to enhance reliability. For others, it may be unrealistic to reliably score in one encounter, thus scoring should be deferred until the clinician has adequate knowledge of the patient. CONCLUSIONS Continued study and refinement that are coordinated and integrated systematically strongly recommended. Comprehensive study in an automated system with a controlled format will increase the efficiency of future studies. [source]

Retrospective Review of Reconstructive Methods of Conchal Bowl Defects Following Mohs Micrographic Surgery

DERMATOLOGIC SURGERY, Issue 5 2001
Nina Wines BSc
Background. Mohs micrographic surgery has consistently been demonstrated to be the most effective method for excision of potentially aggressive lesions of the conchal bowl. A variety of techniques are employed to reconstruct the conchal bowl following surgery. Objective. To explore the type and frequency of reconstruction techniques used and the factors influencing the surgeons choice of reconstruction method. Method. Retrospective analysis of 272 patients with conchal bowl tumors. Results. Split thickness skin grafting was the preferred method of reconstruction. The histopathology of the lesions and the size of the post-Mohs defect did not influence the choice of technique, except for lesions less than 1 cm in which healing by secondary intention was favored. Conclusion. Tumor size, type, and aggressiveness did not influence repair technique choice. Surgeon preference was therefore the principle factor dictating method of reconstructive technique following Mohs micrographic surgery. [source]

The effect and safety after extended use of continuous negative pressure of 75 mmHg over mesh and allodermis graft on open sternal wound from oversized heart transplant in a 3-month-old infant,

INTERNATIONAL WOUND JOURNAL, Issue 5 2010
Kangwoo Nathan Lee
Negative pressure therapy (NPT) has been reported to be effective in treating infants with open chest wounds. This report further supports its effectiveness by treating a 3-month-old infant with a 12 × 7 cm sized opening in its chest after an oversized heart transplantation. After applying a mesh and allodermis over the defect, 75-mmHg continuous negative pressure was set and used for an extended period of 104 days. The haemodynamic status was evaluated during this period. The wound was closed with secondary intention and it healed well after NPT. There was no haemodynamic instability during the treatment course. The extended use of a continuous negative pressure of 75 mmHg over the mesh and alloderm graft was a reliable and safe option to close the massive defect in the chest of a 3-month-old infant. [source]

Silver dressings: their role in wound management

INTERNATIONAL WOUND JOURNAL, Issue 4 2006
David J Leaper
Abstract Dressings have a part to play in the management of wounds; whether they are sutured or open, usually chronic wounds of many aetiologies which are healing by secondary intention. They traditionally provide a moist wound environment, but this property has been extended through simple to complex, active dressings which can handle excessive exudate, aid in debridement, and promote disorganised, stalled healing. The control of infection remains a major challenge. Inappropriate antibiotic use risks allergy, toxicity and most importantly resistance, which is much reduced by the use of topical antiseptics (such as povidone iodine and chlorhexidine). The definition of what is an antimicrobial and the recognition of infection has proven difficult. Although silver has been recognised for centuries to inhibit infection its use in wound care is relatively recent. Evidence of the efficacy of the growing number of silver dressings in clinical trials, judged by the criteria of the Cochrane Collaboration, is lacking, but there are good indications for the use of silver dressings, to remove or reduce an increasing bioburden in burns and open wounds healing by secondary intention, or to act as a barrier against cross contamination of resistant organisms such as MRSA. More laboratory, and clinical data in particular, are needed to prove the value of the many silver dressings which are now available. Some confusion persists over the measurement of toxicity and antibacterial activity but all dressings provide an antibacterial action, involving several methods of delivery. Nanocrystalline technology appears to give the highest, sustained release of silver to a wound without clear risk of toxicity. [source]

Letter: Systematic review of dressings and topical agents for surgical wounds healing by secondary intention (Br J Surg 2005; 92: 665-672)

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 12 2005
I. Loefler
The Editors welcome topical correspondence from readers relating to articles published in the Journal. Responses can be sent electronically via the BJS website (http://www.bjs.co.uk) or by post. All letters will be reviewed and, if approved, appear on the website. A selection of these will be edited and published in the Journal. Letters must be no more than 250 words in length. Letters submitted by post should be typed on A4-sized paper in double spacing and should be accompanied by a disk. [source]

Authors' reply: Systematic review of dressings and topical agents for surgical wounds healing by secondary intention (Br J Surg 2005; 92: 665-672)

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 12 2005
H. Vermeulen
No abstract is available for this article. [source]

Surgical excision of acne keloidalis nuchae with secondary intention healing

CLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 1 2008
V. Bajaj
Summary Acne keloidalis nuchae (AKN) is a chronic scarring folliculitis that presents clinically as follicular papules and pustules. These can coalesce into firm hypertrophic plaques and nodules on the nape of the neck, most commonly affecting young adult men. Treatment includes topical steroids/antibiotics and oral antibiotics, but often has disappointing results. Surgical approaches include excision with primary closure or skin grafting, and hair-removal lasers. Another surgical approach is excision with secondary intention healing. This can result in good cosmesis with little or no recurrence. We report two men with AKN where treatment by excision with secondary intention was successful. [source]