Prevention Of Pressure Sores Research Articles

Pressure sore prevention and treatment knowledge of nurses

Pressure sore prevention and treatment knowledge of nurses

Single-Leg Spica Cast Application for Treatment of Pediatric Femoral Fracture.

Use of a single-leg spica cast for femoral fractures in ambulatory children 1 to 5 years of age facilitates care and mobilization of the patient. It may allow a shorter duration of cast treatment than is possible with a traditional one and one-half-leg spica cast, particularly in patients 1 to 3 years of age. The single-leg spica is indicated for children who are small enough to be lifted safely in the cast and who have an isolated, closed, low-energy femoral shaft fracture. The procedure consists of the following steps:Step 1: Obtain adequate sedation. General anesthesia should be used in the operating room, whereas conscious sedation may be used in the emergency or procedure room setting. The location of the procedure should be determined by available resources.Step 2: Determine the position of optimal alignment by visual examination of the thigh and leg. If intraoperative imaging is available, assess fracture stability by performing the telescope test described by Thompson et al.1-i.e., by gently applying axial load to the thigh to assess for shortening under fluoroscopic monitoring. Shortening of >3 cm reflects substantial periosteal stripping and is associated with an increased risk of loss of reduction in the cast. Alternative stabilization techniques should be considered for grossly unstable fractures with a positive telescope test. Use of intramedullary nails, external fixation, or traction with delayed cast application may decrease the risk of excessive shortening or unacceptable angulation of the fracture in the cast.Step 3: Apply a stockinette or waterproof pantaloons cast liner to the torso and involved lower extremity.Step 4: Position the patient on a spica-cast application table, which provides a support under the thorax and head with a strut that supports the spine and pelvis to the sacrum, allowing application of the cast material to the pelvic area and involved extremity. Position the patient on the table with the involved extremity flexed 30° to 60° at the hip and 30° to 60° at the knee and the contralateral leg supported. Greater flexion makes it easier to fit the child into a car seat or high chair and to carry him/her on the caretaker's hip, whereas flexing the hip and knee less allows the patient to bear weight more easily. However, Illgen et al.2 found knee flexion of <50° to be associated with an increased risk of reduction loss. More proximal fractures are better treated with greater hip flexion because of their tendency to drift into apex anterior angulation.Step 5: Overwrap the cast liner from nipple line to ankle with cotton or synthetic undercast padding to prevent pressure sores. Some families prefer waterproof cast padding as it allows the child to be immersed for bathing, but it provides less padding at pressure points and increases the cost of the cast.Step 6: Apply fiberglass or plaster cast material starting 1 in (2.5 cm) below the edge of the cast padding and ending 1 in above the malleoli to allow the edges of the cast to be adequately padded when the liner is folded back.Step 7: Apply an iliac crest mold to stabilize the hip, and apply an anterior and valgus mold to the involved thigh to recreate the anterior bow and address the tendency of femoral shaft fractures to drift into varus.Step 8: Trim and finish the cast. Inspect the groin region for rough edges and trim them as needed using the cast saw or bandage scissors. Cast edges should be "petalled with" (covered with short strips of) moleskin as needed.Step 9: After the cast is hard, remove the patient from the spica table and wake him/her up. Place a smaller diaper over the groin inside the cast to prevent cast soiling and a second, larger diaper over the outside of the cast to hold the smaller diaper in place. Following cast application, distal neurovascular status is assessed. The caretakers are trained in cast care and safe patient transport. The fit of the car seat is checked prior to discharge from the emergency room or hospital. Follow-up radiographs with the patient in the cast should be obtained 10 days after cast application. Angulation of ≤15° and shortening of <2 cm can generally be accepted in patients with a midshaft fracture. Angulation of >15° can often be managed with wedging of the cast in the clinic. Excessive shortening may require reapplication of the cast or a change to another stabilization method. Single-leg spica treatment of femoral fractures in children ≤5 years of age has provided reliable outcomes with few complications. Usually, the cast can be removed 4 to 6 weeks following application.

Figure 8 (Heel open) short leg cast

Category: Ankle, Trauma Introduction/Purpose: To report the results of applying heel open (figure 8) short leg cast on foot &amp; ankle trauma or disease patients requiring short leg casts. Methods: 380 patients who were confirmed and treated by diagnosed of foot &amp; ankle trauma or diseases were included between November 2014 and July 2016. Comprised of 222 males and 158 females, their mean age was 46 years old. The bottom of the figure 8 cast covered the metatarsal head to half portion of the medial longitudinal arch, while leg portion covering consisted from the prominence of the both malleolus to halfway of the lower leg, resulting in complete exposure of the heel and distal portion of the achilles tendon. After application of the figure 8 cast, changes in the ROM in active ankle dorsiflexion &amp; plantarflexion, passive foot inversion &amp; eversion, and foot internal &amp; external rotation were measured. Results: In all cases, measurements of active ankle dorsiflexion &amp; plantarflexion was less than 5 degrees, measurements of passive foot inversion &amp; eversion was less than 5 degrees, foot internal &amp; external rotation was less than 0 degrees, and were stably held without skin or soft tissue injury until cast removal. Notable were 22 cases of foot &amp; ankle fractures treated with conservative therapy with figure 8 short leg cast resulting in bone union and stabilization without surgery. VAS discomfort score was an average of 2.6 (0~5) and figure 8 short leg cast was selected in all cases requiring a short leg cast. Conclusion: The use of figure 8 short leg cast in patients of foot &amp; ankle trauma and diseases requiring short leg cast provides safety and prevention of skin necrosis and pressure sores from open heels while providing high patient satisfaction in daily life, such as heel touch. We believe that figure 8 short leg cast could replace the traditional short leg cast, if the safety of the figure 8 cast could be proven through long-term follow up study with various patient and cases.

Study on the use of textiles to manufacture mattresses in order to prevent decubitus ulcers due to post-fracture immobilization syndrome in the elderly patient

Study on the use of textiles to manufacture mattresses in order to prevent decubitus ulcers due to post-fracture immobilization syndrome in the elderly patient

Bibliometric analysis of neonatal pressure sore literature in China

Objective Through the analysis of the status quo of the research on neonatal pressure sore in the relevant nursing research, we can understand the strategy and the problems of the prevention of neonatal pressure sore, which provides reference for future research. Methods This article used bibliometric analysis method to construct literature reading and reviewing database, screening articles in the Chinese biological medical disc (CBMdisc), China Journal Full-text Database (CJFD), China Science Periodical Database (CSPD) and China Science and Technology Journal Database (CSTJ) , according to the criteria of inclusion and exclusion. Results A total of 74 articles were integrated into the literature, the first published in China in 2006, after the overall trend of growth, especially since 2011 began to significantly increase. Of which 29 (39.2%) of the literature published in 13 kinds of professional nursing journals. The total number of citations was 1.84, the cohort rate was 39.19%, the total number of citations was 54, and the number of citations per article was 0.73. The total number of citations was 447, and the average number of citations was 6.04. Literature research types are subdivided into 10 categories, of which experienced literature was the most (23.0%). Literature research concentrated on the use of chemical or physical methods to prevent neonatal pressure sores. Conclusions Neonatal pressure sore is paid more and more attention by the nurses, and the policy support for it is acceptable, but the related research needs to be further strengthened in the breadth, depth and comprehensive aspects. It is necessary for us to use scientific research methods, combining with the culture of pediatric and the characteristics of pediatric management in our country, to construct the best practice manual for preventing neonatal pressure sore in China. Key words: Newborn; Pressure ulcer; Bibliometric

Application of evidence-based nursing intervention to pressure sore prevention and cure of ICU critical patients

Objective To investigate the application effect of evidence-based nursing on pressure sore prevention and cure of ICU critical patients, summarize the experience of pressure sore nursing and give reference for making nursing scheme. Methods A total of 50 ICU critical patients of this hospital from January, 2015 to March, 2016 were selected as the study objects, divided into intervention group and control (25 patients on average) according to random number table.Usual nursing intervention was conducted to the patients of control.Evidence-based nursing intervention was carried out to intervention group based on usual care.Braden pressure sore prognostic scale was used to evaluate the pressure sore recovery condition of patients in both groups.SF-36 living quality evaluation scale was used to evaluate the living quality of patients in both groups.Self-made satisfaction questionnaire was used to evaluation the satisfaction of both groups.Pressure sore occurrence rate, pressure sore formation time, pressure sore occurrence degree, Braden pressure sore score, SF-36 score and satisfaction of patients in both groups were compared. Results The pressure sore occurrence rate of intervention group was 4.00%, which was obviously lower than that of the control group's 12.00%, and the difference was statistically significant(P<0.01). The pressure sore occurrence degree of intervention group was obviously lower than control group, and the difference was statistically significant(P<0.01). The pressure sore formation time of intervention group was (9.45±2.82) days, which was obviously longer than control group that was (5.12±2.26) days, and the difference was statistically significant(P<0.01). The Braden pressure sore score and SF-36 score of intervention group were obviously superior to control group. The total satisfaction of intervention group was 96.00%, which was higher than control group that was 84.00%(P<0.01). Conclusions Evidence-based nursing intervention plays an important role in pressure sore prevention and cure of ICU critical patients, which can reduce pressure sore occurrence rate, occurrence degree, improve nursing satisfaction and living quality of patients. Key words: ICU; Evidence-based nursing interventions; Pressure sores

Medical and social consequences of fractures of the proximal femur in elderly and senile subjects (literature review)

The medico-social consequences of fractures of the proximal femur in elderly patients, the medical care system for such in­juries in various countries, complications and lethality are ana­lyzed. It was noted that the mortality rates during the first year after the fracture of proximal femur ranges from 21.5 to 40.0 %, in 20–50 % of cases, patients become disabled and even three years after injury the indicators of «physical functioning» and «general health» remain low. Return to the regular way of life fracture of proximal femur, observes in 20–50 % of patients only. It is established that 20–60 % of the injured persons need daily assistance, and more elderly people living in boarding schools and nursing homes, compared to those living in families. Based on the results of the STOP study (system for recording of osteoporotic fractures), Ukraine is classified as a country with a moderate risk of developing osteoporosis and its compli­cations, and the incidence of fractures of proximal femur is simi­lar to that of Romania and Poland. In Sweden and the UK, na­tional programs have been developed for the treatment of pa­tients with fracture of proximal femur, which include surgical intervention within 48 hours after trauma, geriatric consultation within 72 hours after admission, early post-operative mobiliza­tion, bedsore prevention, osteoporosis medication, supervision of a geriatrician. All this allowed to reduce the length of stay of the patient in the hospital, to reduce the number of complica­tions, to reduce the lethality and the cost of treatment by 40 %. Surgical treatment of elderly and senile patients with proximal femur fractures as soon as possible is the «gold standard».

Use of Olive Oil in Prevention of Bedsores in Intensive Care Unit

Use of Olive Oil in Prevention of Bedsores in Intensive Care Unit

Does intramuscular gluteal augmentation using implants affect sensitivity in the buttocks?

The evolution of techniques and materials has made gluteoplasty a safe and reproducible operation with high acceptance among surgeons and patients. Functional aspects should be considered in gluteoplasty but are poorly studied. The sensitivity of the buttocks is fundamental as it represents an erogenous zone and provides protection through sensory stimuli for the prevention of pressure sores and burns. This study aimed to evaluate the sensitivity of the gluteal region in patients undergoing gluteal augmentation with implants. We included 20 consecutive patients undergoing gluteoplasty and 20 controls not undergoing gluteal surgery. All patients are females and were being treated at the Division of Plastic Surgery of the Rio de Janeiro State University. The right and left gluteal regions were delimited, and each one was divided into four quadrants numbered 1-8. Sensitivity tests were performed in all quadrants for six different stimuli: touch, heat, cold, pain, vibration, and pressure. The mean age and BMI were 36.3 years and 26.3, respectively. No difference in sensitivity was observed in the gluteal region after augmentation gluteoplasty when compared with those patients who had no operation in this series. Prospective and controlled studies are needed to better assess these issues.

Knowledge and practices of bed sore prevention among staff nurses working in a selected hospital, Ludhiana, India

The majority of pressure ulcers are preventable. Nurses are able to constantly observe their client’s skin for breaks or impairment in skin integrity. Pressure ulcers not only cause suffering to the patients but also increases the workload on nurses. To identify the deficits in knowledge and practices of bed sore prevention among staff nurses’ working in general wards as well as special units and to prepare a Self Instructional Module (SIM) for improving the quality of nursing practices.An exploratory approach and participating observation approach was adopted. This study was conducted in Christian Medical College &amp; Hospital, Ludhiana, Punjab, India among 60 staff nurses working in general wards and special units. Purposive sampling method was used for data collection with self prepared questionnaire. Multiple-choice questions were administered for study the knowledge level and an audit form with checklist for assessment of practice. The data was analyzed using in terms of descriptive and inferential statistics. SIM was developed based on the deficit found in the result. Staff nurses working in special units have significantly better knowledge (72.92%) than the nurses in general wards (62.50%). Similarly, the results showed special unit nurses practice significantly better (60.29%) than general ward nurses (46.68%). Overall knowledge of staff nurses was higher (67.71%) as compared to their practice (53.49%) regarding bed sore prevention. Although 40% of overall staff nurses achieved excellent level on knowledge, none of them crossed the excellent level on practice. It strongly suggested developing SIM for them. Self instructional Module was developed inferring the results that staff nurses’ working in special units have excellent (deficit only 2.08%) knowledge in different areas of knowledge compared to staff nurses working at general wards (deficit 12.50%) where as 100% of respondents did not achieve excellent level on practice regarding Bed Sore prevention. Hence all of them need improvement in practices of Bed Sore prevention to come up to excellence level.

Knowledge and practices of bed sore prevention among staff nurses working in a selected hospital, Ludhiana, Punjab, India

The majority of pressure ulcers are preventable. Nurses should be able to constantly observe their client’s skin for breaks or impairment in skin integrity. Pressure ulcers not only cause suffering to the patients but also increases nurses’ work­load in clinical setting. Prevention of pressure ulcers is a significant nursing concern to reduce the costs of treatment and patients’ suffering. To assess the level of knowledge and observe the practices of bed sore prevention among staff nurses working in general wards as well as special units. A descriptive, cross sectional and participating observational method was adopted. This study was conducted in Christian Medical College &amp; Hospital, Ludhiana, Punjab, India among 60 staff nurses working in general wards and special units. Non probability, purposive sampling technique was used. Semi structured self administered questionnaire was developed for assessing knowledge and observation checklist was developed for practice of bed sore prevention for data collection procedure. Data were entered in SPSS 17.0 version and analyzed using in terms of descriptive (Frequency, percentage, mean, standard deviation and mean percentage) and inferential statistics (Inde­pendent t test, ANOVA and correlation). Findings highlight a difference in knowledge between special (73%) and general (62%) based nurses regarding pressure ulcers. Similar results were also found for practice. Overall discrepancies between knowledge (68%) and practice (53%) were reported for staff nurses regarding bed sore prevention. The results showed special unit nurses’ practice significantly better (60.29%) than general ward nurses (46.68%). Although 40% of overall staff nurses achieved excellent level on knowledge, none of them crossed the excellent level on practice. It is concluded that knowledge and practice of bed sore prevention among nurses working within specialists and generalist ward differed and a theory practice gap exists which has implications for patients care suggesting the need for a specific educational interven­tion to respond to this need.

Knowledge and Practices of Bed Sore Prevention among Staff Nurses Working in a Selected Hospital, Ludhiana, Punjab, India

The majority of pressure ulcers are preventable. Nurses should be able to constantly observe their client’s skin for breaks or impairment in skin integrity. Pressure ulcers not only cause suffering to the patients but also increases nurses’ work­load in clinical setting. Prevention of pressure ulcers is a significant nursing concern to reduce the costs of treatment and patients’ suffering. To assess the level of knowledge and observe the practices of bed sore prevention among staff nurses working in general wards as well as special units. A descriptive, cross sectional and participating observational method was adopted. This study was conducted in Christian Medical College & Hospital, Ludhiana, Punjab, India among 60 staff nurses working in general wards and special units. Non probability, purposive sampling technique was used. Semi structured self administered questionnaire was developed for assessing knowledge and observation checklist was developed for practice of bed sore prevention for data collection procedure. Data were entered in SPSS 17.0 version and analyzed using in terms of descriptive (Frequency, percentage, mean, standard deviation and mean percentage) and inferential statistics (Inde­pendent t test, ANOVA and correlation). Findings highlight a difference in knowledge between special (73%) and general (62%) based nurses regarding pressure ulcers. Similar results were also found for practice. Overall discrepancies between knowledge (68%) and practice (53%) were reported for staff nurses regarding bed sore prevention. The results showed special unit nurses’ practice significantly better (60.29%) than general ward nurses (46.68%). Although 40% of overall staff nurses achieved excellent level on knowledge, none of them crossed the excellent level on practice. It is concluded that knowledge and practice of bed sore prevention among nurses working within specialists and generalist ward differed and a theory practice gap exists which has implications for patients care suggesting the need for a specific educational interven­tion to respond to this need.

Fundamentals of tissue viability, 1.2. Skin care: assessment

British Journal of Healthcare AssistantsVol. 11, No. 2 ClinicalFundamentals of tissue viability, 1.2. Skin care: assessmentMenna Lloyd JonesMenna Lloyd JonesSearch for more papers by this authorMenna Lloyd JonesPublished Online:8 Feb 2017https://doi.org/10.12968/bjha.2017.11.2.72AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Andrews H (2012) Skin assessment: a vital skill for HCAs and APs. British Journal of Healthcare Assistants 6(11): 540–5 Link, Google ScholarBale S, Finlay I, Harding KG (1995) Pressure sore prevention in a hospice. Journal of Wound Care 4(10): 465–8 Link, Google ScholarDougherty LLister S, eds (2011) Royal Marsden Hospital Manual Of Clinical Procedures. Student edn. 8th edn. Wiley-Blackwell, London Google ScholarLloyd Jones M (2017) Fundamentals of tissue viability, 1. Introduction. British Journal of Healthcare Assistants 11(1): 12–4 Link, Google ScholarRoyal College of Nursing (RCN) (2015) First Steps for Health Care Assistants. Assessing Patient's Skin. http://rcnhca.org.uk/clinical-skills/assessing (accessed 11 January 2017) Google ScholarVoegeli D (2007:17–21) Factors that exacerbate skin breakdown and ulceration. In: Skin Breakdown, The Silent Epidemic. Smith and Nephew Foundation, Hull Google ScholarWounds UK (2012) Care of the Older Person's Skin. 2nd edn. http://tinyurl.com/lfpmkmt (accessed 11 January 2017) Google Scholar FiguresReferencesRelatedDetailsCited byEczematous conditions in the older personLesley Butcher19 November 2018 | Nursing and Residential Care, Vol. 20, No. 12Eczematous conditions in the older personLesley Butcher31 July 2018 | British Journal of Community Nursing, Vol. 23, No. 8 2 February 2017Volume 11Issue 2ISSN (print): 1753-1586ISSN (online): 2052-4420 Metrics History Published online 8 February 2017 Published in print 2 February 2017 Information© MA Healthcare LimitedPDF download

筋骨格モデルを用いた褥瘡予防マットレスの有効性の検討

筋骨格モデルを用いた褥瘡予防マットレスの有効性の検討

Effect of St.John's wort (Hypericum perforatum) oily extract for the care and treatment of pressure sores; a case report

Ethnopharmacological relevanceTopical formulations such as oily extracts or ointments prepared with the flowering aerial parts of St. John's wort (Hypericum perforatum L., Hypericaceae) have been used in the management of a wide range dermatological problems including superficial wounds and burns, bruises, contusions and many others in the worldwide traditional medicines. Aim of the studyThis is the first case study reporting the beneficial effects of an oily extract of St. John's wort in the treatment of pressure sores in a intensive care unit (ICU) patient. Material and methodsThe oily extract of St. John's wort was applied to a volunteer patient at ICU daily for forty successive days for wound care and treatment. Healing status was monitored macroscopically by measuring the wound size and stages at certain intervals as well as histopathological evaluation of the tissue sections taken at the initial and final dates of treatment. ResultsEvaluation of the results obtained from the macroscopical and histopathological experimentation have shown that oily extract of St. John's wort provided significant efficacy for the treatment of pressure sore wounds. ConclusionSt. John's wort oily extract may be suggested as a cost-effective option for the prevention or treatment of pressure sores in ICU patients.

Infections in the spinal cord-injured population: a systematic review.

Spinal cord injury (SCI) patients are an increasing population due to recent military conflicts. SCI patients are at an increased risk of infection, but the epidemiology management and prevention strategies for these infections are unclear. To review the incidence, microbiology and management of pneumonia, skin and soft tissue infections (SSTI), urinary tract infections (UTI) and bloodstream infections in the SCI population via literature review. With the assistance of an experienced medical librarian, we developed a search strategy for the Ovid MEDLINE database and then adapted it for the Ovid Embase, Scopus and Web of Science databases. The databases were searched from their inception to April 2014 with no restrictions on language or time period. Data were extracted using a standardized form. All studies were reviewed by two independent investigators. Forty-one studies reporting on the described infections were identified. UTIs were the most commonly identified infections, but studies failed to identify consistently effective preventive strategies. SSTIs were also common, and the best preventive strategies focused on decubitus ulcer prevention and skin decolonization protocols. Pneumonia management and course were not significantly different from the general population. Bloodstream infections were associated with delays in recognition, and were most often secondary to UTI, pneumonia or SSTI. There is a paucity of literature on consistently effective infection prevention strategies in SCI patients. Identification and implementation of evidence-based interventions that optimize prevention and management of infections in this patient population are needed.

Pressure sore prevention: knowledge of formal caregivers of institutionalized elderly people

ABSTRACT Objective: to investigate knowledge of the elder’s caregivers about pressure ulcers (PU) and the necessary precautions to prevent them. Method: this is a cross-sectional study with quantitative approach, conducted with 51 caregivers of two long-stay institutions for elderly nursing in Joao Pessoa/PB, Brazil. The interview technique was used and the data were analyzed with descriptive statistics. Results: 96% of caregivers are women, 41% are 31-40 years-old and only 18% have formal education for elder’s care. Regarding the development of UP, 55% pointed to the lack of changing positions as a determining factor and as a means of prevention, 55% highlighted the body hydration. Conclusion: caregivers value preventive care, however, they need to improve the knowledge through capabilities that address the prevention of skin lesions of the elderly people, such as UP. Descriptors : Pressure Ulcer; Disease Prevention; Caregivers; Homes for the Aged. RESUMO Objetivo: investigar os saberes de cuidadores de idosos sobre ulcera por pressao (UP) e os cuidados necessarios para preveni-las. Metodo : estudo transversal, de abordagem quantitativa, realizado com 51 cuidadores de idosos de duas instituicoes de longa permanencia para idosos de Joao Pessoa/PB, Brasil. Empregou-se a tecnica de entrevista e os dados foram analisados sob a estatistica descritiva. Resultados : 96% dos cuidadores eram mulheres, 41% possuiam 31 a 40 anos e apenas 18% apresentava formacao de Cuidador de idoso. Quanto ao desenvolvimento de UP, 55% apontaram a falta de mudanca de decubito como fator determinante e como forma de prevencao, 55% destacaram a hidratacao corporal. Conclusao: os cuidadores valorizam os cuidados preventivos, no entanto, necessitam aprimorar os conhecimentos por meio de capacitacoes que abordem a prevencao de lesoes na pele do idoso, como as UP. Descritores: Ulceras por Pressao; Prevencao de Doencas; Cuidadores; Instituicao de Longa Permanencia para Idosos. RESUMEN Objetivo: investigar los saberes de cuidadores de los ancianos acerca de las ulceras por presion (UPP) y las precauciones necesarias para prevenirlos. Metodo: estudio transversal con un enfoque cuantitativo, realizado con 51 cuidadores de dos instituciones de larga estancia para ancianos de Joao Pessoa/PB, Brasil. La tecnica de la entrevista fue utilizada y los datos se analizaron con estadistica descriptiva. Resultados: El 96% de los cuidadores eran mujeres, el 41% tenia 31-40 anos y solo el 18% tienen la formacion del cuidador de anciano. En cuanto al desarrollo de UP, 55% senalo la falta de cambio de posiciones como un factor determinante y como medio para la prevencion, el 55% destaco la hidratacion del cuerpo. Conclusion: los medicos valoran la atencion preventiva, sin embargo, que necesitan para mejorar el conocimiento a traves de las capacidades que se ocupan de la prevencion de lesiones en la piel de las personas mayores, tales como UP. Descriptores : Ulcera por Presion; Prevencion de Enfermedades; Cuidadores; Hogares para Ancianos. Normal 0 21 false false false PT-BR X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:Tabela normal; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:Calibri,sans-serif; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:Times New Roman; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Times New Roman; mso-bidi-theme-font:minor-bidi;}

Effects of different nursing interventions on preventing pressure sores during the long-time pediatric neurosurgery operation

Objective To compare two different methods of pressure sores prevention in the pediatric (0-14 years old) neurosurgery operation which duration more than 6 hours. Methods A total of 193 pediatric brain tumors patients, which were in accordance with the inclusive criteria in October 2014 to December 2015, were randomly divided into control group (96 cases) and observation group (97 cases). The patients of control group used conventional pressure sores nursing care plus foam dressings and the patients of observation group used conventional pressure sores nursing care plus homemade rubber water sac decompression pad. Instantly after the operation, 4 hours later and 24 hours after the operation, the situation of skin pressure sores was recorded respectively, and the maximum diameter of erythema was measured, and the process was put into phases. The skin pressure sores was compared between the two groups. Results Preoperative pediatric waterlow pressure sore risk rating scale was similar between the two groups, and there was no statistical significance (P>0.05). In control group, 12 cases appeared different degree of erythema in the head, hip, tail lumbosacral region, heel, and other easy to pressure parts of the body, but no blister and burst. The with incidence of pressure sores 12.5%. In observation group, 4 cases appeared phase I pressure sores. The difference was statistically significant between two groups (P<0.05). Conclusions For pediatric neurosurgery, especially the operation time is more than 6 hours, the rubber decompression homemade water sac mat can reduce the pressure of surgery in children with skin effectively, improve local blood circulation, prevent the occurrence of pressure sores, and also reduce the treatment cost. It eases to use, and is worth of promoting. Key words: Children; Pediatric neurosurgery; Rubber water sac decompression pad; Pressure sore

Impact of Educating the patients and attendants on preventionof pressure sores in paraplegics

Background: A pressure ulcer is localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear [1].Pressure sores have been a common complication in cases of paraplegic/quadriplegic patients. The main cause is unrelieved prolonged pressure usually over bony prominences along with various intrinsic and extrinsic causes in patients with impaired sensations. Prevention of pressure sore has been the objective of educating the patient and the attendant regarding this dreaded complication. This study aims at evaluating the outcome of educating the patients and the attendees and defining their role in prevention of development of pressure sores. Materials and methods: One hundred & fifty patients (98 males & 52 females) of traumatic and non-traumatic spinal cord injury (SCI) were enrolled from the in-patient department of Paraplegia and Rehabilitation in our institute from 2010-15. The patients were assessed for the presence of pressure ulcers and skin condition at the time of admission. The patients & their attendees, during the stay were educated for their risk of developing pressure ulcers and its prevention as per NPUAP/EPUAP (National Pressure Ulcer Advisory Panel and European Pressure Ulcer Advisory Panel) guidelines and patient teaching protocol for pressure ulcers prevention and management in a comprehendible language [2]. The patients were monitored daily and reassessed at discharge, 1, 6 and 12 months’ time. Results: The assessment was done according to quality indicators suggested by NPUAP/EPUAP guidelines in the form of point prevalence of pressure ulcers and incidence of facility acquired rate of pressure sores in hospitalized patients. It was seen that there was a statistically significant difference in the patients of both the groups with respect to development of bed sores and their prevention. The patients and attendees with higher scores on patient teaching protocol for pressure ulcers prevention and management had significantly lower incidence of developing pressure sores in comparison to patients with lower scores. Conclusion : The need for patient and attendant education is most important for the prevention and management of Bed sores. In a country like ours where the ratio of health care providers to the number of patients availing facilities is very high, patient and attendant education on prevention & progression of pressure sores remains the key to reducing morbidity and decreasing burden for both the patient and health care system. In coherence to the same fact, our study had shown significantly low rate of development of bed sores were seen with educated attendees who could verbally reproduce the guidelines of care and prevention.

Percutaneous correction of forefoot deformities in diabetic patients in order to prevent pressure sores

Percutaneous correction of forefoot deformities in diabetic patients in order to prevent pressure sores