By Woundsite.info
For healthcare professionals in woundprevention and woundcare
Background The recent conflicts in Afghanistan and Iraq have demonstrated that body armor has led to increase survival of combatants but the extremity injuries have been alarming. The increased numbers of extremity injuries have led to the necessity for new technologies in managing complex...
Open fractures are still a challenging situation for every trauma surgeon. Soft tissue defects are often associated with necrotic areas and with bacterial superinfection especially after open fractures. Up to 40 % of those injuries are leading to an amputation.�...
Although necessary and possibly life saving, decompressive laparotomy (DL) will leave the patient with an open abdomen (OA) prone to complications such as bleeding, infection, enterocutaneous fistula or excessive fluid losses. To avoid these complications a form of temporary abdominal closure...
Open abdomen treatment (OAT) is now an essential element in the management of severely traumatized patients, both after penetrating and blunt trauma. It is often necessary, after damage control surgery for either abdominal or extra abdominal injuries, to prevent the development of abdominal compartment...
A new Temporary Abdominal Closure concept: Active Abdominal Therapy. The surgical treatment of patients suffering from peritonitis, abdominal compartment syndrome or in case of damage control surgery with an open abdomen (OA) is common place. There are clear advantages but...
Periprosthetic infection remains a main complication in arthroplasty. In case of a possible infection the surgeon needs to have a concept of treatment which can be individually adjusted. In early and secondary infections, component retention can be successful and sometimes is...
� Therapy beds are seen as an essential aspect of the prevention of pressure ulcers. The Newcastle Upon Tyne Hospitals Hospital NHS Foundation Trust (NUTH) is a large regional centre, with 1982 patients? in-beds over four sites in the city of Newcastle...
Scientific abstract The project purpose was to implement a comprehensive pressure ulcer prevention program with the implementation of evidence-based interventions and staff education to reduce hospital-acquired pressure ulcers. Hospital-acquired pressure ulcers are a complication threatening many hospitalized patients and may lead to...
Until recently our understanding of pressure ulcer aetiology had made little significant progress since the classic studies of the early 1960?s. These landmark experiments attempted to define the relationship between tissue damage, the magnitude of external pressures and the duration of...
Healthcare professionals are generally well aware of the terms pressure, shear and friction in relation to pressure ulcers. They may be less familiar with use of microclimate when discussing pressure ulcer aetiology. Whilst most will have a basic understanding of...
Until recently our understanding of pressure ulcer aetiology had made little significant progress since the classic studies of the early 1960?s. These landmark experiments attempted to define the relationship between tissue damage, the magnitude of external pressures and the duration...
The concepts involved in understanding pressure, shear, friction and microclimate, and their roles in the development of pressure ulcers are widely acknowledged to be challenging. However, comprehension of these concepts should assist clinicians in consistent and effective implementation of pressure...
Economic constraints on healthcare spending require clinicians to deliver high-quality services with more effective targeting of resources and better outcomes for patients. Ensuring that patients benefit from excellence in healthcare is an absolute for a medical professional. The challenge that...
Infected wounds are a well known problem in the world of wound healing. Severe debridement and systemic use of antibiotics belongs to the standard treatment. Application of Negative Pressure Wound Treatment (V.A.C.� Therapy System) has shown to be an effective treatment...
Instillation technology in infected wounds Debridement of devitalized tissue along with irrigation has become the gold standard in trauma surgery for the initial treatment of open fractures and prevention of infection. The method of wound irrigation is still an area of...
Clinical experience with incisional negative pressure. Implementation of new wound management technologies in the clinic Healthcare professionals are faced with an unenviable task in the current economic climate. Clinicians must provide patients with evidence based treatments even when evidence is sparse. They...
On March 18 and 19, the first International Surgical Wound Forum (ISWF) took place in Amsterdam. The ISWF is a scientific platform designed to share and debate state-of-the-art information and opinions on the management of surgical wounds. More than 170...
Background Traditionally, surgical debridement with immediate closure with our without irrigation or plastic reconstructive surgery was the therapy of choice in sternal wound infections There has been a notable change in the treatment of sternal wound infection during the last years...
Results from a retrospective review of 97 consecutive Gustillo III fractures treated in circular fixators, demonstrate how the use of distraction histiogenesis can allow radical bony and soft tissue excision back to healthy tissue, maintaining a low deep infection rate...
Surgical management of the infected�orthopedic�implant�
This presentation will concentrate on the use of NPT on post-operative surgical wounds following high energy skeletal trauma. There will be three major sections of the talk concerning NPT. Initially we will discuss the proposed mechanisms of action of NPT,...
Microbes, in particular bacteria, are known to cause various types of infections in humans. Antibiotics can be used either to kill or inhibit the growth of unwanted microbes, and they are usually the treatment of choice for infections. However, the...
Debridement of devitalized tissue along with irrigation has become the gold standard in trauma surgery for the initial treatment of open fractures and prevention of infection. The method of wound irrigation is still an area of much debate. Low pressure...
Is there a role for NPWT and Instillation technology in the innovation of the future daily surgical clinical practice? Scientific abstract Background Between 1993 and 2010 the number of NPWT indications increased markedly in all surgical specialties. Simultaneously, more and more peer-reviewed articles...
In many clinics no specific budget is allocated to wards to treat patients with Negative Pressure Wound Therapy (NPWT). Often there is also no funding or referral guidance from Primary Care Trust?s (PCT?s) to support this therapy upon discharge. Consequence:...
The Economics of Wound Management with focus on Patients with chronic ulcers and impact on the health care system.� The Economics of Wound Management is a topical issue in Australia and internationally. Dr Jan Apelqvist from Lund University in Sweden provides...
VAP in the ICU ? how to prevent? Ventilator associated pneumonia (VAP) is a common infectious complication in patients admitted to the intensive care unit (ICU) and it is associated with several risk factors such as duration of mechanical ventilation and...
Aim: Critical care patients are at elevated risk of developing pulmonary complications such as ventilator-associated pneumonia (VAP); 23% of mechanically ventilated patients develop VAP. Kinetic therapy (KT) has been shown to aid the prevention and treatment of VAP. The aim of this study...
Diabetic foot (DF) is the most frequent chronic complication in both type 1 and type 2 diabetes mellitus, affecting up to 25% of patients at least once in their life and the most frequent cause of non traumatic lower extremity...
Introduction: Neuropathic ulcers or minor trauma often lead to severe or limb threatening infections in diabetics. Main principle of infection surgery has always been radical debridement. "Ubi pus, ibi evacua", often cited in medicine is not enough. All necrotic and...
Cost effectiveness in diabetic feet: Your responsibility! Diabetic foot ulcers (DFU) are one of the most demanding complications of diabetes. The prevalence of diabetes is increasing exponentially and major amputations remain high cost to patients with loss of independence and life....
The Institution for Healthcare Improvement (IHI) recently estimated that 2.5 million patients�in US health-care institutions develop pressure ulcers (PUs) each year, resulting in�60,000 predicted deaths (ref 1). These ulcers prevent functional recovery and cause substantial pain�and serious infection (ref 2)....
Aim: The aim of this study was to determine the impact of different pressure relieving surfaces on the development of pressure ulcers (PUs) and ultimately hospital budgets using a�budget impact model (BIM). The BIM aims to help health service payers...
Pressure ulcers are an all too common problem in health care, affecting large numbers�of�patients�and resulting in a high health system expenditure. Studies examining the magnitude of this problem�provide information needed to evaluate current practice, to improve the quality�of care and...
Working Towards Delayed Primary Closure. Once the decision is made to leave an abdominal wound open, in addition to all the other clinical challenges that require addressing, one goal should remain in the forefront of the clinicians thinking and that is ultimate closure....
Requirements Of An Optimal Device For Temporary Abdominal Closure Temporary abdominal closure (TAC) has been demonstrated to be an effective method for the prevention of intra-abdominal hypertension (IAH) and treatment of abdominal compartment syndrome (ACS). A variety of TAC devices have been described...
Development of�a Comprehensive Guideline To Improve Outcomes In High-Risk Trauma Patients With Open Abdomens Kaplan, M., Md, Liebman, J, Md, Wheel, K Md, Bones, K, Rn, Hooper, A, Rn, Servas, P, Rn, And Simms, H Md Objective: To evaluate a comprehensive multidisciplinary...
Rationale for consensus on clinical guidelines. Classification, an important step to improve the management of patients with an open abdomen. � The patient may reach the situation of needing to be treated with an open abdomen (OA) through different clinical pathways: 1) The septic...
Globally, the World Health Organisation (WHO) estimates that over 1 billion people are currently overweight, including 800 million women, and that over 300 million people are obese. Yet it is apparent that this is a global issue much like pressure...
The aim of this study was to determine the impact of different pressure relieving surfaces on the development of pressure ulcers (PUs) and ultimately hospital budgets using a budget impact model (BIM). The BIM aims to help health service payers...
Pressure ulcers affect large numbers of people and result in considerable health system expenditure worldwide. Studies that examine pressure ulcer occurrence are of increasing interest in the drive to reduce the number of patients affected. However, quantifying pressure ulceration is...
The introduction of vacuum assisted closure therapy at our Institution was delayed, compared to other centers, but was strictly bound with the development of new concepts on mechanical forces (macro-mechanical, and micro-mechanical/cellular action able to modulate cells fate, one of...
Ensuring seamless patient care across healthcare organisations prevents interruptions in treatments and delays as well as unnecessary stresses for the patient. It is vitally important to ensure that bureaucracy and budgetary differences are overcome and do not prevent or interfere...
While there are many causes of pressure ulcers, a significant proportion arises due to immobility, particularly when associated with lengthy periods of bed rest in hospitals or long-term community care facilities. Estimates of pressure ulcer prevalence vary significantly ? studies...
Recent clinical practice guidelines generally concur regarding the necessary elements required for successful pressure ulcer preventive strategies. However, the implementation of these strategies and tactics may be incomplete, while evidence of success in terms of reduced pressure ulcer occurrence remains...
Diabetic foot ulcers impose tremendous medical, psychosocial and financial loss or burden on millions of people in the United States. Vacuum assisted closure therapy is generally well tolerated, appears to stimulate a robust granulation tissue response compared to other wound...
The move towards managing chronic conditions outside of hospital settings is associated with a number of potential benefits to both healthcare planners and patients. From the planners? perspective, managing patients outside of hospitals reduces the demand for scarce hospital beds,...
