Pressure Ulcers: Risk Stratification and Prognostic Factors That Promote Recurrence After Reconstructive Surgery

Sirimaharaj, Wimon; Charoenvicha, Chirakan

doi:10.1177/1534734618779858

Cited by 12 publications

(18 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…10 There are few studies that discuss treatment of the broad area of undermining that may occur with extended injury. [11][12][13] Topical antiseptics have limited effect on biofilm matrix in the undermined cavity unless they are coupled with mechanical debridement. [14][15][16][17][18] Negative-pressure wound therapy also is not effective without thorough mechanical…”

Section: Introductionmentioning

confidence: 99%

“…From a practical perspective, the important treatment objectives are eliminating pressure to stop further ischemia/reperfusion injury, controlling the biofilm bacterial chronic infection, and optimizing the general status of the host with nutrition and other supportive measures 10 . There are few studies that discuss treatment of the broad area of undermining that may occur with extended injury 11–13 . Topical antiseptics have limited effect on biofilm matrix in the undermined cavity unless they are coupled with mechanical debridement 14–18 .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Jet Lavage Irrigation Resolves Stage 4 Pelvic Pressure Injury Undermining

Stiehl

2023

Adv Skin Wound Care

View full text Add to dashboard Cite

OBJECTIVE Patients with stage 4 pelvic pressure injuries that have large, undermined cavities are at high risk for treatment failure and often fall into the category of palliative care. This case series identified five cases where treatment had stalled, and surgical reconstructive options were limited. Jet lavage irrigation in the outpatient setting was assessed as a treatment alternative. METHODS From an investigational review board study assessing the use of low-pressure jet lavage irrigation in the outpatient setting for chronic wounds, five patients were identified where the wound dimension increased at least 50% resulting from undermined cavities. All were considered high risk with Charlson Comorbidity Index scores of 5 or greater, and their wound healing had stalled with extended treatments of topicals and medicated dressings. A team of physical therapists irrigated these patients’ wounds at the bedside with 3 L of saline 3 to 5 days per week using a special long irrigation tip to reach the depth of the undermined cavity. Digital planimetry was used to assess healing with wound size as the outcome. RESULTS Reduction of the undermined cavities was seen early within the first 3 weeks. No patient developed wound sepsis, and bacterial contamination was determined by use of autofluorescence digital imaging. Undermining resolution occurred in four patients, and one patient with an improving wound died of COVID-19. CONCLUSIONS This simple method offered clear benefits in each patient, but only one patient survived to complete wound healing. Patient and family satisfaction were high regarding the treatment, which created a painless, odor-free wound.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Jet Lavage Irrigation Resolves Stage 4 Pelvic Pressure Injury Undermining

Stiehl

2023

Adv Skin Wound Care

View full text Add to dashboard Cite

show abstract

“…It is associated with up to 3 times longer hospital stay, as well as more complications and higher risk of death. 5 The risk of developing PML can be evaluated using scales such as the Braden scale. Diagnosis through this scale uses six sub-scales to evaluate the patient: sensory perception, skin wetness, physical activity, mobility, nutritional status, and friction/ scratching, and indicates whether the individual has high, medium, or low risk of developing CLP.…”

Section: Introductionmentioning

confidence: 99%

Increased pressure sore risk has a worse diagnosis in hospitalized Stroke patients / Maior risco de lesão por pressão tem pior prognóstico na hospitalização de pacientes com Acidente Vascular Cerebral

Beche

Schott

Marques

et al. 2022

RPCF

View full text Add to dashboard Cite

Objetivo: associar o risco de lesão por pressão com a gravidade de pacientes hospitalizados com Acidente Vascular Cerebral. Método: estudo transversal, 64 pacientes hospitalizados com Acidente Vascular Cerebral. Foram coletados dados sociodemográficos em prontuário, sendo realizada avaliação antropométrica, risco de lesão por pressão pela Escala de Braden e vitamina C sérica. Resultados: amostra predominantemente de idosos com Acidente Vascular Cerebral isquêmico, 48,4% apresentaram alto risco de desenvolver lesão por pressão. Pacientes com maior risco de lesão por pressão tiveram maior mortalidade (p < 0,001), leucocitose (p = 0,028) e linfopenia (p <0,001) quando comparados com pacientes com menor risco. No entanto, os níveis de vitamina C sérica não diferiram estatisticamente entre o risco de lesão. Sobre o estado nutricional não houve diferenças significativas entre o risco de lesão por pressão. Conclusão: conclui-se que pacientes com alto risco de desenvolver lesão por pressão apresentam leucocitose, linfopenia e maior risco de mortalidade./p>

show abstract

“…Skin conditions, including pH and microbiota, are different in patients with recurrent PIs compared with the skin conditions in patients with nonrecurrent PIs (Arisandi et al, 2020; Okamoto et al, 2021; Shibata et al, 2021). The recurrence rates of PIs after skin reconstructive surgery are 11%–22% (Grassetti et al, 2014; Sirimaharaj & Charoenvicha, 2018; Wettstein et al, 2015), while the rate of PI recurrence after conservative treatment in a general hospital is 33.3% within 8 weeks after a first PI closes (Arisandi et al, 2020). Providing appropriate skin conditions for patients is a fundamental and essential part of nursing care.…”

Section: Introductionmentioning

confidence: 99%

Multilayered silicone foam dressings potentially used for preventing recurrence of pressure injuries: A bench‐to‐clinical bedside study

Kohta

Urai

Saad

et al. 2022

Japan Journal Nursing Sci

View full text Add to dashboard Cite

Aim: This study aimed to evaluate the use of multilayered silicone foam dressings for preventing pressure injury recurrence by reducing friction, pressure, and shear force at skin sites where previous pressure injuries closed. Methods: A bench-to-clinical bedside investigation was conducted. In the bench, three multilayered silicone foam dressings were assessed. The simulated skin-shearing test consisted of a weight, a polyurethane-based skin model containing a three-axis tactile sensor, dressings, a table covered with bedsheets, and a mechanical tester. The mechanical tester simultaneously measured the interface friction force and internal shear force and pressure continuously during skin model movements. No-dressing was used as a negative control. In clinical bedside assessments, a multilayered silicone foam dressing with lower friction and shear force was applied to two bedridden patients. Photographs and ultrasound images were used to assess the recurrence of pressure injury. Results:The dressings significantly reduced friction, pressure, and shear force compared with these parameters in the negative control. No significant differences in the shear forces between the dressings were observed. One clinical case did not develop a new pressure injury reaching the dermis. However, the second case developed a new pressure injury within one month after the first pressure injury closed. Conclusion:Our bench-to-clinical bedside study revealed that multilayered silicone foam dressings can potentially prevent pressure injury recurrence.

show abstract

Pressure Ulcers: Risk Stratification and Prognostic Factors That Promote Recurrence After Reconstructive Surgery

Cited by 12 publications

References 11 publications

Jet Lavage Irrigation Resolves Stage 4 Pelvic Pressure Injury Undermining

Jet Lavage Irrigation Resolves Stage 4 Pelvic Pressure Injury Undermining

Increased pressure sore risk has a worse diagnosis in hospitalized Stroke patients / Maior risco de lesão por pressão tem pior prognóstico na hospitalização de pacientes com Acidente Vascular Cerebral

Multilayered silicone foam dressings potentially used for preventing recurrence of pressure injuries: A bench‐to‐clinical bedside study

Contact Info

Product

Resources

About