Debridement in Patients with Pressure Ulcers

Debridement is a topical treatment for pressure ulcers based on wound bed preparation. and wound healing is triggered only after removal of the necrotic tissue. There are three types of debridement: surgical, mechanical. and autolytic. Surgical debridement is invasive; however, it promotes the wound healing process. It is mainly performed in hospitals. Autolytic debridement is performed in situations wherein it is not possible to cope with bleeding, such as in homecare settings. Although less invasive, removal of necrotic tissue by autolytic debridement takes a substantial amount of time. Mechanical debridement is performed by physically removing small areas of necrotic tissue from the granulation surface using negative-pressure wound therapy, curettes, or the wet-to-dry technique

Negative pressure wound therapy with instillation: International consensus guidelines update.

The use of negative pressure wound therapy with instillation and dwell time (NPWTi-d) has gained wider adoption and interest due in part to the increasing complexity of wounds and patient conditions. Best practices for the use of NPWTi-d have shifted in recent years based on a growing body of evidence and expanded worldwide experience with the technology. To better guide the use of NPWTi-d with all dressing and setting configurations, as well as solutions, there is a need to publish updated international consensus guidelines, which were last produced over 6 years ago. An international, multidisciplinary expert panel of clinicians was convened on 22 to 23 February 2019, to assist in developing current recommendations for best practices of the use of NPWTi-d. Principal aims of the meeting were to update recommendations based on panel members\u27 experience and published results regarding topics such as appropriate application settings, topical wound solution selection, and wound and patient characteristics for the use of NPWTi-d with various dressing types. The final consensus recommendations were derived based on greater than 80% agreement among the panellists. The guidelines in this publication represent further refinement of the recommended parameters originally established for the use of NPWTi-d. The authors thank Karen Beach and Ricardo Martinez for their assistance with manuscript preparation

Social isolation in patients with chronic limb-threatening ischemia: a cross-sectional study

Abstract Assistance by family members or friends plays important roles in the course of treating patients with chronic limb-threatening ischemia (CLTI), both during hospitalization and after discharge. The aim of this study was to reveal the prevalence of social isolation and to explore relevant clinical backgrounds in patients with CLTI presenting with tissue loss and requiring revascularization. We analyzed 413 patients registered in a multicenter study in whom revascularization were scheduled for CLTI with tissue loss. Social isolation was analyzed by assessing the residence status of the patients and the involvement of a trusted family member or friend in their daily lives and during hospitalization. Patients living alone accounted for 24.5% (95% confidence interval [CI] 20.1–28.8%) of the study population. Patients receiving welfare were more likely to live alone (P < 0.001). For patients living alone, 21.8% (95% CI 12.8–30.8%) met a trusted family member or friend in their daily lives less than once per year. Younger age and receiving welfare were independently associated with lower frequency of meeting the trusted person in their daily lives (both P < 0.05). The adjusted odds ratio of age and receiving welfare was 0.44 (95% CI 0.29–0.67) per 10-year increase and 3.47 (95% CI 1.43–8.44), respectively. During hospitalization, 9.9% (95% CI 6.8–13.0%) of the patients had no hospital visits by a trusted family member or friend on three key occasions: the patient’s first hospital visit, the preoperative explanation regarding the planned operation, and the day of the operation. Younger age and receiving welfare were independently associated with lower frequency of hospital visits by a family member or friend (both P < 0.05). The adjusted odds ratio of age and receiving welfare for no visit versus ≥ 1 visit was 0.51 (0.36–0.74) per 10-year increase and 5.29 (2.46–11.4), respectively. In conclusion, social isolation is common among patients with CLTI, especially younger patients and those on welfare. Practical countermeasures against social isolation are warranted in the management of CLTI

An international consensus on device-related pressure ulcers: SECURE prevention

info:eu-repo/semantics/publishedVersio