Abstract
People undergoing orthopedic surgery receive care at many points along the healthcare continuum. Although heel pressure ulcer (HPU) incidence in the orthopedic population has been reported to be 13.3%, information is limited. The purpose of this prospective observational study was to evaluate: 1) the cumulative incidence of HPUs in orthopedic patients across the continuum of care, and 2) the outcome of HPUs once they occurred. Of the 72 study participants (average age 76 ± 16 years, 60% women, 53% required surgery for hip fractures), 57 were recruited consecutively upon admission to a rehabilitation center from one of two acute care facilities and 15 were assessed upon admission to one of the acute care sites and at discharge to the home. All but two study participants were followed-up in the community 1 month after discharge from the acute care or rehabilitation facility. Medical charts were reviewed and study participants underwent a bedside assessment, with direct examination of both heels and staging of the ulcer at admission and discharge. The cumulative incidence of HPUs was 17% (95% CI 8%–26%). All ulcers were identified upon admission to the rehabilitation center; 41% of HPUs were either suspected deep tissue injury (sDTI) or unstageable. Both of the Stage I and two of the five Stage II ulcers were resolved at the time of follow-up; three of the five sDTI or unstageable ulcers were unresolved. HPUs occurred in 17% of people undergoing orthopedic procedures. All ulcers occurred in acute care and severe ulcers persisted while patients received rehabilitation and community care. This is the first study to follow orthopedic patients across the continuum of care.
This cross-sectional descriptive survey examined use (knowledge, perception and practices) of water-filled gloves (WFGs) by nurses in the prevention of heel pressure ulcer (PU) in the University College Hospital (UCH), Ibadan, Nigeria. Participants were 250 purposively selected nurses working in the Neurosciences and Surgical units. Quantitative data were generated through the administration of a semi-structured questionnaire, whereas the qualitative data were collected through in-depth interview. Hypotheses were tested using chi-square analysis at a significance level of 0.05, whereas the manual content analysis was used to analyse the qualitative data. Results showed that a significant number of nurses at UCH, Ibadan, were knowledgeable about WFGs and actually used them in their clinical practice. Years of experience in clinical practice was found to be significantly related to knowledge and use of WFGs in heel PU (X2 = 41·677; DF = 5; P = 0·001). Nurses with adequate knowledge of risk factors in the development of PU used WFGs more than those who were not aware (X2 = 44·907; DF = 3; P = 0·009). Nurses’ perception about WFGs was also significantly related to its use (X2 = 4·527; DF = 1; P = 0·033). Although knowledge level and perception of WFGs and its use by nurses was fairly adequate, continuous education for practicing nurses should be encouraged in resource-limited settings.
From the International Wound Journal…
Silver sulfadiazine has been used as a topical burn wound treatment for many years. Pain associated with dressing changes is a common problem in burn wounds. Aquacel Ag, a hydrofiber dressing coated with ionic silver has been reported to reduce burn wound infection and promote antimicrobial activity. The purpose of this [...]
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Burns |
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From Podiatry Today…
For those with diabetes, careful management of blood sugar is imperative to prevent any number of complications, including those that contribute to poor wound healing, which is so common in diabetes.
One such problem is the development of foot ulcers, which reportedly affects 15 percent of individuals with diabetes.1,2 Diabetic foot ulcers are significant [...]
From their website…
A. Brown
Journal of Wound Care, Vol. 19, Iss. 2, 11 Feb 2010, pp 70 – 74
Leg ulcer management focuses on healing, but if the wound does not respond to treatment, the patient may feel dejected and guilty. Centring the patient’s life around treatment only makes matters worse. An alternative approach is needed
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Wounds |
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Objective: To evaluate the effect of ultrasound irradiation when used alongside standard care in the treatment of pressure ulcers; outcome measures were reduction in wound size and exudate weight.
