Wound management & prevention最新文献

Background: Chronic leg ulcers affect approximately 1% to 2% of the European population, with an increasing prevalence. The treatment of chronic wounds is a socioeconomical problem worldwide.

Purpose: The main purpose of the current investigation was to detect the etiology of leg ulcers treated in a dermatologic wound clinic from January 1, 2010, to December 31, 2019.

Methods: This retrospective observational study was performed at the Dermatologic Clinic of Spedali Civili in Brescia, Italy. The authors enrolled 465 patients with chronic leg ulcers.

Results: The 3 most represented causes of ulcers were vascular (238 patients, 51.2%), inflammatory (71 patients, 15.3%) and traumatic (43 patients, 9.3%). Altogether, a total of 13 different entities were identified as a cause of leg ulcer.

Conclusion: Vascular genesis was the most common etiology of leg ulcers in this population, even though uncommon causes were also represented. These findings are in agreement with other studies reported in the literature.

Background: Evidence about moxibustion and abdominal massage for treating constipation in older hospitalized patients is limited.

Purpose: To investigate the safety and effectiveness of moxibustion and abdominal massage in hospitalized older patients with constipation.

Methods: Hospitalized older patients (age ≥60 years) with constipation were retrospectively categorized as 2 cohorts according to whether the patients received moxibustion and abdominal massage in addition to routine nursing care. Gastrointestinal symptoms, Constipation Assessment Scale (CAS) scores, and Geriatric Depression Scale (GDS) scores were compared before and after treatment between cohorts.

Results: The 2 cohorts (n = 100 for each) had similar baseline characteristics and gastrointestinal symptoms; the control cohort and the additional intervention cohort also had similar CAS scores (7.14 ± 3.67 vs 7.48 ± 2.96, respectively), and GDS scores (>17: 31% vs 29%, respectively). Improvement in the 2 scores from baseline was observed after 2 weeks in both the control cohort and the additional intervention cohort (CAS, 5.37 ± 5.34 and 3.80 ± 4.47, respectively; GDS, >17: 28% and 15%, respectively). The cohort with additional interventions had a lower ineffective rate (defined as persistent symptoms or absence of decrease in CAS, 49% vs 32%; P = .028) but had more diarrhea (9% vs 21%; P = .017).

Conclusion: Moxibustion and abdominal massage may help relieve constipation in hospitalized elderly patients, but attention should be paid to the increased occurrence of diarrhea. More study is needed.

Background: Many health-related videos are available online. One type of health-related video is related to stoma pouch change. However, a system to evaluate the quality and content of these videos is lacking.

Purpose: To evaluate the content and quality of YouTube videos on colostomy pouch change.

Methods: A descriptive study was carried out by searching for videos on March 15, 2021, using the key words "colostomy care," "colostomy bag/pouch change," and "ostomy bag/pouch change." A 5-point Global Quality Scale was used to evaluate the quality of the videos, and a 10-point scale was used to evaluate the content. The videos were classified as "useful" or "useless" according to their content and quality scores.

Results: A total of 128 videos were found; 94 videos met the criteria and were included in the study. The content of the 94 videos was examined by 2 independent researchers. The overall content score of the videos was 8.24 ± 1.56, and the overall quality score was 3.14 ± 0.97. A total of 66 (70.21%) videos were useful, and 28 (29.79%) videos were useless. The mean scores of useful videos for content (9.09 ± 0.83) and the average Global Quality Scale scores (3.53 ± 0.76) were significantly higher than those of useless videos (6.17 ± 0.90 and 2.25 ± 0.75, respectively; (P < .05). The results showed that 57.6% of the useful videos were uploaded by universities, professional organizations, and health care professionals, and 67.9% of the useless videos were uploaded by patients; the difference was statistically significant (P < .05).

Conclusions: Results indicated that the majority of online videos evaluated were accurate. Most of these videos were uploaded by universities, professional organizations, health care professionals, or medical advertisers. Although there were many limitations to this study, the authors suggest that health care professionals can direct their patients to these sources after hospital discharge. However, future studies are needed..

Background: Pretibial injury is common. Although the mechanism of injury may be minor, in a specific patient population, misdiagnosis and delay in appropriate treatment can lead to dire consequences. The ability to identify and properly treat these patients early has the potential to reduce the need for surgical intervention, hospitalization, and prolonged care.

Methods: A literature review was performed to develop the Lower Extremity Hematoma Algorithm (LEHA) to aid in identifying and managing these injuries in the patient population at greatest risk.

Results: A case example is provided to demonstrate how implementation of the LEHA may have led to early diagnosis and treatment, avoiding expensive advanced and prolonged care.

Conclusion: Implementation of the LEHA may expedite the identification of patients at risk for deep dissecting hematomas, enabling faster implementation of appropriate treatment and thereby helping to contain health care costs through avoiding surgical intervention.

Background: Temporary ileostomy reduces the incidence of severe anastomotic leakage and postoperative mortality. However, little is known about ileostomy-related complications in older adults.

Purpose: To clarify the safety and feasibility of temporary ileostomy for rectal cancer in older patients.

Methods: Data were collected from a prospectively created database and complemented by secondary chart review for consecutive patients with rectal malignancy who underwent curative proctectomy with diverting loop ileostomy between 2013 and 2018. Ileostomy construction and closure were compared between two groups (defined as elderly and non-elderly patients). Data for 22 patients who were 75 years of age and older (elderly group) and 160 patients who were younger than 75 years (non-elderly group) were analyzed.

Results: The median maximum fecal output was significantly higher in the non-elderly group compared with the elderly group. No significant differences were observed between the two groups in postoperative intravenous hydration, creatinine ratio, and ileostomy-related complication rate. Although the elderly group had a higher rate of early stoma closure, the causes were not related to those complications.

Conclusion: Temporary ileostomy was a safe and feasible procedure in this population of older patients with rectal malignancies.