Pub Date : 2023-07-01DOI: 10.35279/jowm2023.24.02.03
{"title":"Organisation of NPWT in primary care in Europe – a descriptive survey","authors":"","doi":"10.35279/jowm2023.24.02.03","DOIUrl":"https://doi.org/10.35279/jowm2023.24.02.03","url":null,"abstract":"","PeriodicalId":54656,"journal":{"name":"Ostomy Wound Management","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84908916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.35279/jowm2023.24.02.06
B. Ragghianti, A. Piaggesi, E. Mannucci, M. Monami
Background To assess the effects of a local antibiotic delivery system on the incidence of post-surgical infective complications after surgical procedures in patients with diabetic foot osteomyelitis (DFO). Methods A retrospective study was carried out on patients with forefoot DFO associated with soft tissue infection undergoing minor amputations using local antibiotics in calcium-sulphate granules. Patients were matched with a historical series using propensity-score matching. The principal endpoint was a composite of relapse/recurrence/new onset of DFO, infection/ dehiscence at the surgical site, re-intervention for abscesses drainage, and major amputation. Direct costs were analysed as a secondary endpoint. Results Composite endpoint occurred in 19% and 36.4% (p=0.17) of cases and controls, respectively. Only three patients in the control group had recurrent DFO. After adjusting for ulcer duration, the risk of infective complications and major amputation was significantly lower (Hazard Ratio [HR] 0.20 [0.04;0.95], p=0.047) and the 90-day healing rate was significantly higher (HR 4.44 [1.03;19.07], p=0.045) in cases than in controls. The median direct healthcare costs for cases and controls during the 90-day follow-up were €2,050 [1,829;3,946] and €1,731 [1,028;14,817] per patient, respectively (p=0.072). Median costs for antibiotics were lower for cases than controls (p<0.001).
{"title":"Effects of local antibiotics in calcium-sulphate granules for the treatment of diabetic forefoot osteomyelitis: a propensity-matched observational study","authors":"B. Ragghianti, A. Piaggesi, E. Mannucci, M. Monami","doi":"10.35279/jowm2023.24.02.06","DOIUrl":"https://doi.org/10.35279/jowm2023.24.02.06","url":null,"abstract":"Background To assess the effects of a local antibiotic delivery system on the incidence of post-surgical infective complications after surgical procedures in patients with diabetic foot osteomyelitis (DFO). Methods A retrospective study was carried out on patients with forefoot DFO associated with soft tissue infection undergoing minor amputations using local antibiotics in calcium-sulphate granules. Patients were matched with a historical series using propensity-score matching. The principal endpoint was a composite of relapse/recurrence/new onset of DFO, infection/ dehiscence at the surgical site, re-intervention for abscesses drainage, and major amputation. Direct costs were analysed as a secondary endpoint. Results Composite endpoint occurred in 19% and 36.4% (p=0.17) of cases and controls, respectively. Only three patients in the control group had recurrent DFO. After adjusting for ulcer duration, the risk of infective complications and major amputation was significantly lower (Hazard Ratio [HR] 0.20 [0.04;0.95], p=0.047) and the 90-day healing rate was significantly higher (HR 4.44 [1.03;19.07], p=0.045) in cases than in controls. The median direct healthcare costs for cases and controls during the 90-day follow-up were €2,050 [1,829;3,946] and €1,731 [1,028;14,817] per patient, respectively (p=0.072). Median costs for antibiotics were lower for cases than controls (p<0.001).","PeriodicalId":54656,"journal":{"name":"Ostomy Wound Management","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83173312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.35279/jowm2023.24.02.sup01
{"title":"Lower leg ulcer diagnosis and principles of treatment","authors":"","doi":"10.35279/jowm2023.24.02.sup01","DOIUrl":"https://doi.org/10.35279/jowm2023.24.02.sup01","url":null,"abstract":"","PeriodicalId":54656,"journal":{"name":"Ostomy Wound Management","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88519051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.35279/jowm2023.24.02.07
Carole Guex, Das Rn, Géraldine Gschwind PhD, Paul Bobbink MsC, P. Rn
Background Foot ulcers are an important cause of multiple hospitalisation and clinical complications in patients with diabetes. Before hospital discharge, the care transition should be planned across multiple care settings. Many problems occur during care transitions, resulting in negative patient outcomes and unnecessary readmissions. Aim This paper presents a protocol for a qualitative study exploring the experience of care transitions from both patients’ and clinicians’ perspectives in a regional hospital context in Western Switzerland. Methods design A qualitative descriptive design will be used to solicit patients‘ and clinicians’ perceptions of care transitions. Semi-structured interviews will be conducted with six patients with a diabetic foot ulcer (DFU) and six community nurses. Data will be analysed according to Braun and Clarke’s thematic analysis. Discussion Exploring participants’ experiences will afford information about their role within the process, any barriers to effective care transitions, and any strategies to overcome. Implication for clinical practice The findings of this study will be pivotal to informing and developing new and enhanced transition planning for people with DFU, with the ultimate goal of improving patient outcomes, reducing hospital readmissions and enhancing cost savings. Additionally, this study takes a unique approach as it seeks experiences of both the patient and the clinician and is in alignment with the EWMA project Living with chronic wounds.
{"title":"Diabetic foot ulcer patients’ and clinicians’ experiences of care transitions from hospital to home: a study protocol","authors":"Carole Guex, Das Rn, Géraldine Gschwind PhD, Paul Bobbink MsC, P. Rn","doi":"10.35279/jowm2023.24.02.07","DOIUrl":"https://doi.org/10.35279/jowm2023.24.02.07","url":null,"abstract":"Background Foot ulcers are an important cause of multiple hospitalisation and clinical complications in patients with diabetes. Before hospital discharge, the care transition should be planned across multiple care settings. Many problems occur during care transitions, resulting in negative patient outcomes and unnecessary readmissions. Aim This paper presents a protocol for a qualitative study exploring the experience of care transitions from both patients’ and clinicians’ perspectives in a regional hospital context in Western Switzerland. Methods design A qualitative descriptive design will be used to solicit patients‘ and clinicians’ perceptions of care transitions. Semi-structured interviews will be conducted with six patients with a diabetic foot ulcer (DFU) and six community nurses. Data will be analysed according to Braun and Clarke’s thematic analysis. Discussion Exploring participants’ experiences will afford information about their role within the process, any barriers to effective care transitions, and any strategies to overcome. Implication for clinical practice The findings of this study will be pivotal to informing and developing new and enhanced transition planning for people with DFU, with the ultimate goal of improving patient outcomes, reducing hospital readmissions and enhancing cost savings. Additionally, this study takes a unique approach as it seeks experiences of both the patient and the clinician and is in alignment with the EWMA project Living with chronic wounds.","PeriodicalId":54656,"journal":{"name":"Ostomy Wound Management","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89462894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.35279/jowm2023.24.02.05
Adriana L Caixinha, K. Md, DMSci Rikke Bech Md
Background Pyoderma gangrenosum (PG) is a neutrophilic dermatosis associated with systemic inflammatory diseases. Peripheral arterial disease (PAD) is a manifestation of atherosclerosis, which is a chronic inflammatory disease. Hypothesis Is the presence of PAD a risk factor for the prognosis of PG? Methods We performed a retrospective medical chart review of seven patients with an overlap of PAD and PG and compared treatment strategies and outcomes. Results Six out of seven patients had a poor outcome, requiring amputation, even though adequate treatment was initiated. Conclusions We propose that PAD, whether by reducing the healing potential or by partially contributing to the pathophysiology of the wounds, is a risk factor for the prognosis of PG. Furthermore, the fact that three of the patients developed PAD within a very short period of time after the diagnosis of PG suggests that PG could itself be a risk factor for the development of PAD. However, more clinical data is required to adequately assess this possible relation. Implications for clinical practice Raise awareness to the possible co-existency of both diagnoses and the importance of early screening.
{"title":"Pyoderma gangrenosum and peripheral arterial disease: a case series and literature review","authors":"Adriana L Caixinha, K. Md, DMSci Rikke Bech Md","doi":"10.35279/jowm2023.24.02.05","DOIUrl":"https://doi.org/10.35279/jowm2023.24.02.05","url":null,"abstract":"Background Pyoderma gangrenosum (PG) is a neutrophilic dermatosis associated with systemic inflammatory diseases. Peripheral arterial disease (PAD) is a manifestation of atherosclerosis, which is a chronic inflammatory disease. Hypothesis Is the presence of PAD a risk factor for the prognosis of PG? Methods We performed a retrospective medical chart review of seven patients with an overlap of PAD and PG and compared treatment strategies and outcomes. Results Six out of seven patients had a poor outcome, requiring amputation, even though adequate treatment was initiated. Conclusions We propose that PAD, whether by reducing the healing potential or by partially contributing to the pathophysiology of the wounds, is a risk factor for the prognosis of PG. Furthermore, the fact that three of the patients developed PAD within a very short period of time after the diagnosis of PG suggests that PG could itself be a risk factor for the development of PAD. However, more clinical data is required to adequately assess this possible relation. Implications for clinical practice Raise awareness to the possible co-existency of both diagnoses and the importance of early screening.","PeriodicalId":54656,"journal":{"name":"Ostomy Wound Management","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72510934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.35279/jowm2023.24.02.01
{"title":"Time to refocus on the principles of lower limb ulceration management","authors":"","doi":"10.35279/jowm2023.24.02.01","DOIUrl":"https://doi.org/10.35279/jowm2023.24.02.01","url":null,"abstract":"","PeriodicalId":54656,"journal":{"name":"Ostomy Wound Management","volume":"4 6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75942549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.35279/jowm2023.24.01.01
{"title":"Who will take care of our future patients?","authors":"","doi":"10.35279/jowm2023.24.01.01","DOIUrl":"https://doi.org/10.35279/jowm2023.24.01.01","url":null,"abstract":"","PeriodicalId":54656,"journal":{"name":"Ostomy Wound Management","volume":"24 2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80192967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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