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Predictive Validity of the Braden Scale for Pressure Ulcer Risk in Elderly Residents of Long-Term Care Facilities

SOUZA, Diba Maria Sebba Tosta de; SANTOS, Vera Lucia Conceicao de Gouveia; IRI, Helena Keiko; OGURI, Miriam Yukiko Sadasue
Fonte: MOSBY-ELSEVIER Publicador: MOSBY-ELSEVIER
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
47.79424%
The aim of this study was to evaluate the predictive validity of the Braden Scale for Predicting Pressure Sore Risk in elderly residents of long-term care facilities (LTCFs) in Brazil. The determination of the cutoff score for the Brazilian population is important for the comparison between Brazilian and international studies and establishment of guidelines for prevention of pressure ulcers in our health care facilities. This is the first study of its kind in Brazil. This was a secondary analysis of a prospective cohort study conducted with 233 LTCF residents aged 60 and over who underwent complete skin examination and Braden Scale rating every 2 days for 3 months. Two groups of patients were considered: the total group (N = 233) and risk group (n = 94, total scores <= 18). Data from the first and last assessments were analyzed for sensitivity, specificity, and likelihood ratios. The best results were obtained for the total group, with cutoff scores of 18 and 17, sensitivity of 75.9% and 74.1%, specificity of 70.3% and 75.4%, and area under the receiver operating characteristic curve (AUC-ROC) of 0.79 and 0.81 at the first and last assessments, respectively. For the risk group, the cutoff scores of 16 (first assessment) and 13 (last assessment) were associated with a smaller AUC-ROC and...

Predictive Validity of Waterlow Scale for Pressure Ulcer Development Risk in Hospitalized Patients

SERPA, Leticia Faria; SANTOS, Vera Lucia Conceicao de Gouveia; GOMBOSKI, Gustavo; ROSADO, Sandra Marina
Fonte: LIPPINCOTT WILLIAMS & WILKINS Publicador: LIPPINCOTT WILLIAMS & WILKINS
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
37.29933%
AIM: We sought to evaluate the predictive validity of the Waterlow Scale in hospitalized patients. SUBJECTS AND SETTING: The study was conducted at a general private hospital with 220 beds and a mean time of hospitalization of 7.4 days and a mean occupation rate of approximately 80%. Adult patients with a Braden Scale score of 18 or less and a Waterlow Scale score of 16 or more were studied. The sample consisted of 98 patients with a mean age of 71.1 +/- 15.5 years. METHODS: Skin assessment and scoring by using the Waterlow and Braden scales were completed on alternate days. Patients were examined at least 3 times to be considered for analysis. The data were submitted to sensitivity and specificity analysis by using receiver operating characteristic (ROC) curves and positive (+LR) and negative (-LR) likelihood ratios. RESULTS: The cutoff scores were 17, 20, and 20 in the first, second, and third assessment, respectively. Sensitivity was 71.4%, 85.7%, and 85.7% and specificity was 67.0%, 40.7%, and 32.9%, respectively. Analysis of the area under the ROC curve revealed good accuracy (0.64, 95% confidence interval [CI]: 0.35-0.93) only for the cutoff score 17 in the first assessment. The results also showed probabilities of 14%, 10%, and 9% for the development of pressure ulcer when the test results were positive (+LR) and of 3% (-LR) when the test results were negative for the cutoff scores in the first...

Capacidade preditiva da subescala Nutrição da Escala de Braden para avaliar o risco de desenvolvimento de úlceras por pressão; Predictive capacity of nutrition sub scale of Braden scale to assessment pressure ulcer development risk

Serpa, Letícia Faria
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 19/12/2006 Português
Relevância na Pesquisa
47.512285%
Variáveis nutricionais têm sido consideradas preditoras de risco para o desenvolvimento de úlceras por pressão (UP). A subescala nutrição da escala de Braden, que avalia o consumo alimentar, parece apresentar certa fragilidade para especificar o risco. Muitos estudos ressaltam aspectos mais amplos do estado nutricional associados ao risco de UP. O objetivo deste estudo foi avaliar a capacidade da subescala Nutrição da escala de Braden para predizer o risco de desenvolver UP e verificar as associações estatísticas existentes entre essa subescala e indicadores nutricionais objetivos e sujetivos, além das variáveis demográficas e clínicas, e o desenvolvimento de UP. Após aprovação pelos comitês de ética de duas instituições privadas do Município de SP, 170 pacientes adultos hospitalizados, em risco para desenvolvimento de UP (escore de ?18), foram avaliados durante, no mínimo, uma semana. Os pacientes foram submetidos à avaliação do risco para UP – por meio da Escala de Braden - e da pele a cada 48 horas, às avaliações objetivas e subjetivas na admissão e a cada sete dias e avaliação da aceitação da terapia nutricional diariamente. Para estabelecer o poder preditivo das variáveis independentes em relação ao desenvolvimento de UP...

Avaliação da implementação de um protocolo de prevenção de úlceras por pressão; Evaluation of the implementation of pressure ulcer prevention protocol

Rogenski, Noemi Marisa Brunet
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 02/05/2011 Português
Relevância na Pesquisa
47.29933%
Esta pesquisa é um estudo de caso com os objetivos de: avaliar a implementação de um protocolo de prevenção de Úlcera por Pressão (UP) por meio do estudo da Prevalência e da Incidência de UP nas unidades de Clinica Médica, Clinica Cirúrgica e Terapia Intensiva Adulto, do Hospital Universitário da Universidade de São Paulo; apreender a percepção das enfermeiras multiplicadoras no processo de implementação do protocolo e propor um processo de avaliação, sistematizado e contínuo da adoção do protocolo de UP. Após aprovação do Comitê de Ética em Pesquisa do HU, procedeu-se à coleta de dados. Optou-se, na metodologia, pelo desenvolvimento da pesquisa em dois momentos. O primeiro, na abordagem quantitativa, realizado em duas etapas, para o levantamento da prevalência e da incidência de UP nas unidades do estudo. A avaliação de risco para o desenvolvimento de UP foi feita por meio da Escala de Braden, tendo como nota de corte o escore inferior ou igual a 16. No estudo da prevalência, dos 87 pacientes avaliados, 17 desenvolveram UP, acarretando prevalência de 19,5%. No estudo da incidência, dos 190 pacientes de risco acompanhados, 35 desenvolveram um total de 51 úlceras, acarretando incidência de 18,4%. Para o segundo momento...

Does sealing endotracheal tube cuff pressure diminish the frequency of postoperative laryngotracheal complaints after nitrous oxide anesthesia?

Braz, JRC; Volney, A.; Navarro, LHC; Braz, L. G.; Nakamura, G.
Fonte: Elsevier B.V. Publicador: Elsevier B.V.
Tipo: Artigo de Revista Científica Formato: 320-325
Português
Relevância na Pesquisa
38.24461%
Study Objectives: To study endotracheal tube (ETT) cuff pressures during nitrous oxide (N2O) anesthesia when the cuffs are inflated with air to achieve sealing pressure, and to evaluate the frequency of postoperative laryngotracheal complaints.Design: Prospective, randomized, blind study.Setting: Metropolitan teaching hospital.Patients: 50 ASA physical status I and II patients scheduled for elective abdominal surgery.Interventions: Patients received standard general anesthesia with 66% N2O in oxygen. In 25 patients, the ETT cuff was inflated with air to achieve a sealing pressure (P-seal group). In 25 patients, the ETT cuff was inflated with air to achieve a pressure of 25 cm H2O (P-25 group).Measurements and Main Results: ETT intracuff pressures were recorded before (control) and at 30, 60, 90, 120, and 150 minutes during N2O administration. We investigated the frequency and intensity of sore throat, hoarseness, and dysphagia in patients in the Post-Anesthesia Care Unit (PACU) and 24 hours following tracheal extubation. The cuff pressures in the P-seal group were significantly lower than in the P-25 group at all time points studied (p < 0.001), with a significant increase with time in both groups (p < 0.001). The cuff pressures exceeded the critical pressure of 30 cm H2O only after 90 minutes in the P-seal group and already by 30 minutes in the P-25 group. The frequency and intensity of sore throat...

The effect of intracuff alkalinized 2% lidocaine on emergence coughing, sore throat, and hoarseness in smokers

Navarro, Laís Helena Camacho; Lima, Rodrigo Moreira e; Aguiar, Andressa Simões; Braz, José Reinaldo Cerqueira; Carness, Jeffrey M.; Módolo, Norma Sueli Pinheiro
Fonte: Associação Médica Brasileira Publicador: Associação Médica Brasileira
Tipo: Artigo de Revista Científica Formato: 248-253
Português
Relevância na Pesquisa
28.525518%
Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP); Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES); Processo FAPESP: 05/55458-5; OBJECTIVE: We evaluated whether endotracheal tube (ETT) intracuff alkalinized lidocaine was superior to saline in blunting emergence coughing, postoperative sore throat, and hoarseness in smokers. METHODS: In our prospective, double-blind trial, we enrolled 50 smoking patients undergoing surgery under general anesthesia including nitrous oxide (N2O). Patients were randomly allocated to receive either ETT intracuff 2% lidocaine plus 8.4% sodium bicarbonate (L group), or ETT intracuff 0.9% saline (S group). The ETT cuff was inflated to achieve a cuff pressure that prevented air leak during positive pressure ventilation. Incidence of emergence coughing, sore throat, and hoarseness were analyzed. The volume of inflation solution, the intracuff pressure, the duration of anesthesia, the time elapsed to extubation after discontinuation of anesthesia, and the volume of the inflation solution and the air withdrawn from the ETT cuff were also recorded. RESULTS: Intracuff alkalinized 2% lidocaine was superior to saline in blunting emergence coughing (p < 0.001). The incidence of sore throat was significantly lower in the L group at the post-anesthesia care unit (PACU) (p = 0.02). However...

The effect of intracuff alkalinized 2% lidocaine on emergence coughing, sore throat, and hoarseness in smokers

Navarro,Laís Helena Camacho; Lima,Rodrigo Moreira e; Aguiar,Andressa Simões; Braz,José Reinaldo Cerqueira; Carness,Jeffrey M.; Módolo,Norma Sueli Pinheiro
Fonte: Associação Médica Brasileira Publicador: Associação Médica Brasileira
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2012 Português
Relevância na Pesquisa
28.525518%
OBJECTIVE: We evaluated whether endotracheal tube (ETT) intracuff alkalinized lidocaine was superior to saline in blunting emergence coughing, postoperative sore throat, and hoarseness in smokers. METHODS: In our prospective, double-blind trial, we enrolled 50 smoking patients undergoing surgery under general anesthesia including nitrous oxide (N2O). Patients were randomly allocated to receive either ETT intracuff 2% lidocaine plus 8.4% sodium bicarbonate (L group), or ETT intracuff 0.9% saline (S group). The ETT cuff was inflated to achieve a cuff pressure that prevented air leak during positive pressure ventilation. Incidence of emergence coughing, sore throat, and hoarseness were analyzed. The volume of inflation solution, the intracuff pressure, the duration of anesthesia, the time elapsed to extubation after discontinuation of anesthesia, and the volume of the inflation solution and the air withdrawn from the ETT cuff were also recorded. RESULTS: Intracuff alkalinized 2% lidocaine was superior to saline in blunting emergence coughing (p < 0.001). The incidence of sore throat was significantly lower in the L group at the post-anesthesia care unit (PACU) (p = 0.02). However, at 24 hours after extubation, sore throat incidence was similar in both groups (p = 0.07). Incidence of hoarseness was similar in both groups. Intracuff pressure in the saline group increased with time while the intracuff pressure in the lidocaine group remained constant. CONCLUSION: The present study demonstrated that the intracuff alkalinized 2% lidocaine was superior to saline in decreasing the incidence of emergence coughing and sore throat during the postoperative period in smokers.

The safety and effect of topically applied recombinant basic fibroblast growth factor on the healing of chronic pressure sores.

Robson, M C; Phillips, L G; Lawrence, W T; Bishop, J B; Youngerman, J S; Hayward, P G; Broemeling, L D; Heggers, J P
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /10/1992 Português
Relevância na Pesquisa
37.794236%
The first randomized, blinded, placebo-controlled human trials of recombinant basic fibroblast growth factor (bFGF) for pressure sore treatment were performed. Three different concentrations of bFGF in five dosing schedules were tested for safety using hematology, serum chemistries, urinalysis, absorption, antibody formation, and signs of toxicity. Efficacy was evaluated by wound volumes, histology, and photography. No toxicity, significant serum absorption, or antibody formation occurred. In six of eight subgroups, there was a trend toward efficacy with bFGF treatment. When all subgroups were combined, comparison of the slopes of the regression curves of volume decrease over initial pressure sore volume demonstrated a greater healing effect for the bFGF-treated patients (p < 0.05). Histologically, bFGF-treated wound sections demonstrated increased fibroblasts and capillaries. More patients treated with bFGF achieved > 70% wound closure (p < 0.05). Blinded observers were able to distinguish differences in visual wound improvement between bFGF and placebo groups. These data suggest that bFGF may be effective in the treatment of chronic wounds.

The limits of pressure sore prevention.

Hagisawa, S; Barbenel, J
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /11/1999 Português
Relevância na Pesquisa
48.3394%
Pressure sore prevalence and incidence were assessed in 275 patients who were admitted to a well-staffed internal medicine ward during a 12-month study period or who were present on day 1. Pressure sore risk was assessed by use of the Braden scale and patients scoring 16 or less were provided with intensive preventive care. During the study period 5.1% (95% confidence interval 2.7-7.8) of 275 patients had pressure sores (prevalence) and 4.4% (1.9-6.9) developed sores (incidence). None of the 239 patients who were assessed as not being at risk developed a sore. 36 patients were assessed as being at risk at some time during the study and 12 of these developed sores despite receiving high-quality preventive care. The results suggest that not all pressure sores can be prevented in severely ill patients. We believe that the 4.4% incidence of sores in this study approaches the current limit of prevention.

Aetiology of pressure sores in patients with spinal cord injury.

Thiyagarajan, C; Silver, J R
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em 01/12/1984 Português
Relevância na Pesquisa
28.053472%
One hundred consecutive patients admitted to the National Spinal Injuries Centre, Stoke Mandeville Hospital, with pressure sores were studied to assess the relative importance of factors known to predispose to the development of scores. Loss of feeling was critical, because patients were unable to appreciate pain when the sore was developing. Risk of developing a sore increased with age, but duration of the paralysis was of equal importance. After discharge from hospital the presence of a caring relative or friend was essential for survival. Many patients developed sores because of poor facilities at home or inappropriate advice from those who looked after them. An even more distressing factor was the number of patients who developed sores in hospital owing to inadequate nursing care. There are relatively few paralysed patients in the community, but the lessons learnt in this study may be applied to all patients with orthopaedic injuries and to geriatric patients with limited mobility. Nursing and medical staff must turn patients regularly and ensure that there is proper equipment to relieve pressure on the skin. Patients should not be allowed to sit in a chair if they develop a sacral or trochanteric sore. More effort should be directed towards the appropriate education of patients...

Pressure sores following elective total hip arthroplasty: pitfalls of misinterpretation.

Keong, Nicole; Ricketts, David; Alakeson, Nuki; Rust, Philippa
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /05/2004 Português
Relevância na Pesquisa
38.216736%
OBJECTIVE: To assess the reliability of reporting protocols regarding pressure sores. METHODS: Retrospective data were collected regarding pressure sore rates following total hip arthroplasty operations carried out during 2001 at two orthopaedic units in an NHS hospital (Princess Royal Hospital) and in a local private hospital. RESULTS: Preliminary results presented in audit and interim reports indicated an alarmingly high pressure sore rate across the two sites (17/172 [9.9%] NHS, 23/71 [32.4%] private hospital). On analysis, the data collection system was revealed to be flawed. Grade 1 areas (erythema with no ulceration) were included, leading to a dramatic discrepancy between reported and confirmed pressure sores. Re-analysis showed the confirmed pressure sore rates to be much lower (2.3% NHS, 1.0% private hospital). CONCLUSIONS: This audit suggests that both poor data collection and education lead to inaccurate audit. This may lead to subsequent inappropriate management and inappropriate NHS star ratings.

Pressure Sores: An Age-Old Problem of the Aged

Allega, Rossano L.; Hutchison, Brian
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /10/1981 Português
Relevância na Pesquisa
37.176882%
The most frequently cited and/or best-designed studies of pressure sore prevention and treatment in the last 25 years are almost all uncontrolled. These studies are critically reviewed. An appropriate methodology for evaluating the effectiveness of decubitus ulcer management, based on data and experience, is outlined. A suggested treatment protocol is described.

Pedicled Fillet of Leg Flap for Extensive Pressure Sore Coverage

Jandali, Shareef; Low, David W.
Fonte: Open Science Company, LLC Publicador: Open Science Company, LLC
Tipo: Artigo de Revista Científica
Publicado em 27/10/2009 Português
Relevância na Pesquisa
37.425728%
Objective: Multiple large decubitus ulcers present a reconstructive challenge to the plastic surgeon. When stage IV pressure sores become recurrent or extensive, traditional flaps either have already been exhausted or would not be sufficient to cover the defect. Methods: A retrospective review was performed on all paraplegic patients who had chronic, extensive, and stage IV decubitus ulcers, and underwent reconstruction using a pedicled continuous musculocutaneous flap of the entire leg between 1998 and 2007. The extent and size of the debrided pressure sores, number of previous flap reconstructions, intraoperative blood loss, postoperative complications, and years of follow-up were all recorded. A description of the operative technique is also given. Results: Four patients underwent a total leg fillet flap in the study period, with follow-up ranging from 2 to 7 years. Indications included extensive and bilateral trochanteric, sacral, and ischial pressure sores. Complications included intraoperative blood loss and postoperative heterotopic calcification. Conclusions: The total leg fillet flap is a very large and robust flap that offers paraplegic patients coverage of extensive stage IV pressure sores of the trochanteric, sacral, and ischial areas.

Giant trochanteric pressure sore: Use of a pedicled chimeric perforator flap for cover

Mehrotra, Sandeep
Fonte: Medknow Publications Publicador: Medknow Publications
Tipo: Artigo de Revista Científica
Publicado em //2009 Português
Relevância na Pesquisa
47.79424%
Pressure sores are increasing in frequency commensurate with an ageing population with multi-system disorders and trauma. Numerous classic options are described for providing stable wound cover. With the burgeoning knowledge on perforator anatomy, recent approaches focus on the use of perforator-based flaps in bedsore surgery. A giant neglected trochanteric pressure sore in a paraplegic is presented. Since conventional options of reconstruction appeared remote, the massive ulcer was successfully managed by a chimeric perforator-based flap. The combined muscle and fasciocutaneous flaps were raised as separate paddles based on the anterolateral thigh perforator branches and provided stable cover without complications. Perforators allow versatility in managing complex wounds without compromising on established principles.

Medial circumflex femoral artery flap for ischial pressure sore

Palanivelu, S.
Fonte: Medknow Publications Publicador: Medknow Publications
Tipo: Artigo de Revista Científica
Publicado em //2009 Português
Relevância na Pesquisa
47.79424%
A new axial pattern flap based on the terminal branches of the medial circumflex femoral artery is described for coverage of ischial pressure sore. Based on the terminal branches of the transverse branch of medial circumflex femoral artery, which exit through the gap between the quadratus femoris muscle above and the upper border of adductor magnus muscle below, this fascio cutaneous flap is much smaller than the posterior thigh flap but extremely useful to cover ischeal pressure sores. The skin redundancy below the gluteal fold allows a primary closure of the donor defect. It can also be used in combination with biceps femoris muscle flap.

Evaluating the effects of pentoxifylline administration on experimental pressure sores in rats by biomechanical examinations

Velaei, Kobra; Bayat, Mohammad; Torkman, Giti; Rezaie, Fatemealsadat; Amini, Abdollah; Noruzian, Mohsen; Tavassol, Azaedh; Bayat, Mehernoush
Fonte: Korean Association for Laboratory Animal Science Publicador: Korean Association for Laboratory Animal Science
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
37.920635%
This study used a biomechanical test to evaluate the effects of pentoxifylline administration on the wound healing process of an experimental pressure sore induced in rats. Under general anesthesia and sterile conditions, experimental pressure sores generated by no. 25 Halsted mosquito forceps were inflicted on 12 adult male rats. Pentoxifylline was injected intraperitoneally at a dose of 50 mg/kg daily from the day the pressure sore was generated, for a period of 20 days. At the end of 20 days, rats were sacrificed and skin samples extracted. Samples were biomechanically examined by a material testing instrument for maximum stress (N mm2), work up to maximum force (N), and elastic stiffness (N/mm). In the experimental group, maximum stress (2.05±0.15) and work up to maximum force (N/mm) (63.75±4.97) were significantly higher than the control group (1.3±0.27 and 43.3±14.96, P=0.002 and P=0.035, respectively). Pentoxifylline administration significantly accelerated the wound healing process in experimental rats with pressure sores, compared to that of the control group.

Severe myositis ossificans in a paraplegic trauma patient: Influence in pressure sore management

Parker, Wendy Lynne; Hodge, Jacqueline C; Lessard, Marie-Lucie
Fonte: Pulsus Group Inc Publicador: Pulsus Group Inc
Tipo: Artigo de Revista Científica
Publicado em //2004 Português
Relevância na Pesquisa
37.176882%
Myositis ossificans (MO) is a benign, progressive, ossifying lesion that displays a characteristic zonal histological appearance. MO traumatica is a localized form of heterotopic bone formation, associated with repetitive micro- and/or macrotrauma in the majority of cases. The importance of imaging to differentiate MO from sarcomatous change and to determine maturity of the lesion is identified because suboptimal operative intervention on immature MO inevitably results in recurrence. A severe case of MO in a 24-year-old paraplegic man with chronic bilateral greater trochanteric pressure sores is presented, and the importance of the MO in the etiology and treatment of this case is discussed. An extensive review of the literature is included and integrated.

Factors predicts skin ulcer following coronary artery bypass

Sabzi, F; Faraji, R
Fonte: Carol Davila University Press Publicador: Carol Davila University Press
Tipo: Artigo de Revista Científica
Publicado em //2014 Português
Relevância na Pesquisa
28.584531%
The number of off-pump coronary artery surgery procedures in high-risk patients such as renal failure, hepatic failure and in anticoagulant drug using patients is increasing. The associated co morbidity and repeated use of electrocautery in postoperative bleeding, caused a susceptibility of patients to pressure or electrocautery ulcers. During a period of three years, 1400 off-pump coronary artery bypass surgery were performed in our center. Of these patients, 20 (A group) suffered from electrocautery sore (ES) and 40 (B group) had pressure sore (PS). These patients were compared with respect to variables such as age, hypertension, hypercholesterolemia, operating time, smoking, opium using, diabetes, weight, sex, respiratory failure, renal failure, and cerebrovascular accident, intra aortic balloon pump using, inotropic drug using by x2 or t test, according to categorical or continuous variables consequently. Electrocautery sore and pressure ulcer as dependence variables and others variables with p value less than 0.1 entered a multivariable logistic regression model and odd ratio of significant variables were obtained. These two groups of patients were different with respect to variables such as age, sex, respiratory failure and cerebrovascular accident and...

Vitamin C depletion and pressure sores in elderly patients with femoral neck fracture.

Goode, H. F.; Burns, E.; Walker, B. E.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em 17/10/1992 Português
Relevância na Pesquisa
38.24461%
OBJECTIVE--To evaluate the contribution of specific nutritional deficiencies (as indicated by zinc; vitamin A, C, and E; albumin; and haemoglobin concentrations) to the risk of pressure sores. DESIGN--Observational cohort study. SETTING--St James's University Hospital, Leeds. SUBJECTS--21 elderly patients presenting consecutively to the orthopaedic unit with femoral neck fracture. MAIN OUTCOME MEASURE--Full thickness epidermal break over a pressure bearing surface. RESULTS--10 patients (48%) developed a pressure sore during their hospital stay. Indices of zinc status and concentrations of albumin, haemoglobin, and vitamins A and E were similar in patients who developed a pressure sore and those who did not. Mean leucocyte vitamin C concentration, however, was 6.3 (SD 2.2) micrograms/10(8) cells in patients who developed a pressure sore as compared with 12.8 (4.6) micrograms/10(8) cells in patients who did not. CONCLUSIONS--Low concentrations of leucocyte vitamin C appear to be associated with subsequent development of pressure sores in elderly patients with femoral neck fractures.

Sacral pressure sore reconstruction - the pedicled superior gluteal artery perforator flap

Hurbungs,A.; Ramkalawan,H.
Fonte: South African Journal of Surgery Publicador: South African Journal of Surgery
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2012 Português
Relevância na Pesquisa
48.128823%
OBJECTIVE: To report the use of the pedicled superior gluteal artery perforator (SGAP) fasciocutaneous flap as a reliable surgical option for sacral pressure sore reconstruction. METHODS: A prospective study was conducted between September 2008 and September 2010 of 10 patients with stage 3 or 4 sacral pressure sores treated with a unilateral pedicled SGAP flap. RESULTS: All flaps survived completely with no complications in 9 patients. One patient had a haematoma below the flap that was easily drained. No recurrence of the bedsore occurred during follow-up. CONCLUSION: We suggest that the pedicled SGAP fasciocutaneous flap is a reliable surgical option for sacral pressure sore reconstruction.