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Biomedical subjects

J D Whitney

Publications and source records attributed to J D Whitney.

At least 19 recordsLinked to original sources
PubMed2001

Treatment of pressure ulcers with noncontact normothermic wound therapy: healing and warming effects.

OBJECTIVE: This study compared healing rates in stage III and IV pressure ulcers treated with noncontact normothermic wound therapy or moist dressings. Periwound temperature changes with noncontact normothermic wound therapy were evaluated. DESIGN: This 8-week, prospective, randomized clinical trial evaluated linear rate of healing of the wound edge and periwound temperature changes during the 1-hour warming treatment and for 15 minutes after warming. SETTING AND SUBJECTS: Forty subjects referred from primary care providers, home care providers, acute care facilities, and long-term care facilities were enrolled in the study. Twenty-nine subjects completed the trial (14 received standard care, and 15 received noncontact normothermic wound therapy). INSTRUMENTS: Ulcers were measured with acetate tracings, digital and Polaroid photography, and Pressure Sore Status Tool evaluations. The linear rate of healing was determined with use of computerized planimetry. Periwound temperatures were recorded with use of a Cole Parmer thermometer YSI 400 series. METHODS: Subjects were evaluated weekly. Subjects randomly assigned to noncontact normothermic wound therapy received 3 treatments daily, during which the dressing was warmed to 38 degrees C for 1 hour. Subjects in the standard care group were treated with dressings that were moisture retentive and provided absorption as needed. RESULTS: The two groups were statistically similar with regard to baseline and wound characteristics. The linear rate of healing was significantly faster in the group treated with noncontact normothermic wound therapy (Mann-Whitney U test = 47, P =.01). On average, periwound temperatures increased 2.4 degrees C at the end of warming (1 hour), a significant increase above baseline values (P =.001). CONCLUSIONS: The healing rate was significantly increased with noncontact normothermic wound therapy treatment. Periwound temperature increased significantly after 1 hour of warming, achieving levels approximating normothermia. Healing effects associated with noncontact normothermic wound therapy may be related to several mechanisms, including improvements in perfusion, oxygen supply, and cellular activity in response to warming.

Bandages↗
PubMed2001

Tissue and wound healing effects of short duration postoperative oxygen therapy.

The purpose of this study was to determine the effects of 28% oxygen given in the first 36 hours after surgery on tissue oxygen, collagen deposition, and clinical healing outcomes. Twenty-four subjects having cervical spine surgical procedures participated in a randomized, repeated-measures pilot study of tissue and healing effects of postoperative supplemental oxygen. The treatment group (n = 13) received 28% oxygen for the first 36 postoperative hours, whereas the control group (n = 11) was maintained on room air. Subcutaneous tissue oxygen and temperature were measured at intervals up to 36 hours postsurgery. Wound healing was evaluated by hydroxyproline content in a subcutaneous polytetrafluoroethylene tube removed on the 7th postoperative day. Clinical outcomes were evaluated for the 30 days post-hospital discharge. Subjects in the treatment group had significantly higher tissue oxygen tension overall, and at postoperative hours 1, 2, 18, and 36, with mean values 10 to 20 mm Hg higher than control subjects. Significant differences were not found in hydroxyproline levels or clinical wound outcome measures. Low level, short duration, supplemental oxygen increased and sustained wound tissue oxygen and was well tolerated by subjects. Larger studies of populations at risk for wound complications are needed to investigate variables of dose and duration of oxygen therapy in relation to clinical and cellular wound healing outcomes.

Adult↗
PubMed2000

Nurses' knowledge of wound irrigation and pressures generated during simulated wound irrigation.

OBJECTIVE: Our objective was to describe nurses' knowledge of wound irrigation and their ability to produce appropriate irrigation pressures established by the US Agency for Healthcare Research and Quality (AHRQ) during simulated procedures. SUBJECTS AND SETTING: A convenience sample of 28 registered nurses and licensed practical nurses from a university medical center in the Northwest United States comprised the subjects. METHODS: Participants were asked to complete a demographic data sheet and a questionnaire related to wound irrigation and to perform 2 simulated wound irrigations. The questionnaire developed for the study contained 9 questions about general knowledge of wound irrigation and 9 questions about wound irrigation technique. A device to measure the pressures generated by the participants during simulated wound irrigation was developed and calibrated using a transducer calibrated by the National Institute of Science and Technology. RESULTS: Participants' scores were high on items querying general knowledge of wound irrigation but lower on questions relating to irrigation technique. Thirteen participants achieved irrigation pressures within the guidelines established by the AHRQ, 14 fell below the guidelines, and 1 produced pressures exceeding the guidelines. CONCLUSION: The majority of nurses participating in this small study had some difficulty answering questions relating to wound irrigation technique. In addition, performance on simulated irrigation showed that the majority were not able to generate pressures in the recommended range. Nursing professionals and educators should be aware of these knowledge and performance issues and incorporate educational content and experiences in nursing programs designed to aid nurses in improving wound irrigation practice.

Academic Medical Centers↗
PubMed1999

Identifying and evaluating wound infection.

Wound infection is a serious problem in the home care patient. Early detection of infection, prompt treatment, and continuous surveillance are pivotal to elimination of the infection and prevention of complications. This article addresses identification of wound infection in postsurgical and chronic wounds based on data obtained from the patient's history, physical examination, and diagnostic tests. Appreciating the overt and subtle signs and symptoms of wound infection and acting on them is critical to timely diagnosis and treatment.

Acute Disease↗