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Biomedical subjects

P Lowthian

Publications and source records attributed to P Lowthian.

36 records · Page 2Linked to original sources
PubMedDate not supplied

Pegasus Airwave and Bi-Wave Plus.

The Pegasus Airwave and the Bi-Wave Plus are examples of alternating-pressure air mattress (APAM) systems that are more reliable than the older generation of APAMs. The Pegasus Airwave is useful for managing severe pressure sores, as well as for preventing sores in 'high-risk' patients. The Bi-Wave Plus is more suitable for patients with a 'fairly high risk' of developing sores and some patients may find it more comfortable than the Pegasus Airwave.

Air↗
PubMedDate not supplied

'Last-resort' dressings for intractable pressures sores.

Twenty-five years of recommending dressing techniques for the most intractable pressure sores has taught the author some interesting lessons about the practical problems of wound healing when all else has failed. It is hoped that these personal experiences and opinions will be of some help to the many nurses who are involved in the management of pressure sores and chronic wounds.

Bandages↗
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The Egerton Convertible II and the Elite 3 bed system.

Low air loss bed systems have proved successful in the management of severe pressure sores but they tend to be expensive. The Convertible II promises to provide many of the features of a low air loss bed at a much reduced cost. It is essentially a mattress replacement that can be used for various beds, including contouring-base beds. It is a component of the Elite 3 bed system which comprises an electrically powered contouring bed (with its own air pump) and three different mattresses: the mattress of the Convertible II is Mattress 3 of this system; Mattress 2 is an alternating-pressure air mattress; and Mattress 1 is a static air mattress with a foam envelope. The advantages and disadvantages of these products are discussed and it is suggested that the allocation of patients to the various supports can be facilitated by using a pressure sore risk-assessment score.

Beds↗
PubMedDate not supplied

The Modular Propad and the Softform mattress.

Constant low-pressure supports such as soft mattresses can feel comfortable because they conform well to the shape of the body. When such mattresses are provided with a highly convoluted surface made up of contiguous foam pillars, their efficacy is improved. The Modular Propad is a highly convoluted, but shallow, foam mattress. It is used as an overlay for an ordinary mattress and seems to be superior to earlier forms of convoluted foam overlay. The Softform is a new mattress which has replaceable sections. The outermost sections of the Softform are convoluted foam sheets similar to the Modular Propad. This article discusses the advantages and disadvantages of these products and some potential problems with their covers. It also suggests that the use of a pressure sore risk assessment tool can facilitate the allocation of patients to these special supports.

Beds↗
PubMedDate not supplied

Alternating-pressure air mattresses: the Quattro range.

Alternating-pressure air mattresses (APAMs) have a long history, and after some advances in their design, which began in the 1980s, have become widely used for pressure sore prevention. A recent variation in the inflation/deflation cycle of a 'large-cell' APAM, which allows the use of lower (peak) pressures for inflating the air cells, is used in the Quattro range of APAMs. This should make the new products more comfortable, more versatile, and more durable than earlier large-cell APAMs. This article discusses both the theoretical and practical advantages and disadvantages of these products. It also suggests a simple method of checking the suitability of a given support for promoting a healthy skin for highly dependent patients.

Air↗
PubMedDate not supplied

Notes on the pathogenesis of serious pressure sores.

It is often assumed that pressure sores are caused by the flattening of blood capillaries, resulting in tissue ischaemia. However, the available evidence, especially that from animal experiments, indicates that microvascular trauma has a significant part to play. Published curves showing the relationship between level of pressure and duration of application also show that simple ischaemia is an inadequate explanation of pressure sore pathogenesis. The crucial pressure (tissue pressure) is normally estimated from interface pressure measurements. However, the relationship between tissue pressure and interface pressure is more complex than is generally realized. Other factors, such as shearing and static friction, are discussed briefly, and recommendations are made for clinical practice and further research.

Humans↗
PubMedDate not supplied

The dangers of long-term catheter drainage.

There are many dangers associated with long-term urinary bladder drainage by catheter. For various reasons, the choice of catheter is important, and its initial insertion can be particularly hazardous. All catheterizations should, however, be safer when there is some urine (or other fluid) in the bladder. The appropriate choice of drainage system attached to the catheter can delay bacterial invasion of the bladder. Great care is needed to prevent blockage of the system, particularly when bacteriuria is present. Recent evidence indicates that some bacteria encourage the development of encrustations, so that, in some circumstances, catheters may become blocked within 24 hours. This, together with other considerations, strongly suggests that indwelling catheters should be changed at intervals of not more than 5 days. The practical implications of this are considered, as are the benefits that may accrue. Accidental catheter traction is another danger, and some possible methods of avoiding this are discussed. Finally, the need for a new kind of drainage-bag support is highlighted.

Catheters, Indwelling↗