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Biomedical subjects

P Vowden

Publications and source records attributed to P Vowden.

At least 37 records · Page 2Linked to original sources
PubMed1998

Anatomy, physiology and venous ulceration.

For many years it was believed that disease within the deep venous system, such as a deep vein thrombosis or post-phlebitic limb, was the main cause of venous ulceration. There is, however, increasing awareness of the impact of both deep and superficial venous valvular incompetence and reflux on the aetiology and healing of venous ulceration. It is now widely accepted that superficial venous disease alone can result in increased venous pressure at the ankle and subsequent skin damage and ulceration.

Bandages↗
PubMed1998

Venous leg ulcers. Part 2: Assessment.

The assessment of a patient with a leg ulcer is a complex process. As well as the ability to perform such tasks as Doppler ultrasound and ABPI measurements, nurses must be aware of factors that will delay healing or increase the likelihood of ulcer recurrence.

Bandages↗
PubMed1997

Leg ulcer management in a nurse-led, hospital-based clinic.

This paper describes the clinical outcomes from a nurse-led leg ulcer clinic over a period of three and a half years. Leg ulcers were assessed in a structured way and venous ulcers were treated with four-layer compression bandaging. The study involved retrospective analysis of 159 patients with 180 venous leg ulcers. Overall healing rates were 64.5% at 12 weeks, 84.1% at 24 weeks and 91.4% at 36 weeks. Healing rates were not affected by a history of previous ulceration or by bilateral limb ulceration. However, healing rates varied with previous ulcer duration, ulcer size and patient mobility.

Activities of Daily Living↗
PubMed1997

Vascular assessment in compression therapy.

Successful management of patients with leg ulcers depends on an understanding of the disease process. Accurate assessment is vital in identifying factors which will delay healing and increase the likelihood of ulcer recurrence. With such knowledge nurses can decide when compression therapy is appropriate.

Bandages↗
PubMed1995

Bilateral paravertebral analgesia for major abdominal vascular surgery: a preliminary report.

Paravertebral analgesia is highly effective in blocking unilateral afferent input from the trunk, but its bilateral use does not appear to have been described. Eight patients undergoing major abdominal vascular surgery had pre-operative bilateral paravertebral catheters inserted. A dose of 25 ml of bupivacaine 0.5% divided between the two catheters provided the basis of an effective intra-operative analgesic regimen which was continued postoperatively by infusion of bupivacaine for 4 days. Diclofenac and morphine completed a balanced analgesic regimen which was started pre-operatively and continued for 5 and 3 days respectively. Cardiovascular stability was notable throughout surgery, even with aortic clamping and all patients were extubated at the end of surgery. Good quality analgesia was obtained as assessed by low postoperative pain scores at rest and on movement. Three patients were not admitted to the intensive care unit, where mean stays for the group was 10 h (range 0-24 h) and mean hospital stay was 10 days (range 7-14). There were no additional demands made on the nursing staff and no postoperative pain-related complications occurred. We conclude that bilateral paravertebral analgesia, as part of a balanced analgesic technique, is an alternative method of providing effective afferent blockage for major abdominal surgery.

Abdomen↗
PubMed1994

Measuring leg ulcers using a laser displacement sensor.

A non-contact method for the measurement of a skin ulcer's area and volume has been developed. A commercially available laser displacement sensor is scanned across the ulcer's surface to produce a displacement image. From this image the healthy normal skin's surface is reconstructed and the area and volume found. Results of measurements made with phantom ulcers show that the method has a precision and accuracy +/- 5% of the total size. This compares favourably with results from other non-contact methods that have been published. The method of measurement is simple and reliable. At present, the time taken to produce a displacement image is lengthy but this is due to a limitation in the instrumentation, rather that a failing of the technique. The result of a preliminary measurement made on a patient's leg ulcer is presented.

Humans↗
PubMed1990

Non-invasive estimation of peripheral resistance using Pulse Generated Runoff before femorodistal bypass.

The measurement of peripheral resistance (PR) is a useful technique for predicting the outcome of femorodistal bypass. In an attempt, noninvasively, to predict PR, Pulse Generated Runoff (PGR) was used to assess 35 consecutive patients undergoing femorodistal non-reversed vein bypass for critical ischaemia. The PGR subscores (anterior tibial, posterior tibial, peroneal, pedal arch status were correlated against the measured PR. Using multiple linear regression three resistance values were derived for runoff at different levels: (1) a single calf vessel (R1); (2) distal popliteal artery (R3); (3) irrespective of the level (R0). There was good agreement between the predicted resistances R0, R1 and R3 and the measured PR. In the single calf vessel group (R1) the limits of agreement (-0.41 to +0.39) and 95 per cent confidence interval (-0.16 to +0.14) with the measured PR were better than in the R0 and R3 groups. These levels of agreement are small enough to replace the measured PR with the predicted PR method. Using the appropriate resistance equation in a further prospective series of 14 cases, there was agreement between the predicted and measured PR (limits of agreement -0.67 to +0.41; 95 per cent confidence interval -0.26 to +0.15). These results confirm the value of PGR in the assessment of critically ischaemic limbs particularly with a single calf vessel. Calf vessel continuity with the pedal arch appears to be a major determinant of PR, particularly in the isolated calf vessel group. A non-invasive resistance value can be derived which will predict the intraoperative peripheral resistance and should help predict subsequent graft outcome.

Aged↗