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At least 181 records · Page 10Linked to original sources
PubMed2006

Ventilation and perfusion distribution during altered PEEP in the left lung in the left lateral decubitus posture with unchanged tidal volume in dogs.

Previous studies in anesthetized humans positioned in the left lateral decubitus (LLD) posture have shown that unilateral positive end-expiratory pressure (PEEP) to the dependent lung produce a more even ventilation distribution and improves gas exchange. Unilateral PEEP to the dependent lung may offer special advantages during LLD surgery by reducing the alveolar-to-arterial oxygen pressure difference {(A-a)PO2 or venous admixture} in patients with thoracic trauma or unilateral lung injury. We measured the effects of unilateral PEEP on regional distribution of blood flow (Q) and ventilation (V(A)) using fluorescent microspheres in pentobarbital anesthetized and air ventilation dogs in left lateral decubitus posture with synchronous lung inflation. Tidal volume to left and right lung is maintained constant to permit the effect on gas exchange to be examined. The addition of unilateral PEEP to the left lung increased its FRC with no change in left-right blood flow distribution or venous admixture. The overall lung V(A)/Q distribution remained relatively constant with increasing unilateral PEEP. Bilateral PEEP disproportionately increased FRC in the right lung but again produced no significant changes in venous admixture or V(A)/Q distribution. We conclude that the reduced dependent lung blood flow observed without PEEP occurs secondary to a reduction in lung volume. When tidal volume is maintained, unilateral PEEP increases dependent lung volume with little effect of perfusion distribution maintaining gas exchange.

Adaptation, Physiological↗
PubMed1991

[Gluteus maximus myocutaneous flap in the repair of sacral and gluteal decubitus ulcers].

16 cases of decubitus ulcers in the sacral, ischiadic and great trochanter regions were treated with rotating myocutaneous flap of the caudal portion of the gluteus maximus from 1983 to 1989. They were followed up for 3 to 68 months, with the exception of 4 patients. The results were excellent. 30 gluteus regions were studied in 15 cadavers. It was found that the caudal 3/4 of the gluteus maximus muscle was supplied by the inferior gluteal artery, and a flap measuring 12.9 x 9.7 cm could be formed therein with easy dissection. The flap tolerates pressure well. Unilateral flap is adequate to cover a decubitus ulcer within a diameter of 10cm, while bilateral flaps are necessary for a larger ulcer.

Adult↗
PubMed1990

[Treatment of decubitus ulcer by "Algimaf" preparation].

The process of treatment of 20 spinal patients with 26 decubituses of different localization by means of applications of alginatous coating "Alghimaf" has been observed. The results of treatment are as follows: 22 wounds healed with formation of soft elastic cicatrix, 2 patients have been discharged from hospital with actively epithelializing wounds, 2 patients were subjected to epidermatoplasty. The method of control: chnic observation, planimetry, citologic, microbiologic investigations. It has been demonstrated "Alghimaf" efficiency in treating of decubituses.

Adolescent↗
PubMed1979

Decubitus ulcers: a comparative study.

Seventeen patients with thirty-four decubitus ulcers were treated with dextranomer, collagenase, or sugar and egg white. All seven patients in the dextranomer group and two of five patients in the collagenase group improved at the end of the study, but none of the five patients on sugar and egg white treatment improved. Although collagenase can be helpful in the treatment of decubitus ulcers, dextranomer is significantly better.

Adult↗
PubMed1986

Recent findings on decubitus ulcer pathology: implications for care.

Vasodilators are ineffective therapy for decubitus ulcers because blood vessels are absent in the necrotic areas. Systemic application of vasodilating drugs actually decreases the nutritional blood flow through the damaged zone. Protracted healing of decubitus ulcers may be explained by an altered nutrient transport rate to the cells caused by fibrin thrombi in the capillaries and fibrin deposits in the intercellular space, resulting from decreased fibrinolytic activity.

Disinfectants↗
PubMed1987

[Role and possibilities of compensation filters in lateral decubitus radiographs in opaque enemas].

A wedge-shaped plexiglass compensation filter for use in lateral decubitus radiographs of double contrast barium enema examinations has been designed. This filter, which has been used since February 1985, was compared with a second plexiglass filter, made by E-Z-EM. Voltage and amperage were kept contrast. Two different experiments were conducted in order to demonstrate the benefits of routine use of this compensation filter. First, the changes in skin dose were assessed using an ionization chamber on a phantom. Secondly, three radiologists examined a series of 80 consecutive barium enemas without knowing which had been performed using the new filter. Out of the 70 examinations they considered excellent, as many as 45 had been performed with the new filter. Personal experience and the studies described show that the use of a compensation filter improves the accuracy and thus the diagnostic quality of the examinations as it enhances the detail of the anatomic structure of the colon; moreover the filter reduces skin exposure by up to 73.1% (EZ-E-EM filter 47.3%) and, at the same time, less radiographic films are needed. Routine use of a plexiglass compensation filter in lateral decubitus radiographs while performing a double contrast barium enema examination, is strongly recommended especially in obese patients.

Barium Sulfate↗
PubMedDate not supplied

[Surgical treatment of decubitus ulcer in paraplegics. Experience with 70 reconstructive procedures (author's transl)].

Based upon our own experience with 70 surgical procedures for 49 primary decubitus ulcers, 17 complications and 7 recurrences in 31 paraplegics, and upon the techniques described in the literature, the different reconstructive methods and their advantages and disadvantages are discussed and illustrated with representative cases. The surgical reconstruction of decubitus ulcers requires a thorough planning and an atraumatic surgical technique. Nevertheless complications are not seldom and recurrences are possible.

Humans↗
PubMed1979

[Prevention and therapy of decubitus ulcer. Oxygen availability in the skin as a function of imposed skin pressure].

Pressure is of crucial importance in the formation of decubitus ulcers. In order to elucidate the effect of imposed skin pressure we measured with a new cutaneous oxygen sensor the skin oxygen tension under increasing pressure upon skin tissue on hard sites (bony prominences) and upon soft sites (muscle padded areas). On hard sites the skin oxygen tension fell rapidly under increasing pressure (y = 90.9--0.39 x/r = 0.98) from initially 86.4 +/- 10.6 to 20.2 +/- 12.1 mmHg under an imposing skin pressure of 175 g/cm2. On soft sites a pressure load of 175 g/cm2 decreased the skin oxygen tension only from 82.9 +/- 5.8 to 71.4 +/- 10.0 mmHg. Our results may explain why hard sites (bony prominences) are preferential areas in decubitus ulcer formation.

Adolescent↗
PubMed1983

Bacteremia associated with decubitus ulcers.

We studied 104 episodes of bacteremia in 102 patients with decubitus ulcers observed over five years in the hospitals of one metropolitan area. The ulcers were considered to be the "probable" source of bacteremia in 49% of episodes. Another site of infection was documented in 86% of patients. Proteus mirabilis, Staphylococcus aureus, and Escherichia coli were the most frequent blood isolates in these patients, but only Bacteroides species correlated with "probable" origin of bacteremia from the ulcers. The overall mortality was 55%, with 51% of deaths being attributed to infection. These findings emphasize the importance of decubitus ulcers as potential sources of bacteremia in hospitalized patients.

Adolescent↗
PubMed1980

Anaerobic and aerobic bacteriology of decubitus ulcers in children.

Forty-two children with decubitus ulcers were studied using aerobic and anaerobic techniques. Anaerobic bacteria were isolated in 21 (50%) of the patients, five times as the only isolates and 16 times mixed with aerobes. Aerobes only were present in 20 (48%) of the patients. There were a total of 83 isolates, 46 aerobes and 37 anaerobes, with an average of two species per specimen (1.1 aerobes and 0.9 anaerobes). The predominant anaerobic isolates were gram-positive cocci (17), Bacteroides fragilis (6), and Fusobacterium nucleatum (4). The most common aerobic isolates were Staphylococcus aureus (23), Group A beta hemolytic streptococci (6), Hemophilus influenzae (5), and Enterobacter agglomerans (5). The polymicrobial etiology of decubitus ulcers in hospitalized children is demonstrated.

Adolescent↗
PubMed1994

Laparoscopic right hemicolectomy in left lateral decubitus position.

The laparoscopic surgeon does not have the luxury of manually retracting small-bowel loops during right colonic mobilization and transection. Intraoperative rotation of the table aids gravity-produced displacement of small-bowel loops but is limited because extreme rotation endangers the patient's positional stability. By placing the patient in left lateral decubitus position before sterile draping, gravity-aided displacement of small-bowel loops can be maximized, facilitating safe and swift laparoscopic right colonic dissection and transection. Unlike the supine position, the left lateral decubitus position also permits transoperative colonoscopy, which may be needed to aid laparoscopic identification of nonpalpable intraluminal colonic lesions. Experience with four patients is reported.

Adenoma, Villous↗
PubMed1993

A multicenter study on the use of pulsed low-intensity direct current for healing chronic stage II and stage III decubitus ulcers.

BACKGROUND AND DESIGN: Pulsed low-intensity direct current (300 to 600 microA) has been used in a double-blind placebo multicenter study in the treatment of stage II and stage III chronic decubitus ulcers. RESULTS: Seventy-four ulcers were treated in four centers. Forty-three patients were selected for the experimental group, and 31 control subjects used the sham instrument (placebo group). In the treated group, 25 ulcers (58%) healed in 8 weeks, whereas in the placebo group, only one ulcer (3%) healed and most ulcers increased in size. Statistical analysis, based on surface area and ulcer depth before and after treatment, showed that low-intensity direct current had a significant influence on the healing rates for these ulcers (P < .0001). Experiments with guinea pigs (n = 10) showed that pulsed low-intensity direct current caused a rapid calcium flux in the epidermis. CONCLUSIONS: Pulsed low-intensity direct current represents a useful approach for the treatment of stage II and stage III chronic decubitus ulcers by increasing the healing rate. The growth of fibroblasts and keratinocytes may be enhanced by pulsed low-intensity direct current due to changes in calcium homeostasis.

Adult↗
PubMed1976

[The bacterial flora of decubitus ulcers and the effects of ultraviolet light on this flora].

Decubitus ulcers, their treatment, the effect of UV light on bacterial flora of these ulcers, different effects of UV light according to the wave length, the UV lamp used in experiments, and the bacterial flora of wounds in different phases are explained. From 21 patients, with decubitus ulcers under UV treatment, 974 samples were collected before and after UV treatments. These samples were cultured on blood agar plates by the isolation method in 5 steps. After 24 hours incubation, the colonies were counted at each step and then identified. It has seen that bacterial flora decreased gradually from 1 MED, up to 6 MED of UV exposure. (MED = Minimal eritemal dose = about 1 minute) From 6 MED up to 20 MED the rate of decrease remained almost at the same level as in 6 MED. The number of colonies at each step before and after UV exposures were compared with each other. Only the averages of first steps in every MED, their standard errors and (P) values are shown in table III. The ulcers showed higher granulation tissue and faster healing parallel to the effect of UV light on bacteria. In cultures from 974 samples, pseudomonas was most commonly found, followed by diphtheroides, hemolytic staphylococci, non-hemolytic staphylococci, Gram (--) micrococci, proteus, mima (only in two patients), candida, saprophytic staphylococci, neisseria, haemophilus, and aerobic spore-forming bacilli.

Adolescent↗
PubMed1976

Hemicorporectomy for intractable decubitus ulcers.

A hemicorporectomy was successfully employed for control of intractable decubitus ulcers, osteomyelitis, and low-grade epidermoid cancer in a 55-year-old man marked reduction in pulmonary functions. Strict attention to postoperative fluid balance was associated with a smooth convalescence. The operation may be more applicable to paraplegic patients with intractable pelvic decubiti than to those with advanced pelvic tumors. In view of the increased number of paraplegics who may be at risk for developing this problem, more frequent consideration of the procedure seems warranted.

Adolescent↗
PubMed1977

Reappraisal of the left lateral decubitus X-ray in splenic rupture.

The lateral decubitus view of the barium-filled stomach has been reassessed in a series of 42 patients with possible splenic rupture and compared with a group of 17 patients with splenomegaly. Displacement of the gastric fundus of more than 4 cm from the inner rib margin is highly suggestive of splenic rupture. Where doubt exists, the test should be repeated within a short while. Peritoneal lavage and a full blood count investigation both add to the diagnostic accuracy.

Adult↗
PubMedDate not supplied

MR-guided biopsy of the breast after lumpectomy and radiation therapy using two methods of immobilization in the lateral decubitus position.

We describe two methods of breast immobilization using the lateral decubitus position to increase patient comfort and access to the axillary tail for MR-guided biopsy in the postsurgical or irradiated breast. The first method uses a compression device with good immobilization but poor patient tolerance. The second approach uses a thermoplastic mesh material to form a rigid exoskeleton around the breast: immobilization is adequate and patient acceptability is good. The latter method is preferred and requires formal evaluation in larger scale trials.

Biopsy, Needle↗