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At least 253 records · Page 14Linked to original sources
PubMed2000

['Decubitus' guideline of the Dutch College of Family Practice; response from family practice].

The guideline on pressure ulcers issued by the Dutch College of General Practitioners gives a lot of practical information for the family doctor and the practical nurse. The main thought is the treatment of decubitus in a moist environment. Furthermore this guideline will help the doctor to make the right choice in the chaos of supplies. It is of great interest that interdisciplinary collaboration will take place on this issue, for a well developed communication gives the best results of treatment.

Family Practice↗
PubMed2000

[Summary of 'Decubitus' guideline of the Dutch College of Family Practitioners].

The guideline 'Decubitus' published by the Dutch College of General Practitioners contains guidelines with instructions for prevention, diagnosis and treatment of pressure ulcers in primary care. The classification used for severity is: redness of the skin, superficial damage, superficial ulcer, deep ulcer. This classification follows the one used internationally and the one in the consensus of the Dutch Institute for Health Care Improvement CBO. For each patient who becomes (totally or partly) immobile measures to prevent pressure ulcers are necessary, with emphasis on minimizing pressure and shearing forces acting upon the skin. After a pressure ulcer has developed these measures remain important. Guidelines for treatment are given for each level of severity of the pressure ulcer; the main aim is to keep the ulcer moist, to remove necrosis and exudate and to treat infection.

Family Practice↗
PubMed1999

[Don't let it get that far! Tips and tricks for prevention of decubitus ulcer and therapy in general practice].

Successful prevention and treatment of decubitus ulcer requires a high level of skill and competence on the part of the diverse professional groups involved in providing nursing care and medical treatment. Pressure relief can be achieved in a variety of ways, and the needs of the patients must be integrated in the approach adopted. Constant inspection and care of the skin, and promotion of patient movement/activity, coupled with familiarity with the latest information on wound and pain management are the prerequisites for appropriate treatment. A reduction of the problem to the use of special mattresses and beds must be avoided.

Aged↗
PubMed2000

Rhabdomyolysis after a long-term thoracic surgery in right decubitus position.

We report a rare case who developed rhabdomyolysis associated with the use of the right decubitus position for 10 h during thoracotomy with lobectomy. It appears that an increasing of the compartment pressure may induce reperfusion injury of the ischemic muscle by prolonged compression of the gluteal and flank muscles against the operation table. Early recognition and aggressive treatment with intravenous fluid and diuresis may prevent the development of acute renal failure. Adequate prevention in high-risk patients, early diagnosis and aggressive treatment are the keys to a successful recovery.

Adult↗
PubMed2002

The pressure is on: midwives and decubitus ulcers.

Research regarding pressure area care and management in nursing extends back many years, but remains relevant and cited today. With relevant knowledge, midwives can help prevent the development of pressure sores in the maternity setting. Clinical governance and risk management should ensure that the incidence and occurrence of pressure sores in the midwifery arena is reported and fed into appropriate audit analysis at local, regional and national levels. Midwives need to seriously consider the implications of modern midwifery care and management in relation to the development of pressure sores in our population. Labour suite, high dependency, ward and community areas should include guidelines for the prevention, treatment and management of pressure sores, including mattress policies. Prophylactic measures and assessment scores could be incorporated into partogram documentation in the labour suite and as part of postoperative documentation in the ward environment for women who have undergone caesarean section. Trusts may find that a link midwife liasing with tissue viability nurses proves beneficial. Community midwives should forge links with the district nursing services in their Primary Care Trust areas with regard to developing or adapting tools. Knowledge of pathophysiology, prophylaxis and subsequent management of decubitus ulcers in maternity care is sadly lacking in midwifery textbooks. Future authors and editors should include this subject and it should feature more prominently in midwifery education curricula. It is clear that there is much work to be done in this area, both educationally and clinically. Further research is required to evaluate pressure prevention strategies in the midwifery arena, including the increasing provision of one-to-one care in labour suite units. Improvements in the appropriate prevention and subsequent treatment and management of pressure sores will benefit women and help save the NHS hundreds of thousands of pounds in treatment and litigation costs.

Bandages↗
PubMed2002

[Consciousness disturbance caused by iodoform absorption in a patient with decubitus ulcer topically treated with iodoform-gauze].

A 76-year-old man with supranuclear palsy, developed consciousness disturbance followed by the treatment of decubitus ulcer in the sacral region using iodoform-gauze. He was semicoma and tachycardia. His pupils were miotic and light reflexes were absent. EEG demonstrated diffuse and random slow activities. Plasma concentration of free iodine was high (151 micrograms/dl), but the other laboratory findings including thyroid functions were normal. He was diagnosed as suffering from iodoform poisoning. The symptoms and laboratory abnormalities of the patient recovered soon after the removal of iodoform-gauze. Although iodoform has been widely used for the treatment of wounds, there are few case reports of its side effects, such as consciousness disturbance, delirium, headache and tachycardia.

Acute Disease↗
PubMedDate not supplied

Bilateral ulnar decubitus as a complication of macular hole surgery.

Bilateral ulnar decubitus is described in a 69-year-old patient maintaining prone positioning after vitrectomy, membrane peeling, and perfluoropropane gas injection for the treatment of a macular hole. Patients should be warned to report any skin breakdown or ulnar paresthesias resulting from positioning and to change position frequently to allow weight bearing on other parts of the body. Patients with certain personality traits may be more likely to maintain correct positioning despite pain or injury to ensure surgical success.

Aged↗
PubMed2003

[Treatment of decubitus ulcers in the geriatric patient].

Pressure sores (decubitus ulcers) and their treatment are a typical problem of old people in need of nursing care, after traumatization or in diseases of the peripheral nervous system. Patient instruction and appropriate schooling of nursing staff with regard to risk factors, and the use of standardized risk assessment aids, such as the Norton scale, can improve risk identification and prophylaxis, and minimize recurrent ulcers. Patients put at particular risk by paralysis, cachexia, shock, disturbed arterial perfusion, anemia, dehydration or major surgery should be bedded appropriately. In addition to the development of numerous modern wound dressings, the introduction of continuous vacuum therapy (V.A.C.) is of proven value, both as sole treatment resulting in healing and for accelerated preparation for plastic surgery. In stage 3 and 4 ulcers, plastic surgery involving displacement of tissue are usually required for permanent treatment.

Age Factors↗
PubMed2005

[A guide to prevent decubitus ulcers in bedridden patients].

The authors present a report they produced dealing with how to prevent decubitus ulcers in bedridden patients. This report, designed in a practical use format, can be easily understood by all those nursing care professionals who have to care for bedridden patients; it is a highly useful tool for the nursing field.

Humans↗
PubMed2005

[How to evaluate nursing procedures for bedsores, or decubitus ulcers by means of a codified and computerized record-keeping system].

Bedsores, or decubitus ulcers, are a very serious health problem in our society which has more elderly people all the time. Clinical files, whether they record preventive care or actual treatment and follow-up analysis of results, are a challenge for nursing practice. Therefore, the authors developed a simple, easy to use and fill out document: a "File to record the evolution, care and treatment of bedsores". Treatment methods are recorded by means of previously designated numerical codes corresponding to the treatment methods carried out which enables their subsequent computerization and makes it possible to analyze them. The results obtained permit nursing professionals to analyze work tasks assigned, treatment quality and the efficiency of procedures and products used: furthermore, this file enables nurses to elaborate a description of an elderly patient having multiple pathologies, a target for these lesions, and to establish a nursing treatment procedure especially adapted to the required treatment.

Cross-Sectional Studies↗
PubMed2006

Redistribution of blood flow and lung volume between lungs in lateral decubitus postures during unilateral atelectasis and PEEP.

The effect of left lung atelectasis on the regional distribution of blood flow (Q), ventilation (V(A)) and gas exchange on the right lung ventilated with 100% O2 was studied in anesthetized dogs in the lateral decubitus posture. Q and V(A) were measured in 1.7 ml lung volume pieces using injected and aerosolized fluorescent microspheres, respectively. Hypoxic pulmonary vasoconstriction (HPV) in the atelectatic lung shifted flow to the ventilated lung. The increased flow in the ventilated lung ensured adequate gas exchange, compensating for the hypoxemia due to shunt contributed by the atelectatic lung. Left lung atelectasis caused a compensatory increase in the ventilated lung FRC that was smaller in the right (RLD) than left (LLD) lateral posture, the effect of lung compression by the atelectatic lung and mediastinal contents in the RLD posture. The O2 deficit measured by (A-a)DO2 increased with left lung atelectasis and was exacerbated in the LLD posture by 10 cm H2O PEEP, a result of increased shunt caused by a shift in Q from the ventilated to the atelectatic lung. The PEEP-induced O2 deficit was eliminated with inversion to the RLD posture.

Adaptation, Physiological↗
PubMed1991

[Treatment of suppurative-necrotic decubitus ulcers in patients with spinal injuries by using alginate coating teralgim and algimaf].

Alginate coating teralgim and algimaf were applied to 24 decubitus ulcers of various sites in 19 spinal patients. Stage--specific choice of applications produced a good cleansing effect and ulcer healing in 62.5% of the lesions within 48.5 days on the average. Indications for surgery were defined in 37.5% of the cases (repair of the ulcer defect) which were also treated with alginate coating with a good preoperative effect.

Adult↗
PubMed1991

[Value of surgical treatment of decubitus ulcer in geriatric patients].

Geriatric patients have a high incidence of pressure sores. Pain, chronic and acute infection and protein loss may impair their general condition. Pressure relief, local débridement, disinfection and physiologic wound dressing are the first steps in local treatment. The spontaneous healing time of a pressure sore is very slow, even if concomitant diseases as diabetes, urinary tract infection and pneumonia could be stabilized and the general condition of the patient be improved. In these selected and stable cases, surgical débridement and plastic pressure sore closure may be indicated. Simple skinflaps can give good results in superficial sores without bone involvement and have a low operative morbidity. Musculocutaneous flaps are technically more difficult, but resist better to infection and may fill bigger and deeper defects. In any operation, vascular territories (angiosomes) of further flaps, suitable for a recurrent or second decubitus closure, must be preserved. Long-term results in 30 operated patients over 60 are presented. Although the postoperative complication rate is very high, healing could be achieved in all surviving patients.

Aged↗
PubMed1990

The 1988-1989 decubitus study. Can a standardization of treatment be set for the elderly patient with decubiti ulcers stage III?

On July 1, 1988, a 6-month study began which included 15 ICF and SNF facilities and a census of approximately 1,300 patients. Forms and instructions were sent to each facility prior to the study. Stage II to Stage IV decubiti ulcers were reported on a monthly basis. Information obtained on all decubiti included: Nutritional intake, mental state, mobility, incontinence, contributing diagnoses, decubiti sizes and locations, recurrence of decubiti sites, stages, dates healed, cultures taken and reported, and treatments given. The completed forms were mailed into the Decubitus Study Committee every 3 months being due October 1, 1988 and January 1, 1989. The forms were designed to be as brief as possible yet provide the desired information.

Aged↗
PubMed1990

Why asthmatic patients should not sleep in the right lateral decubitus position.

The topographical points affecting nasal resistance include the shoulders, upper thorax and buttocks, and we have demonstrated that vagal tone increases with right-sided pressure and decreases with left. We would therefore strongly recommend that asthmatic patients should avoid sleeping in the right lateral decubitus position. It would be interesting to speculate on a number of ramifications ensuing from the presence of increased vagal tone in asthmatic patients. If present, atrophic rhinitis, nasal polyps, and septal deviation may possibly affect incidence of asthma depending upon its presentation in the left or right nasal turbinate. We suggest that there should be increased incidence of right septal deviation and increased incidence of right turbinate nasal polyps in patients presenting with asthma. Patients with asthma may possibly have certain nasal cycle patterns that could easily be measured using Podoshin plates. Finally, our animal model of forced unilateral nostril breathing may explain certain facets of asthma.

Asthma↗
PubMed1989

[Bacteremia secondary to decubitus ulcer].

We have prospectively evaluated 16 episodes of bacteremia induced by decubitus ulcers. The most commonly isolated microorganisms were Staphylococcus aureus, Proteus mirabilis, Pseudomonas aeruginosa and Bacteroides fragilis. Bacteremia was polymicrobial in 5 cases (31%). Most ulcers were already present at the time of admission, but bacteremia developed within the hospital in 13 patients. In 3 patients, ulcers did not show local features of infection. The initial antibiotic therapy was satisfactory in 13 cases. Mortality rate directly associated with bacteremia was 18%, but the overall mortality rate was 62%. We did not identify data permitting a reliable prediction of the findings of blood culture; therefore, the initial empirical therapy should be active against Staphylococcus aureus, Pseudomonas, enteric Gram-negative bacilli and anaerobes including Bacteroides fragilis.

Aged↗
PubMedDate not supplied

Decubitus ulcers.

Decubitus ulcers are frequently encountered in the elderly and in bedridden or wheelchair-bound patients. Successful treatment is often difficult and expensive. Pressure, time, and friction are the major factors involved in the development of skin ulcers with such risk factors as age, female sex, and nutritional status predisposing to their development. Complications can be life threatening. A number of treatment modalities have been used over the years, but the mainstays of treatment include attention to preventive measures, relief of pressure over bony prominences, and debridement, following the basics of wound care.

Humans↗