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Decubitus ulcers.

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Humans↗
PubMed1989

Guidelines for evaluating decubitus ulcer research.

The classic critique of research is applied to a systematic evaluation of the components of research reports and company literature related to pressure ulcer products and devices. Emphasis is on the need to control variables that influence the findings; some of these are: relief of pressure, nutrition and hydration, comparability of subjects, the Hawthorne Effect and the Pygmalion Effect. Replication of research before adopting products/devices for protocol use is advocated.

Humans↗
PubMed1989

[Treatment of chronic decubitus ulcers by fascio-cutaneous and cutaneous flaps in paraplegic patients].

Together with musculocutaneous flaps, cutaneous and fascio-cutaneous flaps have proved to be the most successful for the closure of decubital ulcers in paraplegic patients. These complicated and infected skin/soft tissue defects must not be closed until the ulcers have been cleaned locally as far as possible of necrotic and suppurating secretions and coverings and a specific antibiotic treatment administered. From October 1986 to May 1988, a total of 67 decubital ulcers in 53 patients were covered with fascio-cutaneous or cutaneous flaps after a preparatory local treatment. Except in 6 patients who had preoperative sepsis with temperatures ranging from 38 degrees C to 39 degrees C (infection of the urinary tract) no antibiotic treatment was used perioperatively. As a result, we observed a reduced rate of local complications (11%) and a shorter duration of treatment and hospitalization (about 6 weeks less) even though these patients were at risk of complications in view of the average ulcer size, frequency of bone involvement and the frequent presence of multiple ulcers.

Humans↗
PubMed1989

[Expert assessment of decubitus ulcers].

After the Supreme Federal Court (Bundesgerichtshof; BGH) has commented on the liability in civil law in occurrence of decubital ulcers in two judgments in 1986 und 1987, requests for expert reports on this problem area are to be expected more frequently in the future. Thus three forensic autopsies in which the appraisal of decubiti was the reason for the request were already performed in 1988 at the Munich Institute of Forensic Medicine. The priorities of the forensic appraisal are specified on the basis of the criteria enunciated by the BGH. Essentially, care must be taken with regard to exact documentation of whether a risk patient is involved, what prophylactic measures were instituted and that their implementation was checked. The minimum requirements of prophylaxis which have been exactly prescribed by the BGH are described.

Expert Testimony↗
PubMed1987

[Plasma variation of atrial natriuretic peptide in central hypervolemia (diurnal or nocturnal) induced by antiorthostatic decubitus at -6 degrees].

Plasma levels of ANP were measured during a 4 hrs head-down tilt at -6 degrees in 5 healthy male volunteers (aged 20-22 M.2). The experiments took place from 8 to 14 hrs, (day), and from 22 to 7 hrs (night). The control period was 1 hr. in a seated position (8 to 9 hrs. for day and 22 to 23 hrs. for night). Blood samples were collected at 9 and 23 hrs. and every 20 min. during the first hours, and every hours thereafter. Electroencephalograms were continuously recorded during night. Our results showed a similar increase in ANP during both experimental conditions. During night there was no correlations between ANP and sleep stages. Finally the differences observed in renal responsiveness to central volume expansion during day or night could not be explained by a difference in renin, aldosterone, vasopressin (previously demonstrated in several studies) or ANP secretion.

Adult↗