Valuing diversity--a foundation stone of advanced wound caring.
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Returning home after stoma surgery can be fraught with difficulties. Identifying potential problems and dealing with them promptly is an important part of the stoma care nurse's role. This article is the third in a series of three guides on stoma care.
Patients undergoing stoma surgery need a lot of information and support beforehand. The role of the stoma care nurse in helping patients adjust to the situation is paramount. This article is the first in a series of three guides on stoma care.
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BACKGROUND AND OBJECTIVES: A new filtering procedure, the Intrastromal Holmium Laser Keratostomy (ILK) has been developed. A laser canal is created intrastromally in the cornea anterior to Schwalbe's line in the floor of a corneo-scleral tunnel incision made with a knife from the corneal site. Theoretically, the complications of the conventional Subconjunctival Holmium Laser Sclerostomy (SLS) can thus be avoided. Experimental and clinical evaluation of the new procedure, as well as clinical long-term results are presented. PATIENTS AND METHODS: The ILK was evaluated experimentally on bank eyes and clinically using postoperative Ultrasound Biomicroscopy (UBM). The clinical long-term effect was evaluated by a follow-up of the first 22 ILK performed on 17 eyes in 17 consecutive patients with complicated, refractory primary and secondary open angle glaucoma. Preoperative subconjunctival mitomycin-C injection (0.02 mL of 0.2 mg/mL) was used. RESULTS: The experimental and clinical evaluations show that the collateral thermal tissue coagulation made by the Holmium laser in ILK probably is an advantage, because the subsequent shrinkage prevents postoperative self sealing of the laser canal. Complete surgical success without medication and reoperations was reached in 63% of the eyes with a mean observation time of 22.5 months (range: 16.6-26.7 mos.). Any failure appeared within the first 10 months. Only 13% of the eyes had early iris incarcerations, there were no late incarcerations. Twenty-five percent had temporary shallow anterior chambers. CONCLUSION: The mitomycin-ILK procedure has shown obvious better results than the conventional SLS technique due to a considerable reduction in postoperative complications. Since the present material further developments in the ILK technique has made this procedure still more attractive.
Care pathways set out the anticipated flow of care for a typical patient with a specific diagnosis. The pathway of care is a concept rather than a fixed method, which can be adapted and modified to suit the needs of a specific patient group. Use of patient cards allows routine patient teaching and information-giving to be recorded, while allowing more space and time for focusing on the needs of individual patients.
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