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PubMed1997

Multiply antibiotic-resistant gram-negative bacilli in a long-term-care facility: a case-control study of patient risk factors and prior antibiotic use.

OBJECTIVE: To determine the relation between prior exposure to specific antimicrobials and acquisition of gram-negative bacilli resistant to multiple beta-lactam and aminoglycoside antibiotics among long-term-care patients. DESIGN: Case-control study. Cases were patients from whom multiply resistant Enterobacteriaceae or Pseudomonas aeruginosa were isolated; controls were patients from whom nonresistant bacteria of the same species were isolated. Prospectively defined risk factors included underlying illness, activity level, presence of decubitus ulcers, presence of indwelling devices, and prior exposure to specific antimicrobial agents. Resistant and control isolates of P aeruginosa were compared using pulsed-field gel electrophoresis (PFGE) of genomic DNA after digestion with XbaI. SETTING: 390-bed long-term Veterans' Affairs facility. RESULTS: We identified 35 patients with multiply resistant Enterobacteriaceae and 24 patients with multiply resistant P aeruginosa. Of the resistant Enterobacteriaceae, 87% of isolates were resistant to piperacillin, 55% to ceftazidime, and 90% to gentamicin. Acquisition of multiply resistant Enterobacteriaceae was associated with presence of decubitus ulcers (odds ratio [OR], 12.2; 95% confidence interval [CI95], 3.3-44.2; P = .0002) and prior receipt of ampicillin (OR, 13.7; CI95, 2.2-84; P = .005). Of resistant isolates of P aeruginosa, 88% were resistant to piperacillin, 25% to ceftazidime, 42% to imipenem, and 67% to ciprofloxacin. Isolation of a multiply resistant P aeruginosa was associated with total days of antimicrobial exposure (OR, 1.07; CI95, 1.01-1.12; P = .011) and not with prior receipt of any individual agent. Eleven multiply resistant isolates shared a common PFGE pattern. CONCLUSIONS: In our long-term-care facility, acquisition of multiply resistant Enterobacteriaceae was associated with the presence of decubitus ulcers and prior exposure to ampicillin. Acquisition of resistant P aeruginosa was associated with total antibiotic exposure. Molecular typing of P aeruginosa isolates implicated patient-to-patient transmission of a limited number of resistant strains.

Aged↗
PubMed1950

Skeletal suspension in the treatment of decubiti.

In the usual sacral decubitus, pressure may be relieved by skeletal suspension from Kirschner wires placed in the ilian crests. Pressure sores over the scapulae and thoracic spine may be handled by placing Kirschner wires through the clavicles. Both of these methods lend themselves to the preoperative care of a patient being prepared for the plastic closure of a decubitus.

Humans↗
PubMed1999

Diagnosing pneumonia by physical examination: relevant or relic?

BACKGROUND: The reliability of chest physical examination and the degree of agreement among examiners in diagnosing pneumonia based on these findings are largely unknown. OBJECTIVES: To determine the accuracy of various physical examination maneuvers in diagnosing pneumonia and to compare the interobserver reliability of the maneuvers among 3 examiners. METHODS: Fifty-two male patients presenting to the emergency department of a university-affiliated Veterans Affairs medical center with symptoms of lower respiratory tract infection (cough and change in sputum) were prospectively examined. A comprehensive lung physical examination was performed sequentially by 3 physicians who were blind to clinical history, laboratory findings, and x-ray results. Examination findings by lung site and whether the examiner diagnosed pneumonia were recorded on a standard form. Chest x-ray films were read by a radiologist. RESULTS: Twenty-four patients had pneumonia confirmed by chest x-ray films. Twenty-eight patients did not have pneumonia. Abnormal lung sounds were common in both groups; the most frequently detected were rales in the upright seated position and bronchial breath sounds. Relatively high agreement among examiners (kappa approximately 0.5) occurred for rales in the lateral decubitus position and for wheezes. The 3 examiners' clinical diagnosis of pneumonia had a sensitivity of 47% to 69% and specificity of 58% to 75%. CONCLUSIONS: The degree of interobserver agreement was highly variable for different physical examination findings. The most valuable examination maneuvers in detecting pneumonia were unilateral rales and rales in the lateral decubitus position. The traditional chest physical examination is not sufficiently accurate on its own to confirm or exclude the diagnosis of pneumonia.

Adult↗
PubMed1985

Aphasia following pluridirectional tomography with metrizamide. The effect of patient position.

Eight of 67 patients became transiently aphasic after myelography or cisternography with metrizamide. All eight patients had been placed in the left lateral decubitus position for pluridirectional tomography. Immediate EEGs revealed focal left-sided abnormalities in two patients. In one other patient, a computed tomographic scan showed contrast mainly over the left hemisphere. All of the symptoms resolved within 48 hours. In 34 patients who were placed on the right side, no language disturbance was noted. Aphasia after pluridirectional tomography with metrizamide may be due to local irritation of the perisylvian language centers of the dominant hemisphere. The phenomenon is distinct from syndromes of generalized confusion. The complication may be avoided by placing patients in a right lateral decubitus position for pluridirectional tomography.

Adult↗
PubMed1998

High intra-abdominal pressure increases plasma catecholamine concentrations during pneumoperitoneum for laparoscopic procedures.

BACKGROUND: Laparoscopic procedures are associated with several complications, such as hemodynamic, respiratory, and endocrine complications. In our previous clinical study, plasma epinephrine and norepinephrine concentrations remained unchanged after the insertion of a Veress needle, but increased significantly immediately after insufflation with carbon dioxide into the peritoneum. The mechanisms for this increase are unknown. OBJECTIVE: To investigate whether gas insufflation during pneumoperitoneum affects plasma catecholamine concentrations during laparoscopic procedures. DESIGN: Experimental study in pigs. MAIN OUTCOME MEASURES: The plasma concentrations of epinephrine and norepinephrine were measured in the pigs before and after pneumoperitoneum. The mean arterial pressure, heart rate, cardiac output, and arterial blood gas levels were measured, and the systemic vascular resistance was calculated. INTERVENTION: Air, nitrous oxide, or carbon dioxide were insufflated in turn into the peritoneal cavity of supine pigs. Thereafter, carbon dioxide was insufflated into the peritoneal cavity while the pig was in the left lateral decubitus position, and then in the right lateral decubitus position. Measures were performed before pneumoperitoneum and at the intra-abdominal pressures of 10 mm Hg and 20 mm Hg. One hour of resting time was allowed between each procedure. RESULTS: As compared with baseline values, the plasma concentrations of epinephrine and norepinephrine remained unchanged at 10 mm Hg but increased significantly at 20 mm Hg regardless of the gas used for the pneumoperitoneum (P<.05). The type of gas and differences in the position of the animals had no effect on the plasma epinephrine and norepinephrine concentrations. CONCLUSIONS: Excessive intra-abdominal pressure, but not the type of gas or body position, increases plasma catecholamine concentrations during the insufflation of gas into the abdominal cavity. Therefore, excessive insufflation of the pneumoperitoneum should be avoided.

Abdomen↗
PubMed1995

Hemicorporectomy.

Intractable decubitus ulcers and femoropelvic osteomyelitis are rare sequelae of paraplegia. Therapy for these conditions ranges from the simple to the complex, including wound debridement and care, alimentary and urinary tract diversion, hip disarticulation, and myofasciocutaneous rotational flaps. Should the condition be recalcitrant to these modalities the only curative therapy is hemicorporectomy. A 28-year-old rendered paraplegic 3 years ago presented manifesting sepsis; marasmus; hip and knee flexion contractures; suppurative sacral and femoropelvic decubitus ulcers, exposed bone, and osteomyelitis; and fecal and urinary incontinence. Pre-operative nutritional supplementation, wound debridement and care, and psychological counselling were provided. Hemicorporectomy was performed, including colostomy, ureteroileal conduit, gastrostomy, and translumbar amputation. Several anatomical, physiological, and operative-technical perspectives are emphasized: a two-staged approach may be preferable--at the first setting an intra-peritoneal exploratory celiotomy with alimentary and urinary tract diversion; and at the second setting an extra-peritoneal hemicorporectomy; preservation of abdominal wall musculature and fasciae to facilitate wound closure; sequential and bilateral ligation of the arteriae et venae iliaca communis; translumbar amputation between the fourth and fifth lumbar vertebrae; extirpation of the fourth lumbar processus spinosus vertebrarum; closure of the dura mater and translation of musculi sacrospinalis into the vertebral canal; avoidance of hypervolemia and hyperthermia; avoidance of wound pressure; testosterone replacement therapy for eunuchism; and physical and occupational rehabilitation including adaptation to a customized bucket prosthesis.

Adult↗
PubMed1995

The effect of body position on a free-floating ball thrombus as observed by transesophageal echocardiography.

Two cases of free-floating left atrial ball thrombi (FLABT) in association with mitral stenosis were observed by transesophageal echocardiography (TEE). Our report describes the relation between body position and thrombi kinetics. Both cases demonstrated similar kinetics. In the supine and right lateral decubitus positions, the thrombi recoiled from and sometimes became entrapped within the mitral valve. In the sitting and left lateral decubitus positions, the thrombi appeared to be nearly fixed and did not contact with the mitral valve. Our results indicate that the latter two positions prevent thrombi disintegration and incarceration into the mitral valve. Finally, TEE is an extremely useful tool for assessing the safest position for individuals with FLABT.

Aged↗
PubMed1993

Impact of anomalous vertebral segmentation on measurements of bone mineral density.

In anteroposterior (AP) bone mineral density (BMD) measurements of the lumbar spine (LS), the presence of ribs is used to identify vertebra T12. Similarly, in lateral LS-BMD measurements, the position of the iliac crest is used to identify the lumbar vertebrae. The aim of this study was to determine the impact of variations in spinal segmentation and iliac crest position on BMD measurements. In 375 women (ages 50-85 years) radiographs were taken of the thoracic and lumbar spine, as well as AP measurement of LS-BMD, by dual-energy x-ray absorptiometry (DXA). In 121 subjects lateral decubitus LS-BMD was also measured. Anomalous spinal segmentation was found in 16.5%, and L1 would have been incorrectly identified on the AP-DXA image in 13%. The change in BMC and BMD between adjacent vertebrae was greater in the upper than the lower lumbar spine. Misidentification of L1 for T12 resulted in underestimation of the bone mineral content in grams (BMC) of L1 by a mean of 11.5 +/- 14.4% (SD; range -33.5 to 33.5%). For the usual region of interest, L2-4, the BMC (g) was underestimated by 8.4 +/- 8.7% (range -1.5 to 29.2%), with the BMD (g/cm2) underestimated by 3.6 +/- 4.8% (range -5.4 to 11.6%). The position of the iliac crest on the lateral decubitus DXA scans would have led to misidentification of either L2 or L4 for L3 in 15 cases (12%). This resulted in the BMD of L3 being underestimated by 2.7 +/- 19.4% (range -242.4 to 34.6%).(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗
PubMed1981

Ultrasonic determination of hepatomegaly.

Retrospective evaluation of abdominal ultrasound examinations were made in 36 patients who came to autopsy within 1 month after the ultrasound study. Without knowledge of clinical or autopsy data, two observers made independent determinations of the midhepatic line measurement of the liver on the ultrasound study using supine and left lateral decubitus longitudinal scans. Autopsy determination of hepatomegaly was made using hepatic weight, patient's total body weight, and patient age correlated with pertinent clinical history. Results of the autopsy/ultrasound correlation demonstrated that those livers measuring 13.0 cm or less in the midhepatic line (both supine and left lateral decubitus positions) were normal in 93% of the cases. Similarly, it was demonstrated that when the liver measured 15.5 cm or greater, it was enlarged in 75% of the cases. Used together, these two criteria result in an 87% accuracy rate in determining the presence or absence of hepatomegaly. Approximately 25% of the cases in our study fell into the borderline category of 13.0-15.5 cm.

Age Factors↗
PubMed2005

Sonography of pleural space in healthy individuals.

PURPOSE: This research was performed to detect physiologic pleural fluid by chest ultrasonography, to assess the frequency of this finding, and to check the status of pleural space, searching for possible individual variations of the amounts of pleural fluid. MATERIALS AND METHODS: In the baseline study, chest ultrasonography of both pleural spaces was performed in a group of 106 healthy volunteers, searching for pleural fluid, first in the lateral decubitus position and then leaning on the elbow. An anechoic fluid layer at least 2-mm thick was taken as a positive result. The follow-up study was repeated on each subject after 2-4 months. RESULTS: In the baseline study, a 2-mm-thick pleural fluid layer was found in 28 of 106 (26%) volunteers, both sided in 17 of 28 (61%), and unilaterally in 11 of 28 (39%). The follow-up study, showed a fluid layer in 24 of 106 (23%) volunteers, on both sides in 14 of 24 (58%), and unilaterally in 10 of 24 (42%). In the first study, the mean fluid layer thickness in the decubitus examination position was 2.9 mm (SD, 0.4 mm) and in elbow examination position 2.8 mm (SD, 0.4 mm). On follow-up study, the mean fluid layer thickness in both examination positions was the same, 3.1 mm (SD, 0.6 mm). Taking into consideration baseline and follow-up studies, the fluid was observed in 32 subjects, and 21 (66%) of them showed pleural fluid twice. Their mean fluid layer (3.1 mm) was significantly larger than the group of subjects with only one positive result (2.5 mm), with p values of <.01 for the baseline and <.05 for the follow-up study. CONCLUSION: In experimental conditions, small amounts of pleural fluid can be detected by chest sonography in healthy individuals. Our research suggests that there are individuals with sonographically permanently less ("dry pleural space") or more ("wet pleural space") physiologic pleural fluid.

Adult↗
PubMed1990

Hemicorporectomy: a collective review.

Hemicorporectomy or translumbar amputation has been described as the most revolutionary of all operative procedures. Frederick E. Kredel, who first voiced the concept of the operation in 1950, referred to it as halfectomy. Demonstration of his cadaver studies established the feasibility of the operation. Amputation is effected through the lower lumbar area of the body. Necessary life functions are preserved in the upper torso. Kredel envisioned hemicorporectomy as a curative operation for locally advanced cancer, limited to the pelvis, not encompassable by standard operative intervention. Additional indications are intractable decubitus ulcers with malignant change, particularly in paraplegics; pelvic organs, and bone infection with nonhealing fistulae; and crushing trauma to the pelvis. The first hemicorporectomy operation was reported in 1960. Thirty-four operations have been recorded in the world literature. Two heretofore unreported cases are added, raising the total to 36. Review of these 36 cases confirms the conviction that hemicorporectomy is a humane and ethical alternative to the suffering encumbered by advancing, painful, malodorous malignant disease not treatable by conventional means. While cure rates are not substantial, the best results are reported in paraplegics with intractable decubitus ulcers with or without malignancy. Rehabilitation is prolonged and costly. Most survivors have been restored to preoperative occupations or other gainful employment.

Amputation, Surgical↗
PubMed1995

A porcine model for laparoscopic adrenalectomy.

Laparoscopic adrenalectomy has been successfully performed and described in humans. Though it is presently not widely employed it offers tremendous potential for adrenal surgery. It remains, however, an advanced technique requiring demonstration and practice. The aim of this study is to develop a porcine model of adrenalectomy for teaching and advancing the technique applicable to human surgery. Five female pigs weighing 10-20 kg underwent bilateral adrenalectomy by the lateral approach using endotracheal intubation. The left adrenal was resected with the pig in the right decubitus position. The animal was repositioned to left decubitus and the right adrenal was resected. In each case four 10-mm trochars were placed over the respective flanks. There was no need to mobilize the colon or liver (in the pig model). The peritoneum over each gland was incised and the gland dissected in a cephalocaudal manner. The vessels were ligated and divided particularly those from the vena cava. Upon completion blood loss (< 100 cc) and operating times (mean 60 min for the left and 90 min for the right) were assessed and the animal was sacrificed. The glands were weighed (mean 1.23 g R and 1.15 g L) and measured. Using this model, experience is gained in positioning the subject as well as trocars, in fine dissection in a lateral orientation, and in techniques of hemostasis. Although porcine and human adrenal anatomy differ in some details the pig constitutes an excellent model for the development of the technical experience required to perform adrenalectomy in humans.

Adrenalectomy↗
PubMed1989

Malignant fibrous histiocytoma: similarities to the "fibrohistiocytoid cells" in chronic inflammation.

Ultrastructural, enzyme histochemical and immunohistochemical studies were performed on tissue obtained from eight cases of malignant fibrous histiocytoma (MFH) and five cases of sacral decubitus ulcer. The MFH was composed of two major tumour cell types: fibroblast-like and histiocyte-like cells. Both cell types demonstrated abundant branching, fragmented rough endoplasmic reticulum (rER), many free ribosomes, occasional small mitochondria, an oval, elliptical or irregularly shaped nucleus with one or two prominent nucleoli and often a few dense bodies. However, pseudopodial projections, multivesicular bodies and phagosomes, common histiocyte organelles, were not seen. With little difference between cases or selection sites, the MFH cells reacted to acid phosphatase (AcP) and alpha-naphtyl butyrate esterase (ANBE) by enzyme histochemistry and with ferritin (Fer), alpha 1-antitrypsin (AT), alpha 1-antichymotrypsin (ACT), fibronectin (FN), HLA-DR, HLA-DP, Leu 10 and OKT 9 in immunohistochemical studies. MFH tumour cells did not immunostain with monocyte/macrophage markers (Leu M1, Leu M3, Mo 1, Mo 2 and Macrophage) although non-neoplastic histiocytes did react to these markers. In addition, granulation tissue, such as that found in sacral decubitus ulcers, was examined and the existence of a specific cell type called the "fibrohistiocytoid (FH) cell" was documented. The FH cell was short, spindle shaped and elliptical. Ultrastructurally, it had fragmented rER distributed in a branching pattern, dispersed free ribosomes, small mitochondria and a few dense bodies, but lacked diverse fused lysosomes and distinct pseudopodial cytoplasmic extensions. The FH cells reacted with AcP, alkaline phosphatase and ANBE but not with peroxidase using enzyme histochemistry and with Fer, AT, ACT, FN, HLA-DR, HLA-DP, Leu 10 and OKT 9 but not with monocyte/macrophage markers, C3d receptor, C3bi receptor in immunohistochemical studies. The FH cells had morphological, enzyme histochemical and immunohistochemical characteristics intermediate between fibroblasts and histiocytes. Similarities between MFH cells and the FH cells seen in chronic inflammation are discussed.

Aged↗
PubMed1982

Pseudo-obstruction of the interior vena cava in pediatric abdominal masses.

Extrinsic compression of the inferior vena cava by large abdominal masses may simulate occlusion on supine cavography. Seventeen children with large abdominal masses were evaluated by inferior venacavography. There was either occlusion or severe compression of the IVC on supine cavography in 13 patients; but the decubitus cavagram and subsequent surgery confirmed patency in 12 patients. In four patients only minor indentations or no abnormalities were present. Pseudo-obstruction of the IVC can be accurately differentiated from occlusion due to invasion by a lateral cavagram in the decubitus position.

Abdominal Neoplasms↗
PubMed1997

Cardiac performance during unilateral lumbar spinal block after crystalloid preload.

PURPOSE: The haemodynamic effects of crystalloid preload were evaluated in a randomised blind study in 20 ASA status I-II, 50-80 yr-old patients, undergoing unilateral spinal anaesthesia for leg surgery produced with low doses of hyperbaric bupivacaine. METHODS: Baseline non-invasive blood pressure (oscillometry), heart rate, stroke volume and cardiac index (transthoracic electrical bioimpedance) were recorded. Then, patients were randomly allocated to receive 10 ml.kg-1 Ringer's Lactate solution over 20 min (preload group, n = 10) or no crystalloid infusion (no-preload group, n = 10). Spinal block was performed using 8 mg hyperbaric bupivacaine 0.5% injected slowly at the L2-L3 interspace (0.02 ml.sec-1 through a 25-gauge Whitacre needle) with patients lying on their operated side and with the needle opening directed towards the dependent side. Lateral decubitus position was maintained for up to 15 min after anaesthetic injection to facilitate hyperbaric bupivacaine distribution towards dependent regions of the subarachnoid space. Haemodynamic variables were recorded 5, 10, 15 and 30 min after spinal injection, while sensory level and motor block were evaluated 10, 15 and 30 min after anaesthetic injection on both operated and unoperated side. RESULTS: No differences of upper sensory level and motor block were observed between the two groups on the operated and non-operated sides. Diastolic blood pressure was decreased compared with baseline in the no-preload group only (P = .0001). Systolic arterial pressure and heart rate did not change in either group. Stroke volume and cardiac index were decreased in the no-preload group compared with both baseline (P = .02; P = .001) and the preload group (P = .04; P = .02). CONCLUSION: Crystalloid preload influences cardiovascular function during spinal block, and may be useful when very low bupivacaine doses and lateral decubitus are used to achieve unilateral spinal block.

Aged↗
PubMed2006

[Propofol to facilitate spinal anesthesia in the lateral position in patients with femoral neck fracture].

PURPOSE: The aim of this study was to assess the feasibility and efficacy of propofol before positioning elderly patients with a femoral neck fracture in the lateral decubitus position, to perform a spinal anesthetic. METHODS: In this prospective and descriptive study, 79 consecutive patients, > 75 yr old, with a femoral neck fracture were included. Propofol, 0.5 mg x kg(-1), was administered. If loss of consciousness was not obtained (Ramsay score < or = 3/6), then additional doses of 0.25 mg x kg(-1) were given until a Ramsay score of 4 or 5 was attained. Then, the patient was turned to the lateral decubitus position, the fractured side up. The efficacy of propofol was assessed by observing a grimace during positioning and asking the patients if they had recall of pain. Hemodynamic data and oxygen saturation were collected. RESULTS: Forty-three patients required a single injection, 34 required two injections and only two patients required three injections. No grimace and no recall of pain were recorded during the study. There was no desaturation (SpO(2) < 92 %), and hypotension, defined as a systolic blood pressure decrease > 30% from baseline, was observed. CONCLUSION: Propofol is a simple and efficacious means of providing comfort while positioning elderly patients with a femoral head fracture before performing spinal anesthesia.

Aged↗
PubMed1997

[The trochanteric flip osteotomy.].

GOAL OF SURGERY: Easy access to the posterior, superior and anterior joint capsule through an osteotomy which reduces the risk of complications and the incidence of non-union. INDICATIONS: Hip joint revision with or without intertrochanteric osteotomy, periarticular ossifications, difficult total hip procedures, exchange procedures. CONTRAINDICATIONS: Absolute: None Relative: Distal transfer of the trochanter. PREOPERATIVE WORK UP: Radiographs in 2 planes (anterior-posterior pelvis+"false profile" hip). POSITIONING AND ANAESTHESIA: Lateral decubitus. General anaesthesia. SURGICAL TECHNIQUE: In lateral decubitus the greater trochanter will be osteotomized from posterior leaving a 1 to 1.5 cm thick bony wafer uniting the insertion of the gluteus medius and minimus with the origin of the vastus lateralis. The trochanteric crest remains untouched. After refixation with nonresorbable sutures #3 the fragment is not subjected to a unidirectional tension by the abductors which could interfere with the consolidation. POSTOPERATIVE MANAGEMENT: Bed rest with lower limb in neutral position. Mobilization with 2 canes on the 2nd postoperative day. The timing of partial weight bearing depends on the type of surgery. Abductor exercises after 6 weeks. POSSIBLE COMPLICATIONS: Bony wafer too thin or too thick. Inadequate refixation. Delayed consolidation. Cranial migration of the greater trochanter. RESULTS: Between 1991 and 1994 41 patients were operated. Diagnoses, see Table 1. Method of refixation: see Table 2. After 21+/-9 months 39 patients could be reexamined clinically, and radiological after 17+/-11 months: 38 osteotomies consolidated. Cranial migration varied between 0 and 8 mm. 25 patients were free of symptoms, 12 had slight and 2 moderate pain over the trochanter. Avulsion of wire cerclage: 2, foreign body irritation: 2 necessitating implant removal.

English Abstract↗
PubMed2006

[Interface pressure measurement in the treatment of pressure sores. Comparison with subcutaneous pressure values measured in healthy volunteers].

BACKGROUND: Pressure relief is an important factor to determine the quality of anti-decubitus devices. Many studies have been carried out to measure the interface pressure, but because the results differed markedly, we made a study to assess the measurement devices. METHODS: The systems FSA, a device for internal use in the Lück company, the X-Sensor and an invasive subcutaneous pressure measurement over the os-sacrum (COACH: piezoelectric probe, MIPM) were tested on 20 healthy volunteers (average age 27 years, average BMI 21.8). RESULTS: The values of interface measurement showed obvious deviations from subcutaneous pressure in two cases (FSA +1.8%, Lück -33%, X-Sensor +65%) and some results showed extreme variations (FSA +18 mmHg, Lück -21 mmHg, X-Sensor +27 mmHg). CONCLUSIONS: The interface pressure measurement (with a few volunteers) is not suitable for a correct assessment of anti-decubitus devices. Furthermore, the use of this method is not necessary to monitor pressure relief in intensive care patients. These systems can, however be useful in the training of nursing staff.

Adult↗