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The wet-to-dry phase is a method of cleansing that acts as an alternative to rinsing prior to the application of a modern wound dressing. Debris, exudate and pathogens are removed from the wound, reducing itching and inflammation.
In clinical practice, we have come across people with intellectual disability who have gender dysphoria and cross-dress. Here, we review the literature on this subject and present an illustrative case example. We searched databases, followed-up references from relevant articles, and contacted colleagues in the field. We found nine papers with case examples and one survey. Gender identity problems certainly occur in people with intellectual disabilities, and developmental perspectives are important in assessing and treating them. In some cases autistic spectrum disorder was co-morbid, for individuals with and those without intellectual disability. Aggression was also common. Documented treatments were primarily psychological and social and did not include hormones and sex reassignment surgery. Capacity to consent is a factor that determines treatment.
The article describes an older, simple, and effective method of postoperative fixation of the palatal flaps using celluloid-acetone dressing (CAD). Veau pedicle flaps and the construction of two nasal meatuses are used for the palatoplasty. After the surgery, a wire is round around teeth IV and V on each side: a prolene mattress suture, instead of wire, is used for infants without teeth. A celluloid-acetone paste is applied to the wire or suture over a layer of gauze and petroleum jelly. The CAD mixture hardens in less than 1 hour and is removed after 4 days by cutting the wire or suture. This method prevents the palatal flaps from descending; scar tissue is minimal, and assists in the formation of a high-arched roof of the palate. In addition, the patient feeds normally after the operation.
The incidence of candidiasis in two groups of voluntary participants wearing tight and loose fitted dresses was investigated by both microscopic and cultural techniques for a period of two months. Two-thirds of the positives by stain and culture were recovered from those wearing tight clothing (P < 0.05). The findings suggest that tight clothing can predispose the wearer to candidiasis, an organism that can cause vaginitis. (Am J Public Health 1982; 72:176-177.)
Candida albicans colony counts were far higher in patients with vaginitis wearing tight fitting clothing than in patients wearing loose fitting clothing. In Ile-Ife, Nigeria, tight fitting dresses, woolen and corduroy jeans, coupled with nylon underwear, appear to create an environment favorable to Candida albicans colonization.
We report a case with portal systemic encephalopathy who presented with dressing and constructional apraxia and subtle weakness of the left hand. We initially suspected a cerebrovascular attack in the right cerebral hemisphere, but brain T1-weighted magnetic resonance (MR) imaging revealed high intensity in the basal ganglia and hyperammonemia was detected. We performed abdominal MR angiography, which visualized an intrahepatic portal systemic shunt. Cerebral blood flow, measured by xenon-enhanced computed tomography, was decreased in the bilateral, but more dominantly right-sided, parietal watershed regions. We speculate that these boundary territories might be susceptible to damage by toxic metabolites of hepatic encephalopathy.
Subjects indicated the likelihood that a female, photographed in eight situations, would be raped. The situations were created by the Cartesian product of her dress (seductive/nonseductive), posture (aggressive/nonaggressive), and setting (inside/outside). The three variables combined additively with the highest subjective probability of rape associated with the seductive/nonaggressive/outside condition.
The purpose of this study was to explore the effects of a male teacher's clothing and selected students' characteristics on students' perceptions of teachers' characteristics. The sample consisted of 152 male and female high school students. Respondents selected one of four photographs of a male teacher model dressed in four different clothing styles for each of 20 teachers' characteristic statements. The mediating effects of students' gender, formality of clothing, and perceptions of the importance of clothing were also investigated. Significant differences among the four clothing styles were found for all 20 statements. Students' gender and rated importance of clothing had some influence on this relationship. The results supplement previous research on female teachers by suggesting that different types of clothing also influence students' perceptions of male teachers and that students' characteristics have some mediating effect.
This case note concerns an elderly amputee who presented with delayed healing in the stump. The use of a Silastic foam dressing is described which allowed both prosthetic fitting and final healing to occur simultaneously. The patient's stump ultimately healed and the subject was successfully discharged home walking with his prosthesis.
Between 27 January and 7 February 2002, 12 cases of Salmonella Potsdam infection were notified to NSW Health of which nine were residents of the Hunter Health Area. Interviews with two cases notified by two local doctors initiated the investigation and revealed exposure to foods from the same restaurant (restaurant A). All New South Wales S. Potsdam cases, those accompanying cases to restaurant A and people from restaurant A booking lists were interviewed. Of the 34 people interviewed, 17 met the case definition. The epidemiological investigation did not detect a food source of S. Potsdam infection, however, shell egg-based Caesar salad dressing and mayonnaise, and a swab of a cap from a mayonnaise bottle collected at restaurant A tested positive for S. Potsdam. Environmental and laying hen feed samples from the egg supplier to restaurant A and meat meal, (the major component of laying hen feed) tested positive for various Salmonella serotypes. The investigation identified problems of inadequate cleaning, time-temperature abuse, and ignorance of the hazardous nature of raw shell eggs at the restaurant level, poor sanitation and a lack of hygiene inspections at the egg production level, and problems with cleaning, storage and lack of bacterial monitoring of final product at the animal rendering plant. Investigation of 12 notified cases of Salmonella resulted in public health interventions, which likely prevented further cases of foodborne disease due to Salmonella and other pathogens in the Hunter Health Area and elsewhere in New South Wales.
This prospective, controlled study compared cold compressive dressings with wool and crepe in the postoperative management of patients undergoing total knee replacement (TKR). Forty TKR patients were assessed for blood loss, pain, swelling, and range of motion. Patients in the cold compression group had less blood loss through suction drainage (982 mL versus 768 mL). A higher proportion of patients in the treatment group did not require blood transfusion postoperatively. Mean opiate requirements were lower in the cold compression group (0.57 versus 0.71 mg/kg/48 hours). The cold compression device appeared to reduce blood loss and pain following TKR.
In demented persons, activities of daily living skills may deteriorate more quickly than their cognitive decline warrants because caregivers do not allow them to perform ADLs to the full extent of their abilities. Caregiver actions that promote independent behaviors were used with subjects in home and nursing home settings. Four of five home subjects showed decreased caregiver assistance and increased ability to dress more independently. Although nursing home subjects did not show a decrease in caregiver assistance, observation showed that some nursing home caregivers did incorporate behavioral strategies, suggesting potential clinical efficacy of the strategies.
Wound care presents a particular challenge in the critical care setting. Decisions about how to cleanse a wound and which dressing to use are often complicated by unexpected changes in the patient's condition, or the sudden occurrence of a wound infection. In this high-risk patient population, timely changes in topical therapy often can mean the difference between a wound that heals, or one that rapidly deteriorates. Much of the confusion over wound care and wound care products can be minimized by using a systematic approach to wound assessment. This chapter describes such an approach and summarizes local treatment options based on wound appearance.
Pathogen prions are widely recognized as the causative agent in bovine spongiform encephalopathy (BSE) and other transmissible spongiform encephalopathies. However, more research on the possible transmission mutes of this agent once it has reached the host is needed. There is evidence based on the anatomy and physiology of the autonomous nervous system (ANS), as well as observations for different animal species, that the ANS might be involved in the axonal drainage of pathogen prions toward the central nervous system. In this context, more attention should be paid to the cranial cervical ganglion, the stellate ganglion, the chain of paravertebral ganglia next to the first six thoracic vertebrae, the chain of the paravertebral ganglia next to loin vertebrae 1 through 6, the vagus nerve in the neck region and in the mediastine, and the esophagus (because of its close connection to the vagus nerve). For a more detailed risk analysis with respect to these tissues, the ANSs of animals having shown clinical signs of BSE might be examined to corroborate the evidence presented here. In the meantime, as a precautionary measure, the tissue addressed should be taken out of the human food chain, taken out of animal feed, and handled as if it were specified risk material. It is technically possible to remove these parts during cutting and dressing.
To determine the principal points of microbial contamination of carcasses during beef carcass dressing in Northern Ireland, 190 carcasses were sampled by swabbing 1,000 cm2 of the brisket. A detailed survey of one abattoir was initially conducted, with sampling of a total of 100 carcasses immediately after hide removal (H), after carcass splitting (S), and immediately after washing (W) before dispatch to the chiller. The total bacterial counts after incubation at both 22 and 37 degrees C indicated that there was no significant increase in the numbers of bacteria after the first sampling point, H (P > 0.05). To determine whether this was the case in the majority of Northern Ireland abattoirs, 15 carcasses were then sampled at each of an additional six abattoirs, at points H and W only. Total bacterial counts were significantly higher (P < 0.05) at H than at W, indicating that hide pulling was the major point of bacterial contamination of beef carcasses and hence a critical control point for the final microbiological quality of the carcasses. Mean counts of Enterobacteriaceae at both incubation temperatures were very low (< 10 CFU/cm2) but were higher at W than at H, probably indicating that washing was redistributing bacteria from the posterior to the anterior region.
Changing a surgical wound dressing is a traditional nursing task that incorporates many areas of nursing knowledge. This article describes the construction of a concept map to sort the subjective, objective and constructed knowledge required to perform this task with optimal wound healing the goal. Critical thinking is used to select and exclude information. The use of concept maps as a tool to synthesise knowledge is discussed as is how the chosen concept incorporates the art and science of nursing care. The concept map displays the wholistic assessment of the client and use of nursing knowledge to determine and promote wound healing.
The factory-based permethrin coating technique has only recently been developed. Consequently, no data are available on residual activity, laundering, and weathering resistance in impregnated battle dress uniforms (BDUs) worn under military deployment conditions, or on the cross-contamination potential of such uniforms. Herein, factory-impregnated BDUs worn-out during military deployment to Afghanistan were investigated for residual permethrin concentration, residual efficacy against arthropod vectors, and cross-contamination during laundering and storage. When compared with BDUs subjected to 50 defined washings using the U.S. Insect/Arthropod Repellent Fabric Treatment method, no significant differences in efficacy were observed against Aedes mosquitoes, but remaining knockdown activity in Ixodes ticks was significantly better in polymer-coated BDUs. BDUs impregnated by the polymer-coating method were found to be effective for the life of the uniform, ensuring protection of soldiers in the field from arthropod vectors, while causing less cross-contamination than those treated by the Insect/Arthropod Repellent Fabric Treatment method.
The history of surgical wound management illustrates how dressings have evolved over the years and sets the scene for modern wound-healing products. The aim of this article is to discuss the management of surgical wounds and the value of wound-healing products for carers and patients in the current healthcare climate of cost-efficacy and clinical governance.