Tag: pressure ulcer

Effect of Flap Selection on the Postoperative Success of Sacral Pressure Injuries: A Retrospective Analysis

Pressure injuries (PIs) continue to be a substantial problem and burden for the present-day health care system and are the leading cause of chronic wounds worldwide. There is no current consensus on the long-term results of the use of flaps in sacral PI reconstruction and optimal flap choice. Objective. This study aimed to evaluate whether flap selection influences postoperative results in sacral PI reconstruction. Materials and Methods. Patients who underwent surgery for PIs in the authors’ clinic between 2002 and 2016 were retrospectively analyzed. A total of 63 patients with stage 3/stage 4 sacral PIs and who underwent reconstruction with fasciocutaneous (FC) flaps (group 1), musculocutaneous (MC) flaps (group 2), or perforator (P) flaps (group 3) were included in the study. The mean duration of the follow-up period was 14.4 months, and patients were evaluated in terms of their demographic data … read more

Pressure Injury Prevention, Is It All About Protein?

by Nancy Munoz, DCN, MHA, RDN, FAND

 

The National Pressure Ulcer Advisory Panel (NPUAP) defines a pressure injury as localized damage to the skin and/or underlying soft tissue, usually over a bony prominence or related to a medical or other device. The injury can manifest as intact skin or an open ulcer and may be painful. The injury occurs as a result of intense and/or prolonged pressure, occasionally in combination with shear. The tolerance of soft tissue for pressure and shear may also be affected by microclimate, nutrition, perfusion, comorbidities, and the condition of the soft tissue.

 

Pathophysiologic and intrinsic factors at the core of pressure injury development include nutrition. Maintaining adequate nutrition is considered a best practice for both the prevention and treatment of pressure injuries. Individuals with or at risk for developing pressure injuries should strive to achieve or maintain adequate nutrition parameters … read more

Inflammation in Chronic Wounds

Non-healing chronic wounds present a major biological, psychological, social, and financial burden on both individual patients and the broader health system. Pathologically extensive inflammation plays a major role in the disruption of the normal healing cascade. The causes of chronic wounds (venous, arterial, pressure, and diabetic ulcers) can be examined through a juxtaposition of normal healing and the rogue inflammatory response created by the common components within chronic wounds (ageing, hypoxia, ischaemia-reperfusion injury, and bacterial colonisation). Wound bed care through debridement, dressings, and antibiotics currently form the basic mode of treatment. Despite recent setbacks, pharmaceutical adjuncts form an interesting area of research.

 

The skin forms an important and effective barrier against the environment. It plays a vital role in protection against insults such as bacteria, xenobiotics and dehydration. When a cutaneous injury occurs, the body initiates a series of complex events to re-establish this protection. Wound healing can be roughly divided into four continuous and overlapping phases: (1) haemostasis; (2) an immediate inflammatory response defined by an infiltration of cytokine-releasing leukocytes with antimicrobial functions; (3) these cytokines kick off a proliferative phase where new epithelium, blood vessels, and extracellular matrix (ECM) are laid down; (4) over a period of weeks to months, the wound contracts as the ECM is remodelled []. These highly regulated cellular, humoral and molecular processes have been described as an orchestral performance—a potential flawless interplay can lead to perfect regeneration; however, human adult wounds undergo a repair process that leads to scarring, and, in some cases, non-healing chronic wounds ….  read more