Application of self-made anti-pressure sore cotton cover in preventing facial pressure injury in patients with non-invasive ventilation / 中华危重病急救医学

Objective:To observe the application effect of self-made anti-pressure sore cotton cover on the prevention of facial pressure injury in patients with non-invasive ventilation, and to explore the effective method of preventing facial pressure injury.Methods:A prospective study was conducted. Patients with mild to moderate respiratory failure and non-invasive ventilation admitted to the department of intensive care medicine of Harisen International Peace Hospital Affiliated to Hebei Medical University from March 2020 to August 2021 were enrolled, and they were divided into gauze pad group, foam dressing group and self-made anti-pressure ulcer cotton cover group by random number table method. Before wearing the ventilator mask, the gauze pad group and the foam auxiliary dressing group should fold or cut out the auxiliary dressing with the corresponding size and suitable for the patient's facial contour. In the self-made anti-pressure sore cotton cover group, the ventilator cotton cover could be worn only by selecting the cotton cover suitable for the patient's face shape, aligning the vent to the mouth and nose, and tying the fixed belt behind the ear. The incidence of facial pressure sore, the time required to connect man-machine interface (from the preparation of auxiliary dressing for pressure sores to the connection of ventilator) and the cost of dressing were compared among the three groups.Results:A total of 150 patients with non-invasive ventilation were enrolled, with 50 patients in each group. Compared with the gauze pad group and the foam dressing group, the incidence of facial pressure sore in the self-made anti-pressure sore cotton cover group was significantly reduced [6.0% (3/50) vs. 44.0% (22/50), 12.0% (6/50), both P < 0.05], and the time required to connect the man-machine interface was significantly shortened (minutes: 5.0±1.5 vs. 10.0±1.5, 8.0±2.0, both P < 0.05), dressing cost was significantly reduced (yuan: 30±10 vs. 150±20, 118±29, both P < 0.05). Conclusion:Compared with the gauze pad and the foam dressing, the incidence of facial pressure sore in non-invasive ventilation patients with self-made anti-pressure sore cotton cover is lower, the time required to connect man-machine interface is shorter, and the cost of pressure sore prevention dressing is less, which is suitable for the prevention of facial pressure injury in non-invasive ventilation patients.

Effect of sports fatigue on plantar pressure distribution of healthy male college students / Efeito da fadiga esportiva na distribuição da pressão plantar de estudantes universitários masculinos saudáveis / Efecto de la fatiga deportiva sobre la distribución de la presión plantar en estudiantes universitarios masculinos saludables

ABSTRACT Objective: To understand the influence of sports fatigue on plantar pressure distribution of healthy male college students and provide a theoretical basis for improving their awareness of foot health. Methods: Forty-nine ordinary male college students jogged along the 800-meter runway to moderate fatigue. All the subjects took off their shoes and socks and walked naturally with their usual gait. The dynamic plantar pressure of each foot was measured twice in one step. FootscanUSB2 Belgian flat-plate plantar pressure testing system was used for testing. Results: The average dynamic peak plantar pressure was (206.38 44.59) N for boys, and the changes of AA and CB walking speed in the arch did not change significantly. After fatigue, the peak pressure of FM, AA, RH5 in left foot and FM, AA, CB in right foot decreased significantly (P < 0.05, P < 0.01). The peak time of RH and CB in the left foot was significantly shorter than that before fatigue (P < 0.05, P < 0.01), while FMF, AA, C areas had no significant change but tended to be delayed. There were significant differences in peak force-time between boys' left and right feet except for the fifth metatarsal bone (P < 0.05). There is a significant difference in the peak force-time between the second and fifth toes of the left foot (P< 0.01), and there is a gender difference in the peak force-time between the second metatarsal and the third metatarsal (P < 0.05). Conclusion: Sports fatigue leads to the decrease of physiological functions such as muscle strength of lower limbs, which leads to the corresponding changes in gait stages, plantar pressure distribution parameters, and foot balance. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Objetivo: Entender a influência da fadiga esportiva na distribuição da pressão plantar de estudantes universitários masculinos saudáveis e fornecer uma base teórica para melhorar sua consciência sobre a saúde dos pés. Métodos: Quarenta e nove estudantes universitários masculinos comuns correram ao longo da pista de 800 metros para moderar a fadiga. Todos os sujeitos tiraram seus sapatos e meias e caminharam naturalmente com sua marcha habitual. A pressão plantar dinâmica de cada pé foi medida duas vezes em um único passo. O sistema de teste de pressão plantar de placa plana belga FootscanUSB2 foi usado para testes. Resultados: A pressão plantar dinâmica média de pico foi (206.38 44.59) N para meninos, e as alterações de velocidade de caminhada AA e CB no arco não mudaram significativamente. Após a fadiga, a pressão de pico de FM, AA, RH5 no pé esquerdo e FM, AA, CB no pé direito diminuiu significativamente (P < 0,05, P < 0,01). O tempo de pico de RH e CB no pé esquerdo foi significativamente menor do que antes da fadiga (P < 0,05, P < 0,01), enquanto as áreas FMF, AA, C não tiveram nenhuma mudança significativa, mas tenderam a ser atrasadas. Havia diferenças significativas no tempo de pico de força entre o pé esquerdo e direito dos meninos, exceto para o quinto metatarso (P < 0,05). Houve uma diferença significativa no tempo de pico de força entre o segundo e o quinto dedos do pé esquerdo (P< 0,01), e há uma diferença de gênero no tempo de pico de força entre o segundo metatarso e o terceiro metatarso (P < 0,05). Conclusão: A fadiga esportiva leva à diminuição das funções fisiológicas, tais como a força muscular dos membros inferiores, o que leva às mudanças correspondentes nos estágios de marcha, parâmetros de distribuição da pressão plantar e equilíbrio do pé. Nível de evidência II; Estudos terapêuticos - investigação de resultados de tratamento.

RESUMEN Objetivo: Comprender la influencia de la fatiga deportiva en la distribución de la presión plantar de los estudiantes universitarios varones sanos y proporcionar una base teórica para mejorar su conciencia sobre la salud de los pies. Métodos: Cuarenta y nueve estudiantes universitarios varones normales trotaron a lo largo de una pista de 800 metros hasta alcanzar una fatiga moderada. Todos los sujetos se quitaron los zapatos y los calcetines y caminaron de forma natural con su marcha habitual. Se midió la presión plantar dinámica de cada pie dos veces en un único paso. Para las pruebas se utilizó el sistema belga de pruebas de presión plantar FootscanUSB2. Resultados: El promedio de la presión plantar dinámica máxima fue de (206.38 44.59) N para los niños, y los cambios de la velocidad de marcha AA y CB en el arco no cambiaron significativamente. Después de la fatiga, la presión máxima de FM, AA, RH5 en el pie izquierdo y de FM, AA, CB en el pie derecho disminuyó significativamente (P < 0,05, P < 0,01). El tiempo de pico de RH y CB en el pie izquierdo fue significativamente menor que antes de la fatiga (P < 0,05, P < 0,01), mientras que las áreas FMF, AA, C no tuvieron cambios significativos, pero tendieron a retrasarse. Hubo diferencias significativas en el pico de fuerza-tiempo entre los pies izquierdo y derecho de los niños, excepto en el quinto hueso metatarsiano (P < 0,05). Hay una diferencia significativa en el pico de fuerza-tiempo entre el segundo y el quinto dedo del pie izquierdo (P < 0,01), y hay una diferencia de género en el pico de fuerza-tiempo entre el segundo metatarsiano y el tercer metatarsiano (P < 0,05). Conclusión: La fatiga deportiva conduce a la disminución de funciones fisiológicas como la fuerza muscular de los miembros inferiores, lo que conlleva los correspondientes cambios en las fases de la marcha, los parámetros de distribución de la presión plantar y el equilibrio del pie. Nivel de evidencia II; Estudios terapéuticos - investigación de resultados de tratamiento.

Factors Associated with Medical Device Related Pressure Ulcer Caused by Ankle Foot Orthosis / The Japanese Journal of Rehabilitation Medicine

Purpose：We investigated the factors associated with medical device-related pressure ulcer (MDRPU) due to lower extremity orthosis in patients undergoing convalescent rehabilitation for stroke.Methods：This retrospective study included patients with stroke who wore ankle foot orthosis in the convalescent rehabilitation ward. We measured the following items at admission：Brunnstrom recovery stage, presence of sensory disturbance, exhibition of unilateral spatial neglect, functional independence measures at admission and discharge, and presence of MDRPU. In the statistical analysis, logistic regression analysis was performed to identify the significant factors associated with MDRPU.Results：Ninety-five participants were enrolled in this study (mean age：54.9 ± 11.6 years, Male：78.9%). In logistic regression analysis, Age (odds ratio＝1.05, 95% confidence interval＝1.01-1.10, p＜0.05) and the presence of sensory disturbance (odds ratio＝5.17, 95% confidence interval＝1.39-19.28, p＜0.05) at admission was extracted as the cause of MDRPU.Conclusion：Sensory disturbance at admission is associated with MDRPU in patients undergoing convalescent rehabilitation for stroke who wear ankle foot orthosis.

Factors Associated with Medical Device Related Pressure Ulcer Caused by Ankle Foot Orthosis / The Japanese Journal of Rehabilitation Medicine

Purpose：We investigated the factors associated with medical device-related pressure ulcer (MDRPU) due to lower extremity orthosis in patients undergoing convalescent rehabilitation for stroke.Methods：This retrospective study included patients with stroke who wore ankle foot orthosis in the convalescent rehabilitation ward. We measured the following items at admission：Brunnstrom recovery stage, presence of sensory disturbance, exhibition of unilateral spatial neglect, functional independence measures at admission and discharge, and presence of MDRPU. In the statistical analysis, logistic regression analysis was performed to identify the significant factors associated with MDRPU.Results：Ninety-five participants were enrolled in this study (mean age：54.9 ± 11.6 years, Male：78.9%). In logistic regression analysis, Age (odds ratio＝1.05, 95% confidence interval＝1.01-1.10, p＜0.05) and the presence of sensory disturbance (odds ratio＝5.17, 95% confidence interval＝1.39-19.28, p＜0.05) at admission was extracted as the cause of MDRPU.Conclusion：Sensory disturbance at admission is associated with MDRPU in patients undergoing convalescent rehabilitation for stroke who wear ankle foot orthosis.

Características sociodemográficas de los pacientes con úlceras por presión infectadas y su perfil microbiológico. Serie de casos / Sociodemographic characteristics of patients with pressure ulcers and their microbiological profile. A case series

Introducción Las ulceras por presión (UPP) son una condición frecuente en los pacientes con movilidad restringida, su sobreinfección implica un esfuerzo adicional en el tratamiento, ya que se asocia a complicaciones como osteomielitis crónica y sepsis. El objetivo del estudio es describir las características clínicas y sociodemográficas de los pacientes con UPP enfatizando en el perfil microbiológico de aquellos con sobreinfección. Materiales y métodos Se realizó un estudio descriptivo retrospectivo que incluyó a 76 pacientes adultos con diagnóstico de UPP sobreinfectadas sometidos a cirugía entre 2013 y 2015. Se obtuvo información demográfica, clínica y microbiológica. Se describieron los resultados según la naturaleza de la variable. Resultados De los 76 pacientes, 56 (73.7%) fueron hombres. La mediana de edad fue de 45 años. La mediana de hospitalización fue de 22.5 días, el principal motivo de inmovilidad fue la lesión medular (69,7%). Los patógenos más comunes fueron Enterococcus faecalis (46%), Escherichia coli (43.4%), Streptococcus spp (35.5%) y Proteus spp (30.2%). En el 77,6% de los pacientes se aislaron dos o más microorganismos en los cultivos. Discusión La lesión medular en la condición más asociada a ulceras por presión en nuestro medio, principalmente en hombres jóvenes. La sobreinfección generalmente es polimicrobiana, lo que nos muestra la gran importancia de los cultivos para poder realizar un tratamiento específico y efectivo. Al conocer las características clínicas y demográficas se pueden direccionar estrategias de prevención y rehabilitación que impacten de manera positiva en la calidad de vida de los pacientes y la sostenibilidad del sistema de salud. Nivel de evidencia IV

Background Pressure ulcers (PU) are a frequent condition in patients with restricted mobility. Their infection requires an additional effort in the treatment, since it is associated with complications, such as chronic osteomyelitis and sepsis. The aim of this study is to describe the clinical and sociodemographic characteristics of patients with PU, emphasising the microbiological profile of those with infection. Materials and methods A retrospective descriptive study was carried out on 76 adult patients diagnosed with infected PU who underwent surgery between 2013 and 2015. Demographic, clinical, and microbiological information was obtained. The results were described according to the nature of the variable. Results Of the 76 patients, 56 (73.7%) were men. The median age was 45 years. The median number of days hospitalised was 22.5 days, and the main cause of immobility was spinal cord injury (69.7%). The most common pathogens were Enterococcus faecalis (46%), Escherichia coli (43.4%), Streptococcus spp (35.5%), and Proteus spp (30.2%). Two or more microorganisms were isolated in the cultures in 77.6% of the patients, Discussion Spinal cord injury is the condition most associated with pressure ulcers in this study, mainly in young men. Infection is usually polymicrobial, which shows the great importance of the cultures, in order to be able to carry out a specific and effective treatment. By knowing the clinical and demographic characteristics, prevention and rehabilitation strategies can be directed at having a positive impact on the quality of life of PU patients, and the sustainability of the health care system. Evidence Level IV

Effectiveness of anti-pressure protective mask for medical personnel fighting against coronavirus disease 2019 / 第二军医大学学报

Objective To evaluate the effectiveness of anti-pressure protective mask for medical personnel fighting against the coronavirus disease 2019 (COVID-19). Methods Convenience sampling method was used to select 120 military frontline anti-epidemic medical personnel supporting Wuhan medical team from Jan. 26 to Feb. 24, 2020, and they were evenly divided into blank group, control group and observation group. The blank group did not use anti-pressure dressings, the control group wore face protection equipments after using hydrocolloid dressings, and the observation group wore face protection equipments after using anti-pressure protective mask. At the end of the intervention, the facial comfort, facial pressure injuries, and adverse effects were compared between the three groups. Results At the end of the intervention, the facial comfort score was 6.00 (6.00, 7.00) in the blank group, 5.00 (4.00, 5.00) in the control group, and 1.00 (0.50, 2.00) in the observation group, with significant differences found among the three groups (H=97.392, P<0.001). According to the further inference of the rank mean, the blank group had the largest facial comfort rank mean (96.68), while the observation group had the smallest facial comfort rank mean (20.88). At the end of the intervention, three cases (7.5%, 3/40) in the blank group had no facial injury, 28 cases (70.0%, 28/40) had facial pressure injury at stage 1, and nine cases (22.5%, 9/40) at stage 2; 27 cases (67.5%, 27/40) in the control group had no facial injury and 13 cases (32.5%, 13/40) had facial pressure injury at stage 1; 37 cases (92.5%, 37/40) in the observation group had no facial injury and three cases (7.5%, 3/40) had facial pressure injury at stage 1. There was significant difference in the incidence of facial pressure injuries among the three groups (χ2=71.863, P<0.001). The observation group had the lowest facial pressure injury rate among the three groups. There was no skin allergic reaction in the three groups and none of them was infected with COVID-19. Conclusion Anti-pressure protective mask can effectively reduce the incidence of facial pressure injuries and improve the facial comfort when wearing facial protective equipment, and it can be used for protecting frontline anti-epidemic medical personnel.

Effect of rotating and advancing gluteal superior and inferior perforator artery island flap on gluteal pressure sore / 中华医学美学美容杂志

Objective To explore the clinical effect of gluteal pressure sore repaired by superior and inferior perforating artery island flap with rotation and joint propulsion.Methods From January 2014 to April 2018,37 patients (27 males,10 females,aged 35～79 years) with hip decubitus were admitted to the First People's Hospital of Yulin City for treatment of hip decubitus.According to the situation of the wound surface,the perforating site of superior and inferior perforator arteries and the local soft tissue,the corresponding perforator arteries were selected as the pedicle to form island skin flap,and the wound surface was transferred by rotation and propulsion.Results All the flaps sur vived well.33 cases healed in the first stage,but 4 cases dehisced and infected in the incision.After dressing change,the wounds healed in the second stage and the wounds were locally smooth.Conclusions The rotational combined push type gluteal superior and inferior perforator island flap is a good method to repair gluteal pressure sore.

Application of ACMMM management model in elderly patients with unsafe events / 中国实用护理杂志

Objective@#To explore the application of ACMMM management model in elderly patients with unsafe events.@*Methods@#A retrospective analysis of elderly patients who had been hospitalized for more than three months at the Chinese People′s Liberation Army General Hospital from May 2017 to May 2018 was performed. According to the patient′s hospitalization time, they were divided into group A and group B. Group A was hospitalized between May 2016 and May 2017 (n=1 258), and group B was hospitalized between June 2017 and May 2018 (n=1 309). Patients in group A were given routine nursing intervention, and patients in group B were combined to implement ACMMM management model intervention on the basis of routine nursing intervention. The incidence of various types of unsafe events in the two groups of patients was compared. The severity of the fall in the two groups of patients was compared. Comparison of nursing satisfaction between the two groups of patients.@*Results@#In group A, 47 patients had unsafe events, 11 patients in group B had unsafe events, and group A had higher incidence of unsafe events than group B (χ2=24.358, P<0.05). In group A, the frequency of pressure sores and burns was higher than that of group B (χ2=7.966, 4.353, 5.800, P<0.05). There was no statistically significant difference in the frequency of occurrence of falling, suffocation, self-injury, and misuse between the two groups (P>0.05). The severity of patients with falls in group A was higher than that in group B (Z=-2.124, P<0.05). The satisfaction of nursing in group B was 79.53%(1 041/1 309), the satisfaction of nursing in group A was 57.15%(719/1 258), and the satisfaction degree in group B was better than that in group A. The data were statistically significant (Z=-15.238, χ2=148.962, P <0.05).@*Conclusions@#The use of ACMMM management model for long-term hospitalized elderly patients with nursing intervention can effectively reduce the incidence of unsafe events in elderly patients, reduce the severity of falls and other related injuries, and effectively improve patient care satisfaction.

Application of ACMMM management model in elderly patients with unsafe events / 中国实用护理杂志

Objective To explore the application of ACMMM management model in elderly patients with unsafe events. Methods A retrospective analysis of elderly patients who had been hospitalized for more than three months at the Chinese People′s Liberation Army General Hospital from May 2017 to May 2018 was performed. According to the patient′s hospitalization time, they were divided into group A and group B. Group A was hospitalized between May 2016 and May 2017 (n=1 258), and group B was hospitalized between June 2017 and May 2018 (n=1 309). Patients in group A were given routine nursing intervention, and patients in group B were combined to implement ACMMM management model intervention on the basis of routine nursing intervention. The incidence of various types of unsafe events in the two groups of patients was compared. The severity of the fall in the two groups of patients was compared. Comparison of nursing satisfaction between the two groups of patients. Results In group A, 47 patients had unsafe events, 11 patients in group B had unsafe events, and group A had higher incidence of unsafe events than group B (χ2=24.358, P<0.05). In group A, the frequency of pressure sores and burns was higher than that of group B (χ2=7.966, 4.353, 5.800, P<0.05). There was no statistically significant difference in the frequency of occurrence of falling, suffocation, self-injury, and misuse between the two groups (P>0.05). The severity of patients with falls in group A was higher than that in group B (Z=-2.124, P<0.05). The satisfaction of nursing in group B was 79.53% (1 041/1 309), the satisfaction of nursing in group A was 57.15%(719/1 258), and the satisfaction degree in group B was better than that in group A. The data were statistically significant (Z=-15.238, χ2=148.962, P <0.05). Conclusions The use of ACMMM management model for long-term hospitalized elderly patients with nursing intervention can effectively reduce the incidence of unsafe events in elderly patients, reduce the severity of falls and other related injuries, and effectively improve patient care satisfaction.

Research progress of combined of traditional Chinese medicine and western medicine in the treatment of pressure sore / 中国医学装备

Pressure sores are a kind of damage that results from the sustained ischemia and hypoxia in skin and subcutaneous tissue because local tissue was pressed. Because its treatment is difficult, its treatment process is long and other characteristics, the prevention and treatment have become the important point of clinical nursing work. In this paper, the databases of CNKI, Wanfang and Weipu were used to search key words included "pressure sore, bedsore, table sore, traditional Chinese and western medicine", and the searching term was from January 2012 to May 2017. And then the search literatures were concluded, analyzed and arranged, and the relative diagnostic criteria, stages of symptom and criterion of therapeutic effect were reviewed so as to seek ideal therapeutic scheme for the disease. At the same time, the dialectical regular of traditional Chinese medicine was applied to change drug based on changing of symptom, which was expected to help the clinical work.

Observation of curative effect of Demolin spray combined with comprehensive nursing on pressure sore / 中国生化药物杂志

Objective To investigate and analyze the clinical efficacy of Demolin spray combined with comprehensive care in the treatment of pressure sores. Methods 56 patients with pressure sores from February 2011 to October 2016 were selected and randomly divided into the control group and the experimental group, with 28 patients in each group. The control group was treated with routine treatment, the experimental group on the basis of the given Demolin spray treatment, and comprehensive nursing, based on fully understanding the clinical data of patients, patients were given comprehensive nursing according to focus on the patient's physical and mental health. The therapeutic effects of the two groups were compared and analyzed. Results After the corresponding treatment, the experimental group treated invalid 4 cases, effective in 8 cases, markedly effective in 10 cases, 6 cases recovered. The number of invalid cases in the control group was 10 cases, effective for 5 cases, markedly effective for 8 cases, recovery for 5 cases. The effective rate of treatment in the experimental group was 85.71 %, which was significantly higher than that in the control group, and the effective rate was 64.28 %, with statistical difference (P<0.05). The cure time of the control group was (13.82 ±3.70) days, and the number of dressing change was (20.40 ± 3.10) times. The cure time and change times of the experimental group were significantly better than those of the control group, the difference was statistically significant (P<0.05). Conclusion Demolin spray combined with comprehensive nursing treatment of bedsore clinical effect is better, can significantly improve the clinical efficacy, with clinical significance.

Observation of curative effect of Demolin spray combined with comprehensive nursing on pressure sore / 中国生化药物杂志

Objective To investigate and analyze the clinical efficacy of Demolin spray combined with comprehensive care in the treatment of pressure sores. Methods 56 patients with pressure sores from February 2011 to October 2016 were selected and randomly divided into the control group and the experimental group, with 28 patients in each group. The control group was treated with routine treatment, the experimental group on the basis of the given Demolin spray treatment, and comprehensive nursing, based on fully understanding the clinical data of patients, patients were given comprehensive nursing according to focus on the patient's physical and mental health. The therapeutic effects of the two groups were compared and analyzed. Results After the corresponding treatment, the experimental group treated invalid 4 cases, effective in 8 cases, markedly effective in 10 cases, 6 cases recovered. The number of invalid cases in the control group was 10 cases, effective for 5 cases, markedly effective for 8 cases, recovery for 5 cases. The effective rate of treatment in the experimental group was 85.71 %, which was significantly higher than that in the control group, and the effective rate was 64.28 %, with statistical difference (P<0.05). The cure time of the control group was (13.82 ±3.70) days, and the number of dressing change was (20.40 ± 3.10) times. The cure time and change times of the experimental group were significantly better than those of the control group, the difference was statistically significant (P<0.05). Conclusion Demolin spray combined with comprehensive nursing treatment of bedsore clinical effect is better, can significantly improve the clinical efficacy, with clinical significance.

Effect of Mepilex on pressure sores in patients lying at lateral position after craniocerebral surgery / 现代临床护理

Objective To investigate the effect of Mepilex on pressure sores in patients at lateral position after craniocerebral surgery.Methods Toally 60 patients lying at lateral position after craniocerebral surgery were randomized into two groups in equal number with random digit table:the control group and experiment group.In the control group,Gel pad was used to prevent and treat the pressure sores and in the experiment group Mepilex was used between the compressed skin and operation table before setting the position.The skin conditions of the two groups were observed after operation.Result The prophylactic effect of pressure sore in the experiment group was significantly better than that in the control group (P＜0.05).Conclusion Mepilex can prevent the skin pressure sores in the patients at lateral position after cerebral surgery.

Observations on the Efficacy of Acupuncture plus TDP in Treating StageⅡ-Ⅲ Pressure sore / 上海针灸杂志

Objective To investigate the clinical efficacy of acupuncture plus TDP in treating stageⅡ-Ⅲ pressure sore.Methods Thirty-three patients with pressure sore meeting the inclusion criteria were randomly allocated to treatment and control groups, 17 cases each. Both groups were first given routine clean care. The control group received routine surgical asepsis dressing change and the treatment group, fire needling, surrounding electroacupuncture and TDP irradiation to the affected part. The pressure sore area was observed and the PUSH score was recorded in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups of patients. Results The total efficacy rate was 88.0% in the treatment group and 71.0% in the control group; there was no statistically significant difference between the two groups (P>0.05). The total efficacy rate was 88.0% in the treatment group and 71.0% in the control group; there was no statistically significant difference between the two groups (P>0.05). The cure and marked efficacy rate was 58.8% in the treatment group and 23.5% in the control group; there was a statistically significant difference between the two groups (P<0.05). There was a statistically significant pre-/post- treatment difference in the pressure sore area in the two groups at one, two and three weeks after treatment (allP<0.05). There was a statistically significant difference in the pressure sore area between the two groups at two and three weeksafter treatment (bothP<0.05). There was a statistically significant pre-/post-treatment difference in the PUSH score in the two groups at two and three weeks after treatment (bothP<0.05). There was a statistically significant difference in the PUSH score between the two groups at three weeks after treatment (P<0.01).Conclusions Acupuncture plus TDP can markedly relieve the clinical symptoms and accelerate the sore healing in treating stageⅡ-Ⅲ pressure sore.

Effect observation of using the self-made pressure reduction bilateral nasal oxygen tube to prevent the nasal oxygen tube ear pressure sore for the comatose patients / 中国实用护理杂志

Objective To observe and discuss the effect of using the self-made pressure reduction bilateral nasal oxygen tube to prevent the ear pressure sore for the comatose patients. Methods Totally 86 cases of comatose patients which needed permanent oxygen inhale admitted during Jan 2016 to Dec 2016 were divided into observation group and control group:Each group 43 cases. Observation group used self-made pressure reduction bilateral nasal oxygen tube to inhale the oxygen, control group used the conventional disposable bilateral nasal oxygen tube to inhale the oxygen and the pressure ulcer stage. Results There was no significant difference in Braden score in two groups, the difference was statistically significant (P>0.05) . Observed two groups patients′ nasal oxygen tube ear pressure sore situation, these were only 2 patients happened nasal oxygen tube ear pressure sore in observation group, on the contrary, these were 9 patients happened in control group, occulting probability was higher than observation group significantly. and the extend of the pressure sore is much serious than the observation. Difference was statistically significant (χ2=5.11, P<0.05). Conclusions During the privation of the nasal oxygen tube ear pressure sore for the comatose patients, self-made pressure reduction bilateral nasal oxygen tube can alleviate the ear skin pressure effectively, reduce the pressure sore occur, the effect is obvious, nursing quality is improved, deserve the clinical expansion.

Application of compression-braking pants in preventing postoperative bleeding and pressure sore after TACE / 介入放射学杂志

Objective To assess the clinical value of compression-braking pants in preventing postoperative bleeding and pressure sore after transcatheter arterial chemoembolization (TACE).Methods A total of 50 patients with liver cancer,who received interventional treatment via femoral artery route at authors' hospital during the period from May 2015 to May 2016,were enrolled in this study.The patients were randomly divided into observation group and control group with 25 patients in each group.In the observation group,the patients were asked to put on the compression-braking pants after TACE procedure and routine postoperative nursing care was executed as usual.In the control group,routine postoperative nursing care and compression of puncture point with sandbag were carried out.After TACE,the conditions of local congestion,local hematoma,formation of pseudoaneurysm at the puncture site,etc.in both groups were recorded.The local skin conditions,including skin moist feeling,burning sensation,feeling of numbness and rubefaction were determined.Results The postoperative bleeding incidence in the observation group was 4％,which was obviously lower than 32％ in the control group.No pressure sore occurred in both groups.In aspect of skin moist feeling,burning sensation,feeling of numbness and rubefaction,the observation group was significantly superior to the control group (P＜0.05).Conclusion The use of compression-braking pants after TACE can effectively prevent the occurrence of postoperative bleeding and pressure sore.The compression-braking pants have reasonable design and simple structure,and it is easy to put on and take off the pants.The use of the pants can improve patient's comfort and satisfaction.Therefore,it is worth promoting its use in clinical practice.

The Keystone Flap in Greater Trochanter Pressure Sore

The keystone flap is a fascia-based island flap with two conjoined V-Y flaps. Here, we report a case of successful treatment of a trochanter pressure sore patient with the traditional keystone flap. A 50-year-old male patient visited our department with a 3×5 cm pressure sore (grade III) to the left of the greater trochanter that was covered with eschar. Debridement was done and the defect size increased to 5×8 cm in an elliptical shape. Doppler ultrasound was then used to locate the inferior gluteal artery perforator near the wound. The keystone flap was designed to the medial side. The perforator based keystone island flap covered the defect without resistance. The site remained clean, and no dehiscence, infection, hematoma, or seroma developed. In general, greater trochanter pressure sores are covered with a perforator based propeller flap or fascia lata flap. However, these flaps have the risk of pedicle kinking and require a large operation site. For the first time, we successfully applied the keystone flap to treat a greater trochanter pressure sore patient. Our design was also favorable with the relaxation skin tension lines. We conclude that the keystone flap including a perforator is a reliable option to reconstruct trochanteric pressure sores.

Pedicled Anterolateral Thigh Flaps for Reconstruction of Recurrent Trochanteric Pressure Ulcer

The reconstruction of recurrent pressure sores is challenging due to a limited set of treatment options and a high risk of flap loss. Successful treatment requires scrupulous surgical planning and a multidisciplinary approach. Although the tensor fascia lata flap is regarded as the standard treatment of choice-it provides sufficient tissue bulk for a deep trochanteric sore defect-plastic surgeons must always consider the potential of recurrence and accordingly save the second-best tissues. With the various applications of anterolateral thigh (ALT) flaps in the reconstructive field, we report two cases wherein an alternative technique was applied, whereby pedicled ALT fasciocutaneous island flaps were used to cover recurrent trochanteric pressure sores. The postoperative course was uneventful without any complications. The flap provided a sound aesthetic result without causing a dog-ear formation or damaging the lower-leg contour. This flap was used as an alternative to myocutaneous flaps, as it can cover a large trochanteric defect, recurrence is minimized, and the local musculature and lower-leg contour are preserved.

Predictive Validity of the Braden Scale for Pressure Ulcer Risk: A Meta-analysis

PURPOSE: The Braden Scale is one of the most intensively studied risk assessment scales used in identifying the risk of developing pressure sore. However, not all studies show that the predictive validity of this scale is sufficient. The purpose of this study was to evaluate the Braden Scale for predicting pressure ulcer development. METHODS: Articles published 1946 and 2013 from periodicals indexed in Ovid Medline, Embase, CINAHL, KoreaMed, NDSL and other databases were selected, using the following keywords: 'pressure ulcer'. The QUADAS-II was applied to assess the internal validity of the diagnostic studies. Selected studies were analyzed using meta-analysis with MetaDisc 1.4. RESULTS: Thirty-eight diagnostic studies with high methodological quality, involving 17,934 patients, were included. Results of the meta-analysis showed that the pooled sensitivity and specificity of the Braden Scale were 0.74 (95% CI: 0.72-0.76), 0.75 (95% CI: 0.74-0.76) respectively. However the predictive validity of the Braden Scale has limitation because there was high heterogeneity between studies. CONCLUSION: The Braden Scale's predictive validity of risk for pressure ulcer is interpreted as at a moderate level. However there is a limitation to the interpretation of the results, because of high heterogeneity among the studies.

Nurse-perceived Patient Adverse Events and Nursing Practice Environment / 예방의학회지

OBJECTIVES: To evaluate the occurrence of patient adverse events in Korean hospitals as perceived by nurses and examine the correlation between patient adverse events with the nurse practice environment at nurse and hospital level. METHODS: In total, 3096 nurses working in 60 general inpatient hospital units were included. A two-level logistic regression analysis was performed. RESULTS: At the hospital level, patient adverse events included patient falls (60.5%), nosocomial infections (51.7%), pressure sores (42.6%) and medication errors (33.3%). Among the hospital-level explanatory variables associated with the nursing practice environment, 'physician- nurse relationship' correlated with medication errors while 'education for improving quality of care' affected patient falls. CONCLUSIONS: The doctor-nurse relationship and access to education that can improve the quality of care at the hospital level may help decrease the occurrence of patient adverse events.