Screening complications in the postoperative period of orthopedic surgeries by video arthroscopy

To analyze the prevalence and characteristics of late postoperative complications of orthopedic surgeries by video arthroscopy.This was a descriptive cross-sectional study that evaluated, through its own instrument, local and systemic postoperative complications of patients undergoing orthopedic surgeries by video arthroscopy. The study included 270 patients, who were evaluated on days 30(without prosthesis) and 90(with prosthesis placement) of the postoperative period, by telephone service. The selection of participants occurred sequentially and population-based, within the data collection period, from February to July 2020, in a large hospital for medium and high complexity surgeries. Of the 270 procedures performed in the period, 4.4% (n = 12) presented late postoperative infection. The most frequent complications were erythema (83%), edema (75%) and secretion (67%) in the surgical wound. Most used antibiotic therapy (92%) and anti-inflammatory drugs (67%). Hospital readmission was not necessary concerning the complications. Only 50% required medical evaluation before the scheduled time.The need for practices that ensure the quality of perioperative care and improve the active search to assess surgical outcomes is reinforced.

The education needs of health professionals conservatively managing genital oedema: UK survey findings.

BACKGROUND: Adults and children report genital oedema but prevalence is unknown. Pre-registration nurse training rarely includes genital oedema and postgraduate training opportunities are rare. AIM: To identify the education needs of health professionals regarding management of genital oedema. METHOD: An electronic survey was cascaded to health professionals through relevant professional groups and social media. FINDINGS: Of 149 UK respondents, most manage patients with genital oedema but only 2% felt current training was sufficient. Of 138 responding regarding supplemental training, only a half had completed genital oedema specific education, usually of 1-4 hours' duration. Confidence in knowledge was up to 22.5% higher in those with genital oedema education, even accounting for years of experience. The most common top three individual needs were compression, contemporary surgical and medical management and patient assessment. Educational resources are needed and both offline and online formats were suggested; collaborative events with urology/pelvic health are essential. CONCLUSION: Health professionals working in lymphoedema care have (unmet) specific education needs regarding genital oedema management. The desire for both offline and online resources reflects the necessity of accessing learning at a distance and on an 'as needed' basis.

A point-of-care app for chronic oedema management.

The COVID-19 pandemic of 2020 has led to considerable changes in how healthcare is delivered, as it has pushed people to think outside the box technologically. Mobile working is becoming more widespread, useful and valuable in this innovative period in the NHS. Point-of-care (POC) technology encompasses mobile devices and systems that support health professionals in their daily activities of patient care. It allows the user to safely assess and diagnose individuals at the point of care, providing actionable information to allow rapid clinical decision-making. POC technology also has the ability to support and educate patients with health needs, encouraging patients and their carers to assume greater more control of and responsibility over their health. Providing patients individual care plans to maintain their health will help realise the future of self-care. This article describe the development of a mobile app-Juzo Care-designed to enhance the management of chronic oedema and lymphoedema in mobile working settings.

Nursing Care of Patients With Cirrhosis: The LiverHope Nursing Project.

Cirrhosis is a complex disease that is associated with disturbances in different organs besides the liver, including kidneys, heart, arterial circulation, lungs, gut, and brain. As a consequence, patients develop a number of complications that result in frequent hospital admissions and high morbidity and mortality. Patients with cirrhosis require constant and rigorous monitoring both in and outside the hospital. In this context, the role of nurses in the care of patients with cirrhosis has not been sufficiently emphasized and there is very limited information about nursing care of patients with cirrhosis compared with other chronic diseases. The current article provides a review of nursing care for the different complications of patients with cirrhosis. Nurses with specific knowledge on liver diseases should be incorporated into multidisciplinary teams managing patients with cirrhosis, both inpatient and outpatient. Conclusion: Nurses play an important role in the management and prevention of complications of the disease and improvement in patients' quality of life and bridge the gap between clinicians and families, between primary care and hospital care, and provide medical education to patients and caregivers.

Assessing and managing patients with leg ulceration and oedema.

Leg ulcers are some of the most common wounds treated by the NHS. Ulceration is usually classified as being of venous or arterial origin. Arterial ulcers develop because of reduced arterial flow to the leg caused by peripheral arterial disease. Venous leg ulcers, the most common form, develop because of vein incompetence, with valve failure leading to pressure in the veins. Nurses working with patients with oedema find that chronic oedema can cause the limb affected to swell, causing skin to stretch and break and lead to ulceration. This is known as superficial ulceration. This article discusses the causes, assessment and management of these different types of leg ulcer.

Complicaciones y cuidados de las urostomías / No disponible

Un estoma en general representa la pérdida de continuidad de la piel y por tanto de la barrera de protección que esta ofrece. Es por ello que existe un riesgo elevado de que se produzcan alteraciones tanto en el propio estoma como en la piel periestomal, un riesgo que se ve aumentado cuando se trata de ostomía que excretan secreciones líquidas (orina). Por tanto es de suma importancia hacer una correcta valoración y seguimiento tanto del estoma como de la piel que lo circunda para detectar cualquier anomalía y (minimizar el problema) poner solución

A stoma represents a loss of continuity of the skin, and so the skin barrier it offers. Therefore there is a high risk of alterations in the stoma and peristomal skin, this risk can increase when stomata excrete liquid secretions (urine). thus, it is of utmost importance to make an accurate assessment and follow-up care in order to detect and kind of abnormality and solve it

Haddenham Easywrap: an alternative to compression bandaging in chronic oedema and wound care.

Haddenham Easywrap has been available since 2016 and since then case studies have been presented to demonstrate the efficacy of the product in clinical practice. The aim of the article is to demonstrate how its use in chronic oedema, and wound care is beneficial and cost effective and how versatile one product can be in treating both of these conditions. Information gained from the evaluation of easywrap in wound care and management of chronic oedema, demonstrates that easywrap can be a suitable cost effective alternative to traditional compression therapy modalities, whilst improving concordance and quality of life.

Improving Orthopedic-Related Postoperative Edema Management in a Rehabilitative Nursing Setting.

PURPOSE: The aim of the study was to reduce postoperative edema in total knee and hip arthroplasty rehabilitation patients. DESIGN: A pre- and posttest design was used for this quality improvement project at a rehabilitation facility. METHODS: Staff and patient edema education was standardized. Staff pre- and posttests were administered. Patients were interviewed to assess for knowledge of edema management. Chart audits were assessed for edema management and length of stay. FINDINGS: Average staff knowledge scores (n = 50) increased pre- to posteducational video (64% vs. 70%). Of patients interviewed posteducation (n = 24), 38% were able to list two characteristics of edema. Two chart audits completed pre- and posteducation demonstrated that the majority of patients (n = 30 per group) had edema upon admission (96% vs. 97%). However, length of stay decreased by 3 days (19.2 vs. 16.3). CONCLUSION: Standardized postoperative edema education can improve staff and patient edema knowledge and management. CLINICAL RELEVANCE: Edema education is recommended for orthopedic patients in rehabilitation facilities.

The impact of chronic oedema on quality of life in the elderly.

Quality of life (QoL) is a concept that is relevant for everyone, but individuals experience factors that make up QoL differently. This article considers the impact chronic oedema has on older people's QoL. There are additional challenges in this group, such as the ageing process, which interlink with QoL. The presence of appropriate support networks and psychological strategies can have a positive impact on the management of chronic oedema and the patient's perception of QoL.

An audit of chronic oedema within the care home setting.

This articles outlines the important issue of chronic oedema, its definition and the physiology of the three main categories. The care delivered in the care home (nursing) sector was the subject of a printed questionnaire and the results are presented here. They are discussed and the implications for practice and an evidenced-based approach to care delivery are considered. Several conclusions can be drawn from this study but would be strengthened by a larger study. Care for patients with chronic oedema could be enhanced and this would improve clinical outcomes; significantly fewer patients would need to be referred for GP management if an appropriate and timely first-line treatment was agreed and provided by nursing staff. An educational resource should be developed, including: a resource folder; e-learning, patient information, and a patient leg exercise regime; a crib sheet and myth buster information; and clinical competencies. A further study would be required to confirm whether fewer patients experienced falls or presented with chronic oedema when lower leg swelling was managed.

Pilot evaluation of the management of chronic oedema in community settings project.

AIMS: The aim of this economic analysis was to estimate the economic impact of the On the Ground Education Programme (OGEP) within one local University Health Board (UHB) in Wales. BACKGROUND: The burden of managing chronic oedema can be considerable to the NHS. Developing innovative solutions to the care and management of patients with chronic oedema has the potential to deliver prudent, cost-effective and high quality care within NHS Wales. DESIGN: The study was a pilot Evaluation of the OGEP using retrospectively and prospectively collected patient recalled data. METHODS: A questionnaire collected health care service use data prior to receiving the OGEP (baseline) and at 3 months follow-up from 97 patients during the period June 2016 and January 2017. In addition, we analysed a patient reported health outcome using the EQ-5D 5L, which was completed by patients at the same two assessment points. RESULTS/FINDINGS: The total cost of managing chronic oedema in the 97 patients recruited was £563 729 (mean patient cost £5812 SD (£5870) at baseline and £445 098 (including the addition of intervention costs) (mean patient cost £4589 (SD £5465) at 3 months follow-up. Improvements in the EQ-5D 5L score increasing from 0.40 (SD 0.25) at baseline to 0.54 (SD 0.23) at 3 months follow-up. CONCLUSIONS: Our research show health care resource use and costs decreased, while health-related quality of life scores increased.

Chronic oedema 'on-the-ground' education programme.

The impact of chronic oedema on community nurses' work, the NHS and those directly affected by the condition is immense. As chronic oedema prevalence is projected to rise and financial austerity continues, innovative, sustainable solutions that ensure positive outcomes for patients must be found. This paper reports findings from a focus group (n=3) investigation of the effects of an innovative workplace education intervention designed to enhance community nurses' knowledge for practice in chronic oedema prevention and management in Wales. The main findings indicated that the programme had enhanced community nurses' awareness, knowledge and understanding of chronic oedema management. By enhancing their knowledge base, benefit might be conferred for patients with chronic oedema in terms of improved quality of life, self-efficacy and self-management. However, the magnitude of perceived benefit was variable and contingent on engagement with and support for self-management. Findings indicate the need for a longitudinal study.

Accelerated wound healing with combined NPWT and IPC: a case series.

Negative pressure wound therapy (NPWT) and intermittent pneumatic compression (IPC) have traditionally been used in patients with chronic complicated non-healing wounds. The aim of this study (retrospective case series) was to describe the use of NPWT in combination with IPC in patients with a relatively short history (2-6 months) of ulcers. All wounds showed improved healing during the treatment period with marked or moderate reduction in ulcer size, and granulation tissue formation was markedly stimulated. Oedema was markedly reduced due to IPC. Treatment was generally well tolerated. The results of this study indicate that combined NPWT and IPC can accelerate wound healing and reduce oedema, thus shortening the treatment period. Therefore, patients may have a shorter healing period and may avoid entering a chronic wound phase. However, controlled studies of longer duration are needed in order to show the long-term effect of a more accelerated treatment course.

Chronic oedema: its prevalence, effects and management.

Ageing affects not only individuals but also society. It occurs throughout the western world. The ageing process may lead to the development of conditions, such as chronic oedema, as well as comorbidities such as osteoarthritis. These comorbidities can make the management of chronic oedema even more difficult. This is an especially important consideration when tailoring individualised care plans, such as exercise, as conditions such as rheumatoid arthritis can limit patients' ability to manage their oedema. Despite challenges, education can improve patient outcomes when evidence-based practice is used.