• Title/Summary/Keyword: Pressure Ulcers

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The Effect of Application Parameter of Pulsed Direct Current on Wound Healing of Patients with Pressure Ulcer

  • Kim, Ga Yeong;Lee, Sang Bin;Moon, Ok Kon;Kim, Ji Sung;Choi, Jung Hyun;Wang, Jung San;Park, Joo Hyun;Kim, Hong Rae;Lee, Ju Hwan;Min, Kyung Ok
    • Journal of International Academy of Physical Therapy Research
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    • v.5 no.2
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    • pp.752-756
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    • 2014
  • This study investigated the effects of changes to the pulsation factor of pulsed direct currents on wound healing. Patients with a pressure ulcer at a care hospital for the elderly were randomly divided into three groups: Group 1 involved the application of $100{\mu}s$ in pulse duration, 10 ms in pulse period, 100 pps in a pulsation factor, 15 mA in pulse amplitude, and polarity red+ by using pulsed direct currents; Group 2 involved a change of pulse period to 8 ms; and Group 3 received general wound management. Although there were no statistically significant differences in the changing stages of pressure ulcers among the groups, all the groups dropped in numerical stages. In the two groups to which pulsed direct currents were applied, there was a statistically significant reduction in the stages of pressure ulcers from the initial assessment to the 12-week assessment (p<.05). Even though there were no statistically significant differences in changes to the area of pressure ulcers among the groups, a statistically significant decrease was found in pulsed direct current group 2 whose pulse period was shortened (p<.05). There was no difference in the healing rate of pressure ulcers among the groups, but it made a numerical increase in pulsed direct current group 1 and group 2 and a numerical decrease in group 3. There were no significant differences in the characteristics of those who had a full recovery among the groups. Those findings indicate that pulsed direct currents have positive effects on the wound healing of patients with a pressure ulcer and that a treatment with pulsed direct currents whose pulsation factor is raised by reducing the pulse duration is especially effective.

Two Cases of Grade Four Pressure Ulcer Patients Treated with Pharmacopuncture Soyeom and Herbal Medicine Taklisodok-eum (소염약침과 탁리소독음의 복합 치료를 이용한 4도 욕창 환자 치험 2례)

  • Lee, Dae-Hyun;Nam, Ji-Sung;Jeong, Hyun-Suk;Jang, In-Soo;Seo, Eui-Seok
    • The Journal of Internal Korean Medicine
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    • v.31 no.2
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    • pp.388-394
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    • 2010
  • Objectives : This study reports two cases of grade four pressure ulcer patients mainly treated by pharmacopuncture Soyeom and Taklisodok-eum. Methods : Two patients with grade four pressure ulcers at the oriental medicine hospital of Woosuk University were treated by pharmacopuncture Soyeom and herbal medicine Taklisodok-eum. Soyeom was treated once a day and Taklisodok-eum was given three times a day. We then observed the patients' appearances of pressure ulcer and changes of blood test results. Results and Conclusions : After ten days or three months each, wound sizes were reduced, tissue regeneration was accelerated and blood tests were improved. In conclusion, it is our belief that pharmacopuncture and herb medicine are effective to treat grade four pressure ulcers, and future studies will be required to ascertain this method on grade four pressure ulcers.

Predictive Bayesian Network Model Using Electronic Patient Records for Prevention of Hospital-Acquired Pressure Ulcers (전자의무기록을 이용한 욕창발생 예측 베이지안 네트워크 모델 개발)

  • Cho, In-Sook;Chung, Eun-Ja
    • Journal of Korean Academy of Nursing
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    • v.41 no.3
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    • pp.423-431
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    • 2011
  • Purpose: The study was designed to determine the discriminating ability of a Bayesian network (BN) for predicting risk for pressure ulcers. Methods: Analysis was done using a retrospective cohort, nursing records representing 21,114 hospital days, 3,348 patients at risk for ulcers, admitted to the intensive care unit of a tertiary teaching hospital between January 2004 and January 2007. A BN model and two logistic regression (LR) versions, model-I and .II, were compared, varying the nature, number and quality of input variables. Classification competence and case coverage of the models were tested and compared using a threefold cross validation method. Results: Average incidence of ulcers was 6.12%. Of the two LR models, model-I demonstrated better indexes of statistical model fits. The BN model had a sensitivity of 81.95%, specificity of 75.63%, positive and negative predictive values of 35.62% and 96.22% respectively. The area under the receiver operating characteristic (AUROC) was 85.01% implying moderate to good overall performance, which was similar to LR model-I. However, regarding case coverage, the BN model was 100% compared to 15.88% of LR. Conclusion: Discriminating ability of the BN model was found to be acceptable and case coverage proved to be excellent for clinical use.

Three Cases of Pressure Ulcer Treated with Hwangryunhaedok-tang Pharmacopuncture and Jaungo (黃連解毒湯약침과 紫雲膏도포를 병행한 욕창 환자 치험 3례)

  • Heo, Jong-won;Eom, Tae-min;Oh, Jeong-min;Choi, Ko-eun;Kim, Hyun-tae;Seol, In-chan;Kim, Yoon-sik;Yoo, Ho-ryong;Jo, Hyun-kyung
    • The Journal of Internal Korean Medicine
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    • v.36 no.3
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    • pp.419-426
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    • 2015
  • Objectives This study reports three cases of pressure ulcer treated with Hwangryunhaedok-tang pharmacopuncture. Methods Three patients with pressure ulcers were treated by Hwangryunhaedok-tang pharmacopuncture and Jaungo at the Oriental Medicine Hospital of Daejeon University. Hwangryunhaedok-tang pharmacopuncture and Jaungo was administrated once a day with simple dressing. Thereafter, we observed the pressure ulcers macroscopically. Results and Conclusions After 3 weeks, wound sizes were reduced and tissue regeneration was accelerated. In conclusion, Hwangryunhaedok-tang pharmacopuncture and Jaungo are effective to treat pressure ulcers, but more studies will be required to validate its use in pressure ulcers.

Cost-Effectiveness Analysis in Comparing Alginate Silver Dressing with Silver Zinc Sulfadiazine Cream in the Treatment of Pressure Ulcers

  • Chuangsuwanich, Apirag;Chortrakarnkij, Peerasak;Kangwanpoom, Jupaporn
    • Archives of Plastic Surgery
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    • v.40 no.5
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    • pp.589-596
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    • 2013
  • Background The treatment of pressure ulcers is complicated, given the various wound dressing products available. The cost of different treatments varies and the cost-effectiveness of each product has not been thoroughly evaluated. We compare two wound dressing protocols-alginate silver dressing (AlSD) and silver zinc sulfadiazine cream (AgZnSD) with regard to wound healing and cost-effectiveness Methods Patients with grade III or IV sacral or trochanteric pressure ulcers were eligible for this prospective, randomized controlled trial. The patients were randomized to receive one of the two dressings for an eight-week period. The criteria of efficacy were based on the Pressure Ulcer Scale for Healing (PUSH) scoring tool. The cost of treatment was also assessed. Results Twenty patients (12 women and 8 men) were randomly assigned to receive either AlSD (n=10) or AgZnSD cream (n=10). The demographic data and wound characteristics were comparable in the two groups. The two groups showed no significant difference in the reduction of PUSH score, wound size, or volume of exudate. The tissue type score was significantly lower in the AlSD group ($3.15{\pm}0.68-1.85{\pm}0.68$ vs. $2.73{\pm}0.79-2.2{\pm}0.41$; P=0.015). The cost of treatment was significantly lower in the AlSD group (377.17 vs. 467.74 USD, respectively; P<0.0001). Conclusions Alginate silver dressing could be effectively used in the treatment of grade III and IV pressure ulcers. It can improve wound tissue characteristics and is cost-effective.

Factors Predicting Development of Decubitus ulcers among Patients Admitted for Neurological Problems (욕창발생 예측 요인에 관한 연구)

  • 송미순;최경숙
    • Journal of Korean Academy of Nursing
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    • v.21 no.1
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    • pp.16-26
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    • 1991
  • In this prospective study, factors contributing to the development of decubitus ulcers were examined. Factors were identified by a literature review and a conceptual framework was developed. Regular observations were made during the subjects' hospitalization to determine the incidence of decubitus ulcers, and to assess other decubitus ulcer risk factors. Seventeen out of 146 admitted for neurological problems patients developed decubitus ulcers during the three month study period. There were no significant differences in the level of serum albumin, hemoglobin or age between those who developed decubitus ulcers and those who did not. There also was no difference in incidence between patient who were paralyzed and those not paralyzed. Mean hospitalization days until decubitus ulcer development was 6.5 days. According to the results of discriminant analysis, four factors -1) friction and shear, 2) sensory perceptual impairment, 3) low diastolic pressure, and 4) multiple use of sedative medications - predicted 84.93% of decubitus ulcer Incidence.

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Pressure Ulcer Risk Factors and Preventive Intervention in Long-Term Care Facilities : A Mixed method study (노인요양기관의 욕창발생 위험요인과 욕창예방 관리: 혼합연구)

  • Yun, Haesun;Park, Jeeyeon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.3
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    • pp.147-155
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    • 2020
  • The purpose of this study was to compare the risk factors of pressure sores and preventive intervention strategies and to provide basic data for the management of pressure sores prevention for long-term care facilities. It was a mixed method study using a systematic literature review and focus group interviews for analysis. A PRISMA flow diagram was prepared in accordance with the research selection process for the systemic literature review. The studies were retrieved from domestic and international studies from 2010 to June, 2019. A total of 8 studies were selected according to the selection criteria. The studies were searched electronically using a search engine with the key words of 'pressure ulcers', 'bedsore', 'decubitus ulcers', 'intervention', 'prevention', 'elderly', and 'long term'. Focus group interviews were conducted through a semi-structured questionnaire for nurses who had worked for more than three years in long-care facilities. The study results suggest that position change and pressure reduction device reduced the incidence of pressure sores and were important for prevention. The use of standardized care protocols is necessary. Multidisciplinary cooperation was an important issue.

Nursing Home Employee and Resident Satisfaction and Resident Care Outcomes

  • Plaku-Alakbarova, Bora;Punnett, Laura;Gore, Rebecca J.;Procare Research Team
    • Safety and Health at Work
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    • v.9 no.4
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    • pp.408-415
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    • 2018
  • Background: Nursing home resident care is an ongoing topic of public discussion, and there is great interest in improving the quality of resident care. This study investigated the association between nursing home employees' job satisfaction and residents' satisfaction with care and medical outcomes. Methods: Employee and resident satisfaction were measured by questionnaire in 175 skilled nursing facilities in the eastern United States from 2005 to 2009. Facility-level data on residents' pressure ulcers, medically unexplained weight loss, and falls were obtained from the Centers for Medicare and Medicaid Services Long-Term Care Minimum Data Set. The association between employee satisfaction and resident satisfaction was examined with multiple and multilevel linear regression. Associations between employee satisfaction and the rates of pressure ulcers, weight loss, and falls were examined with simple and multilevel Poisson regression. Results: A 1-point increase in overall employee satisfaction was associated with an increase of 17.4 points (scale 0-100) in the satisfaction of residents and family members (p < 0.0001) and a 19% decrease in the incidence of resident falls, weight loss, and pressure ulcers combined (p < 0.0001), after adjusting for staffing ratio and percentage of resident-days paid by Medicaid. Conclusion: Job satisfaction of nursing home employees is associated with lower rates of resident injuries and higher resident satisfaction with care. A supportive work environment may help increase quality of care in the nation's nursing homes.

The Control System of a Medical Robot Bed for Prevention and Healing of Pressure Ulcer (욕창 예방 및 치유를 위한 의료용 로봇 침대 제어 시스템)

  • Lee, Youngdae;Kim, Changyoung;Chang, Changjun;Kim, Jung Ae;Lim, Jae-Young
    • The Journal of the Convergence on Culture Technology
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    • v.6 no.3
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    • pp.353-359
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    • 2020
  • In this study, the controller structure and control algorithm of medical robot bed developed for pressure ulcer prevention and healing are described. The existing pressure ulcer prevention mattress is operated manually and the remaining maximum body pressure exceeds the pressure of ulcer generation, so there is always room for pressure ulcers. However, the system developed in this study does not generate the pressure ulcers because the body pressure drops to zero when the keyboard of the bed descends using the active electric driving keyboard. In addition, even if the bed is raised and the pressure above the critical body ulcer pressure is abnormal, the device and the control algorithm are designed so that the lasting time is within the pressure ulcer generation critical time and the pressure ulcer itself is not generated. The bed key board motor is a motor designed with the BLDC servos suitable for medical use and these can communicate each other easily through CAN(Car Area Network). The system is new medical robot bed that is effective in preventing pressure ulcers and will be distributed to many patients suffering from pressure ulcers.

Survey on Pressure Ulcers and Influencing Factors of Stage Change in Acute University Hospital Inpatients (일개 대학병원 입원환자의 욕창 실태와 욕창상태 영향요인)

  • Kim, Kyoung Nam;Kang, Kyung Ja;Lee, Hyun Sook;Shin, Yeon Hee;Kim, Sun Kyung;Park, Kwang Hee;Kim, Hye Young
    • Journal of Korean Clinical Nursing Research
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    • v.17 no.3
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    • pp.433-442
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    • 2011
  • Purpose: The purpose of this study was to conduct a retrospective investigation on the general characteristics of pressure ulcer and influencing factors of pressure ulcer stage during hospitalization. Methods: A total of 614 patients were selected between January 1, and December 31, 2009 from one acute university hospital if they had pressure ulcers on admission or newly developed pressure ulcer during hospitalization. The data were analyzed using the SPSS WIN 12.0 with percentage, mean, standard deviation, t-test, Chi-square test, ANOVA, and multiple regression analysis. Results: Influencing factors of pressure ulcer stage at discharge were eating (${\beta}=-.068$, p=.047), elimination (${\beta}=-.145$, p<.001), active exercise and movement (${\beta}=-.505$, p<.001), albumin levels (${\beta}=.166$, p<.001), and inflammatory markers (CRP)(${\beta}=-.091$, p=.005). These variables accounted 55.8% of the variance in ulcer stage. Conclusion: Study results indicate that nurses' active role on pressure ulcer care and systematic approach are necessary to manage acutely ill inpatients' pressure ulcers.