• Title/Summary/Keyword: ulcers

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Clinical Features and Prognosis of Corneal Ulcers in Dogs with Chronic Kidney Disease

  • Choi, Heeyeon;Kim, Se Eun;Kim, Taehyun;Jang, Jaeyoung;Hwang, Sun Young;Seo, Kangmoon
    • Journal of Veterinary Clinics
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    • v.38 no.3
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    • pp.115-119
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    • 2021
  • This study was designed to investigate the characteristics of corneal ulcers in dogs with chronic kidney disease (CKD). Medical records of dogs that had been diagnosed with corneal ulcers and chronic kidney disease at Haemaru Referral Animal Hospital between April 1, 2011 and March 31, 2016 were investigated. A control group was randomly selected during the same time period. This group included patients with corneal ulcers but no evidence of systemic disease. The mean healing time of superficial corneal ulcers in the CKD group was 21.0 ± 15.0 days. This was a significantly longer healing time than was observed in the control group (11.0 ± 6.6 days, p = 0.019). The incidence rates of uveitis and keratoconjunctivitis sicca in the CKD group were significantly higher than in the control group (p = 0.000 and p = 0.026, respectively). Additionally, non-healing ulcers had significantly elevated white blood cell counts, while those with healing ulcers had WBC counts within the normal range in CKD group (p = 0.000). This study revealed that corneal ulcers in CKD patients would be delayed epithelial healing process and accompanied by ocular disease which affected to corneal healing compared to non-CKD patients.

Outpatient Percutaneous Flexor Tenotomy for Diabetic Claw Toe Deformity with Ulcer (궤양을 동반한 당뇨성 갈퀴 족지에 대하여 외래에서 시행한 경피적 굴곡건 절단술)

  • Lee, Dong-Hun;Chung, Jin-Wha
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.4
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    • pp.151-155
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    • 2018
  • Purpose: Toe ulcers have been implicated as a causative factor in diabetic foot amputation. The aim of this study was to evaluate the outcomes of percutaneous needle flexor tenotomies of diabetic claw toes with ulcers or pending ulcers. Materials and Methods: The authors undertook a retrospective chart review between January 2014 and June 2016 to identify those patients who underwent a percutaneous needle flexor tenotomy for diabetic claw toe deformities. We evaluated 54 toes in 42 patients. Twenty-four patients were female and the mean age at the time of operation was 57 years. The mean follow-up time was 11 months. Thirty-four patients (46 toes) had tip toe ulcers or pending ulcers and 8 patients (8 toes) had dorsal pending ulcers. All patients had palpable pulses and good capillary refill. Results: Forty-three of 46 tip toe ulcers (93.5%) healed without significant complications and 8 dorsal ulcers showed no specific changes within 5 weeks. There were no recurrent ulcers at final follow-up. Four patients developed transfer lesion of the adjacent toe and needed subsequent tenotomy. Conclusion: Percutaneous needle tenotomy in an outpatient clinic was an effective and safe method for treating toe ulcers in neuropathic patients to offload the tip of the toe so that ulcer healing could occur.

The Application of Vacuum-Assisted Closures According to the Texas Staging System in the Treatment of Infective Diabetic Foot Ulcers (감염성 당뇨 족부 궤양 치료에서 Texas 기준 체계에 따른 음압치료 적용)

  • Lim, Seong-An;Choi, Yong-Soo;Jang, Young-Jae;Baek, Sung-Nyun;Bae, An-Na
    • Journal of Korean Foot and Ankle Society
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    • v.26 no.2
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    • pp.66-70
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    • 2022
  • Purpose: A group of patients who were hospitalized for diabetic foot ulcers was classified according to the University of Texas Staging System for Diabetic Foot Ulcers, and we attempted to evaluate whether this staging system could be a criterion for treatment success using vacuum-assisted closure (VAC) technique. Materials and Methods: A total of 32 patients were diagnosed with diabetic foot ulcers according to the University of Texas Staging System for Diabetic Foot Ulcers. Of these, 24 patients who were evaluated as stage B according to the staging system were classified as Group 1, and 8 patients in stage D were classified as Group 2. After applying VAC, the treatment success rate was compared by evaluating the size and severity of ulcers between the two groups. Results: The grade of granulation after VAC was on average 3.75±0.53 in Group 1 and 2.25±0.71 in Group 2. There was better granulation after VAC application in Group 1 (p<0.01). The success rate of the treatment was 22 cases (91.67%) in Group 1 and one case (12.5%) in Group 2. Thus there were statistically significant differences in the success rate of treatment between groups 1 and 2 (Pearson's chisquare test, p=0.01; odd ratio 77.00, 95% confidence interval [CI] 1.26~14.66; relative risk 4.30, 95% CI 1.26~14.66). Conclusion: These results suggest that there was a higher success rate of treatment with VAC in stage B patients. The University of Texas Staging System for Diabetic Foot Ulcers can thus be an index for applying VAC to patients with infective diabetic foot ulcers.

Differences in Associated Factors according to the Time of Occurrence of Pressure Ulcers in Intensive Care Unit Patients (중환자실 환자의 욕창 발생 시기에 따른 관련요인의 차이)

  • Lee, Mijung;Seo, Eunjeoung;Kim, Miok;Park, Jeongok;Lee, Seonmi;Shin, Hyunkyung;Yun, Ilsim;Cho, Mina;Cho, Youngcha;Kang, Bomi;Seo, Hyunmi;Lee, Misoon;Lee, Sira;Jang, Hyejoo;Jung, Hyunsuk;Ahn, Jeong-Ah
    • Journal of Korean Critical Care Nursing
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    • v.14 no.3
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    • pp.26-36
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    • 2021
  • Purpose : This study aimed to present the incidence of pressure ulcers and identify different associated factors according to the time of occurrence of pressure ulcers in intensive care unit (ICU) patients. Methods : The participants were 313 patients who reported pressure ulcers among 2,908 patients in ICUs at a large tertiary hospital in Gyeonggi-do. Among them, 220 patients (70.3%) had a pressure ulcer before admission, and 93 patients (29.7%) reported newly developed pressure ulcers after admission to the ICU. Data were collected between August 2018 and April 2019. Along with the time of occurrence and characteristics of pressure ulcers, diverse associated factors were gathered through electronic medical records. Data were analyzed using descriptive statistics, independent t-tests, and 𝑥2-tests. Results : Different risk factors associated with pressure ulcers in ICU patients according to the time of occurrence were main diagnosis, score of acute physiology and chronic health evaluation, score of Richmond agitation sedation scale, level of consciousness, administered sedatives, use of a ventilator, insertion of a feeding tube, and the duration of fasting period. Conclusion : Based on the results of this study, healthcare providers, especially ICU nurses, should try to detect early signs and symptoms of pressure ulcers, taking into account the derived factors associated with pressure ulcers in ICU patients. Practical intervention programs and strategies considering the factors associated with pressure ulcers must be developed to prevent and alleviate such ulcers in ICU patients in the future.

Pressure Ulcers Treatment in Physical Therapy (욕창과 물리치료적 접근에 관한 고찰)

  • Lee, Hyun-Min;Chun, Song-Hee;Kang, Jong-Ho;Bang, Hyun-Soo;Kim, Jin-Sang
    • Journal of the Korean Society of Physical Medicine
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    • v.3 no.1
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    • pp.39-45
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    • 2008
  • Purpose : The purpose of this study was understanding the pressure ulcers and consider the physical therapy for pressure ulcers. Methods : This is a literature study with books, articles and poster. Results : We consider pressure ulcers can be treated with physical therapy which can promote healing process. Conclusion : Physical therapy in patients with pressure ulcers is required and among various physical therapeutic approaches, the method of general coordinative manipulation is considered more necessary.

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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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Protective Effect of 4-(3,4-Dihydroxyphenyl)-3-Buten-2-One from Phellinus linteus on Naproxen-Induced Gastric Antral Ulcers in Rats

  • Kim, Jeong-Hwan;Kwon, Hyun Ju;Kim, Byung Woo
    • Journal of Microbiology and Biotechnology
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    • v.26 no.5
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    • pp.823-828
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    • 2016
  • The present study investigated the protective effect of naturally purified 4-(3,4-dihydroxyphenyl)-3-buten-2-one (DHP) from Phellinus linteus against naproxen-induced gastric antral ulcers in rats. To verify the protective effect of DHP on naproxen-induced gastric antral ulcers, various doses (1, 5, and 10 μg/kg) of DHP were pretreated for 3 days, and then gastric damage was caused by 80 mg/kg naproxen applied for 3 days. DHP prevented naproxen-induced gastric antral ulcers in a dose-dependent manner. In particular, 10 μg/kg DHP showed the best protective effect against naproxen-induced gastric antral ulcers. Moreover, DHP significantly attenuated the naproxen-induced lipid peroxide level in gastric mucosa and increased the activities of radical scavenging enzymes, such as superoxide dismutase, catalase, and glutathione peroxidase, in a dose-dependent manner. A histological examination clearly demonstrated that the gastric antral ulcer induced by naproxen nearly disappeared after the pretreatment of DHP. These results suggest that DHP can inhibit naproxen-induced gastric antral ulcers through prevention of lipid peroxidation and activation of radical scavenging enzymes.

Factors affecting Healing of Stage 2 Pressure Ulcer (2단계 욕창 치유에 영향을 주는 요인 분석)

  • Park, Kyung-Hee;Kim, Keum-Soon
    • Journal of Korean Critical Care Nursing
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    • v.3 no.2
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    • pp.1-11
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    • 2010
  • Purpose: This study was designed to identify the factors affecting healing of Stage 2 pressure ulcer in an acute care facility in Korea. Methods: 286 Stage 2 pressure ulcers of 145 patients were examined. Data were collected in the period between October $1^{st}$, 2006 and September $30^{th}$, 2007. Data were analyzed with Kaplan-Meier survival analysis for cumulative recovery rate of Stage 2 pressure ulcers. Cox proportional hazard model was used to examine effects of multiple variables simultaneously. Results: Out of 286 initial Stage 2 pressure ulcers, 204 (71.3%) pressure ulcers healed completely. The median time to heal was 15 days according to Kaplan-Meier survival analysis. Cox proportional hazard model showed that the Stage 2 pressure ulcers healed more quickly when pressure redistribution surfaces were used (p<.001, HR=2.184), patients were administered with vitamins (p= .038, HR=1.451), and the size of the pressure ulcers were small (${\leq}3.0cm^2$, p= .006, HR=1.765). Conclusion: The factors contributing to the healing of Stage 2 pressure ulcer in an acute care setting were the application of pressure redistribution surface, small ulcer size (${\leq}3.0cm^2$), and the administration of vitamins.

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Oral Bioadhesive Gels of Recombinant Human Epidermal Growth Factor(rhEGF) for the Healing of Gastric Ulcers (재조합 상피세포성장인자를 함유한 경구 점착성 겔제의 위궤양 치유효과)

  • Han, Kun;Lee, Su-Jin;Kim, Jae-Hwan;Chung, Youn-Bok
    • Journal of Pharmaceutical Investigation
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    • v.28 no.2
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    • pp.99-107
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    • 1998
  • The objective of this study was to develop effective oral formulations of rhEGF for gastric ulcer healing using polycarbophil. hydroxypropylcellulose(HPC) and sucralfate as its bioadhesive bases. Cytoprotective effects of rhEGF, cell proliferation and differentiation. on the ulcers induced by ethanol or acetic acid in rats were studied. rhEGF release from HPC formulation was much faster than that from polycarbophil formulation. HPC formulation combined with small amount of sucralfate showed much slower release of rhEGF than only HPC base only. rhEGF preparations with bioadhesive polymers showed better effects on the healing of gastric ulcers than EGF solution when administered orally. When rhEGF preparations were administered at once and the animals were under starvation, polycarbophil formulation showed better effect on gastric ulcers than HPC formulation. Otherwise, when rhEGF preparations were given more than three times and the rats were fed normally, HPC formulation showed good healing efficacy of ulcers compared to polycarbophil formulation. rhEGF showed dose-dependent effect on the healing of both chronic and acute ulcers.

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National perioperative outcomes of flap coverage for pressure ulcers from 2005 to 2015 using American College of Surgeons National Surgical Quality Improvement Program

  • Tran, Bao Ngoc N.;Chen, Austin D.;Kamali, Parisa;Singhal, Dhruv;Lee, Bernard T.;Fukudome, Eugene Y.
    • Archives of Plastic Surgery
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    • v.45 no.5
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    • pp.418-424
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    • 2018
  • Background Complication rates after flap coverage for pressure ulcers have been high historically. These patients have multiple risk factors associated with poor wound healing and complications including marginal nutritional status, prolonged immobilization, and a high comorbidities index. This study utilizes the National Surgical Quality Improvement Program (NSQIP) to examine perioperative outcomes of flap coverage for pressure ulcers. Methods Data from the NSQIP database (2005-2015) for patient undergoing flap coverage for pressure ulcers was identified. Demographic, perioperative information, and complications were reviewed. One-way analysis of variance and Pearson chi-square were used to assess differences for continuous variables and nominal variables, respectively. Multivariate logistic regression was performed to identify independent risk factors for complications. Results There were 755 cases identified: 365 (48.3%) sacral ulcers, 321 (42.5%) ischial ulcers, and 69 (9.1%) trochanteric ulcers. Most patients were older male, with some degree of dependency, neurosensory impairment, high functional comorbidities score, and American Society of Anesthesiologists class 3 or above. The sacral ulcer group had the highest incidence of septic shock and bleeding, while the trochanteric ulcer group had the highest incidence of superficial surgical site infection. There was an overall complication rate of 25% at 30-day follow-up. There was no statistical difference in overall complication among groups. Total operating time, diabetes, and non-elective case were independent risk factors for overall complications. Conclusions Despite patients with poor baseline functional status, flap coverage for pressure ulcer patients is safe with acceptable postoperative complications. This type of treatment should be considered for properly selected patients.