Background: Pressure sores are important and common complications of spinal cord injury. Many preventive and therapeutic approaches have been tried and new trials are evolving. One relatively recent method is application of a hydrocolloid dressing (HD). In this study we compared the therapeutic effects of HD on pressure ulcer healing with two other topical applications, phenytoin cream (PC) and simple dressing (SD).
Methods: Ninety-one stage I and stage II pressure ulcers of 83 paraplegic male victims of the Iran-Iraq war were randomly allocated to three treatment groups. Mean age and weight of the participants were 36.64 +/- 6.04 years and 61.12 +/- 5.08 kg, respectively. All the patients were managed in long term care units or in their homes for 8 weeks by a team of general practitioners and nurses, and the ulcer status was recorded as "Complete healing", "Partial healing", "Without improvement" and "Worsening".
Results: Complete healing of ulcers, regardless of location and stage, was better in the HD group than the PC [23/31(74.19%) vs 12/30(40%); difference: 34.19%, 95% CI = 10.85-57.52, (P < 0.01)] or the SD [23/31(74.19%) vs 8/30(26.66%); difference: 47.53%, 95% CI = 25.45-69.61, (P < 0.005)] groups. Complete healing of stage I ulcers in the HD group [11/13(85%)] was better than in the SD [5/11(45%); difference: 40%, 95% CI = 4.7-75.22, (P < 0.05)] or PC [2/9 (22%); difference: 63%, 95% CI = 29.69-96.3, (P < 0.005)] groups. Complete healing of stage II ulcer in the HD group [12/18 (67%)] was better than in the SD group [3/19(16%); difference: 51%, 95% CI = 23.73-78.26, (P < 0.005)], but not significantly different from the PC group [10/21 (48%); difference: 19%, 95% CI = -11.47-49.47, (P > 0.05)]. We performed a second analysis considering only one ulcer per patient (i.e. 83 ulcers in 83 patients). This "per patient" analysis showed that complete ulcer healing in the HD group was better than in the PC [20/28(71.4%) vs 11/28 (39.3%); difference: 32.1%, 95% CI = 7.4-56.7, (P < 0.01)] or SD [20/28(71.4%) vs 8/27 (29.6%); difference: 41.8%, 95% CI = 17.7-65.8, (P < 0.005)] groups.
Conclusion: We deduced that HD is the most effective method investigated for treating stage I and II pressure ulcers in young paraplegic men.
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http://dx.doi.org/10.1186/1471-5945-4-18 | DOI Listing |
Undersea Hyperb Med
January 2025
Hansjorg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York, NY.
Introduction: When administering HBO , pressures can range from 1.4 atmospheres absolute (ATA) to 3 ATA. While different treatment profiles have been proposed, there is a paucity of literature comparing the effectiveness and risk profile associated with different pressures treating the same condition.
View Article and Find Full Text PDFInt J Numer Method Biomed Eng
January 2025
Center of Mathematics, University of the Republic Uruguay, Montevideo, Uruguay.
The finite-element method (FEM) is a well-established procedure for computing approximate solutions to deterministic engineering problems described by partial differential equations. FEM produces discrete approximations of the solution with a discretisation error that can be quantified with a posteriori error estimates. The practical relevance of error estimates for biomechanics problems, especially for soft tissue where the response is governed by large strains, is rarely addressed.
View Article and Find Full Text PDFChin Med J (Engl)
January 2025
Department of Orthopedic Surgery, Beijing Jishuitan Hospital Affiliated to Capital Medical University, Beijing 100035, China.
This review aimed to provide a comprehensive analysis of the etiology, epidemiology, pathology, and conventional treatment of heterotopic ossification (HO), especially emerging potential therapies. HO is the process of ectopic bone formation at non-skeletal sites. HO can be subdivided into two major forms, acquired and hereditary, with acquired HO predominating.
View Article and Find Full Text PDFInt J Crit Illn Inj Sci
December 2024
Department of Adult Nursing, College of Al-Safwa Uneiversity, Karbala, Iraq.
Background: One of the most vital forms of the affected patient safety is pressure ulcers (PUs), which can be a critical health problem that every day impacts sufferers and healthcare structures. This study aimed to explore the level of nurse's knowledge and perceived barriers regarding PUs prevention among critically ill patients.
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BMJ Open
December 2024
Department of Vascular Surgery, Leids Universitair Medisch Centrum, Leiden, The Netherlands.
Introduction: Foot ulcers are one of the most serious complications of diabetes, leading to significant risks on amputation and mortality. Peripheral arterial disease (PAD) is an important factor for the development and the outcome of diabetic foot ulcers (DFU). Although prompt and accurate detection of PAD is critical to reduce complications, its diagnosis can be challenging with currently used bedside tests (such as ankle-brachial index and toe pressure) due to medial arterial calcification.
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