| 1. |
|
|
| 2. |
|
|
| 3. |
|
|
| 4. |
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
- Bengtsson, L, et al.
(författare)
-
Wound-related pain is underestimated in patients with diabetic foot ulcers.
- 2008
-
Ingår i: Journal of Wound Care. - 0969-0700. ; 17:10, s. 433-435
-
Tidskriftsartikel (refereegranskat)abstract
- Few studies have assessed pain in neuropathic and neuroischaemic foot ulcers. This pilot study found that patients with these ulcers do experience pain, and that the intensity and nature of the pain was similar in both types of ulcer.
|
|
| 8. |
- Bergstrand, Sara, et al.
(författare)
-
Microcirculatory responses of sacral tissue in healthy individuals and in patients on different pressure-redistribution mattresses
- 2015
-
Ingår i: Journal of Wound Care. - : Mark Allen Group. - 0969-0700 .- 2052-2916. ; 24:8, s. 346-358
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to explore the interaction between interface pressure and pressure-induced vasodilation and reactive hyperemia with different pressureredistribution mattresses.Method: A cross-sectional study was performed with a convenience sample of 42 healthy individuals between 18 and 64 years of age, 38 healthy individuals 65 years or older, and 35 inpatients 65 years or older at a university hospital in Sweden. Blood flow was measured at depths of 1 mm, 2 mm, and 10 mm using a combined system of laser Doppler flowmetry and photoplethysmography. The blood flow, interface pressure and skin temperature were measured in the sacral tissue before, during, and after load while lying on one standard hospital mattress and three different pressure-redistribution mattresses.Results: There were significant differences between the three foam mattresses with regard to average sacral pressure, peak sacral pressure, and local probe pressure with the lowest values at the visco-elastic foam/air mattress (23.5 ± 2.5 mmHg, 49.3 ± 11.1 mmHg, 29.2 ± 14.0 mmHg respectively). A greater proportion of subjects had affected blood flow in terms of lack of pressure-induced vasodilation on the visco-elastic foam/air mattress compared to the alternating pressure mattress at tissue depths of 2 mm (39.0% vs. 20.0%, respectively) and 10 mm (56.9 % vs. 35.1%, respectively). Eleven individuals, including subjects in all three subject groups were identified with no pressure-induced vasodilation or reactive hyperemia in any mattress, and this was considered a high-risk blood flow response.Conclusion: Interface pressure magnitudes considered not harmful during pressure-exposure lying on different pressure-redistribution mattresses can affect the microcirculation in different tissue structures. Despite having the lowest pressure values compared to the other mattresses, the visco-elastic foam/air mattress had the highest proportion of subjects with decreased blood flow indicating a more affected blood flow. Three young healthy individuals were identified with the high-risk blood flow response, indicating an innate vulnerability to pressure exposure and may not benefit from pressure-redistribution mattresses. Finally it was shown that the evaluation of pressure-redistribution support surfaces in terms of mean blood flow during and after tissue exposure is not feasible but assessment of pressure-induced vasodilation and reactive hyperemia could be a new possibility to assess individualized physiological measurements of mechanisms known to be related to pressure ulcer development.
|
|
| 9. |
- Blomgren, Lena, 1957-, et al.
(författare)
-
The influence of socioeconomic factors on intervention and postoperative healing of venous ulcers : a prospective study
- 2024
-
Ingår i: Journal of Wound Care. - : MA Healthcare. - 0969-0700 .- 2052-2916. ; 33:7, s. 474-479
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: In previous studies, venous ulcers (VUs) have been found to occur more often in patients with lower socioeconomic status. The aim of this study was to explore if socioeconomic factors influence the delay of referral to a vascular service or the time to healing after superficial venous intervention.Method: In this prospective study, patients answered a questionnaire about the duration and recurrence of their VU, comorbidities, body mass index (BMI), smoking, alcohol, social and physical activities, ambulatory status, education, marital status, housing, perceived economic status and dependence on home care. Postoperative complications, VU healing and recurrence were noted one year after superficial venous intervention.Results: A total of 63 patients were included in this study (30 females and 33 males), with a mean age of 71.2 years (range: 37-92 years). Duration of the present VU in patients was: <3 months in 48%; 3-6 months in 27%; 6-12 months in 11%; and >12 months in 14%. Risk factors for delayed referral were recurrent VU (odds ratio (OR): 4.92; p=0.021); walking impairment (OR: 5.43; p=0.009) and dependence on home care (OR: 4.89: p=0.039) in a univariable analysis. The latter was the only significant finding in a multivariable analysis with socioeconomic risk factor (OR: 4.89; p=0.035). In 85% of patients, their VU healed without recurrence during one year follow-up. Healing took longer if the patients: were of older age (p=0.033); had a normal BMI (independent samples t-test, p=0.028); had a recurrent VU (OR: 5.00; p=0.049); or walking impairment (Fishers exact test, OR: 9.14; p=0.008), but no significant socioeconomic risk factors were found.Conclusion: In this study, socioeconomic factors were not important risk factors for delayed referral of VU patients to a vascular service or prolonged healing time after superficial venous intervention.
|
|
| 10. |
- Blomstrand, Edvin, 1993, et al.
(författare)
-
Clinical investigation of use of an antimicrobial peptide hydrogel wound dressing on intact skin
- 2023
-
Ingår i: Journal of Wound Care. - 2052-2916 .- 0969-0700. ; 32:6, s. 368-375
-
Tidskriftsartikel (refereegranskat)abstract
- A material with the ability to rapidly eradicate bacteria via a contact-killing mechanism has the benefit of a more localised treatment that is easy to implement when needed to prevent or treat a bacterial infection. Here, we present an antimicrobial material based on covalently attached antimicrobial peptides (AMPs) to a soft amphiphilic hydrogel. This results in a material that exhibits an antimicrobial effect based on contact-killing. In this study, the antimicrobial efficacy of the AMP-hydrogel was investigated by observing the changes in total bioburden on the intact skin of healthy human volunteers when the AMP-hydrogel dressing was placed on the forearm for three hours. The AMP-hydrogel significantly reduced the bioburden on the skin from a mean value of 1200CFU/cm2 for the untreated skin to 23CFU/cm2. Biocompatibility evaluations of the AMP-hydrogel showed no sign of cytotoxicity, acute systemic toxicity, irritation or sensitisation, demonstrating the safety of the AMP-hydrogel as a potential wound dressing. Leachability studies confirmed no release of AMPs and that the antimicrobial effect was localised to the surface of the hydrogels, demonstrating a pure contact-killing mode of action.
|
|
| 11. |
|
|
| 12. |
- Ebbeskog, B, et al.
(författare)
-
A follow-up study of leg ulcer patients in south Stockholm
- 1999
-
Ingår i: Journal of wound care. - : Mark Allen Group. - 0969-0700 .- 2052-2916. ; 8:4, s. 170-4
-
Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to follow up patients with leg ulcers, previously identified in an epidemiological study in South Stockholm. Rate of healing, non-healing, recurrence, amputation and mortality were recorded. A total of 254 patients were identified for follow-up after 18 months, using a questionnaire; at the time of the follow-up study, 61% of the ulcers were healed, 29% of the patients still had open ulcers, and 8% of the ulcers had recurred after healing. During this period, 20% of the patients had died, with arterial disease (39%) being more common than venous insufficiency. A further objective was to investigate 21 patients with non-healed venous leg ulcers by means of a structured assessment instrument, and to study if wound healing could be encouraged by using a triple-layer bandage for three months. Patients with non-healed venous leg ulcers treated in community care were recruited for assessment by means of a standardised form and given a triple-layer bandaging treatment for a three-month period. Two ulcers had healed and nine ulcers had improved and were healing. In the group of patients with healed or improved ulcers, five had normal mobility. Venous aetiology was also more common than arterial aetiology
|
|
| 13. |
- Elgzyri, T, et al.
(författare)
-
Can duplex arterial ultrasonography reduce unnecessary angiography?
- 2008
-
Ingår i: Journal of Wound Care. - : Mark Allen Group. - 0969-0700 .- 2052-2916. ; 17:11, s. 497-500
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To assess the value of arterial duplex ultrasound, which assesses the location and severity of arterial disease, in determining whether invasive vascular intervention is required.METHOD: A total of 166 consecutive diabetic patients presenting at a multidisciplinary foot clinic with severe peripheral vascular disease, with or without a foot ulcer, were included in this prospective study. The choice of vascular intervention was based on the results of a duplex ultrasound examination. Subjects were followed up for two years, and their clinical management, vascular assessments and interventions given, and patient outcomes were recorded in a specially designed protocol.RESULTS: Based on findings of the duplex ultrasound, it was recommended that 55 patients (33%) should undergo angioplasty (percutaneous transluminal angioplasty [PTA] and/or subintimal recanalisation), 64 patients (39%) diagnostic angiography and 47 patients (28%) medical treatment only, thereby avoiding unnecessary angiography and its potential complications. Diagnostic angiography was recommended when the duplex ultrasound results were inconclusive. Fifty-two of the 55 patients recommended angiography with simultaneous angioplasty had an angiography; of these, 42 (81%) then had an angioplasty. Fifty-seven of the 64 patients with inconclusive results had an angiography. Of these, 23 (40%) subsequently had angioplasty, only 10 (18%) had reconstructive surgery and 24 (42%) had a diagnostic angiography only.CONCLUSION: Arterial duplex ultrasound may assist evaluations of the need for and type of invasive vascular intervention in patients with an ischaemic diabetic foot. It can thus help avoid diagnostic angiographies that do not result in vascular intervention. However, such decision-making remains at the discretion of the vascular surgeon and radiologist.
|
|
| 14. |
|
|
| 15. |
- Eliasson, B, et al.
(författare)
-
Debriding effect of amino acid-buffered hypochlorite on hard-to-heal wounds covered by devitalised tissue: pilot study
- 2021
-
Ingår i: Journal of wound care. - : Mark Allen Group. - 0969-0700 .- 2052-2916. ; 30:6, s. 455-464
-
Tidskriftsartikel (refereegranskat)abstract
- Wounds such as lower extremity ulcers are serious, costly and frequently hard to heal. Guidelines conclude that new dressings and treatments generally fail to show superiority compared with standard of care. Several mechanisms are probably responsible for impaired healing of hard-to-heal wounds, including inflammation and infection. Amino acid-buffered hypochlorite has presumed antiseptic and antibacterial properties and has been shown to be useful in the treatment of diabetic foot ulcers (DFUs). We evaluated the debriding effect of amino acid-buffered hypochlorite (ChloraSolv) on full skin hard-to-heal lower extremity ulcers covered with devitalised tissue (≥50%), with six applications over 5 weeks and follow-up at 12 weeks. Method: This was an open-label, single-arm, multicentre, pre-market pilot investigation. We recruited subjects with a lower extremity ulcer, covered with devitalised tissue (≥50%), who were candidates for cleansing and debridement/desloughing. There was a weekly application of the investigational device for five weeks. Follow-up for wound status evaluation was performed at 12 weeks from baseline. Results: We evaluated 57 subjects (33 males, 24 females, median age 73 years, range 51–90 years) (intention-to-treat). Of these, 61.4% had a leg ulcer and 38.6% a foot ulcer. The median wound size at baseline was 7.7cm2 (range 2.1–52cm2) with devitalised tissue coverage of 76.5%. After 5 weeks, a decrease of 72.7% in devitalised tissue was seen, and 71.4% of the subjects showed a decrease in devitalised tissue of ≥50% (evaluated independently using PictZar). At 12 weeks' follow-up the decrease in devitalised tissue was 84.4%. Wound-related pain was reported by ten subjects, resulting in 17 adverse events (AEs). Among these, 12 AEs from eight subjects were recorded as possibly or probably related to the investigational device and one AE was reported to have a causal relationship with the investigational device. Conclusion: This clinical study suggests that amino acid-buffered hypochlorite can be effective and well tolerated in the treatment of hard-to-heal lower extremity ulcers to dissolve and remove devitalised tissue.
|
|
| 16. |
|
|
| 17. |
|
|
| 18. |
- Fourie, Anika, et al.
(författare)
-
Development of prone positioning and skin damage prevention digital education : the PRONEtect project
- 2023
-
Ingår i: Journal of Wound Care. - : MA Healthcare Ltd.. - 0969-0700 .- 2052-2916. ; 32:9, s. 570-578
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The incidence of skin/tissue damage, such as pressure ulcers, remains high in mechanically ventilated patients in the prone position. According to guidelines, critically ill patients with acute respiratory distress syndrome (ARDS) should be prone for at least 12-16 hours to improve oxygenation and decrease mortality. Therefore, educating clinicians on how to reposition and manage the patient safely in a prone position plays a vital role in preventing adverse events. This project aimed to develop accessible online educational content to assist clinicians in safely executing the prone manoeuvre and minimise skin/tissue damage.METHOD: The development of the educational content was based on: a gap analysis and comprehensive review of available educational resources; evidence-based scientific literature; advice from international experts; and a qualitative study exploring the learning needs of 20 clinicians in Belgium and Sweden between February-August 2022.RESULTS: Volunteer clinicians assisted with the creation of eight simulation videos which were professionally filmed and edited. The interactive videos included the supine-to-prone and prone-to-supine manoeuvres, endotracheal and nasogastric tube securement, eye care, stoma care, protecting high-risk areas from pressure damage, and incontinence-associated dermatitis prevention. A prone positioning protocol, a checklist summarising the key aspects of the protocol, and teaching aids (slide deck for didactic lecturing) were developed and validated by a review of the relevant evidence-based literature and the international expert panel. A website was designed to host the content, with free user access, at www.pronetection.com.CONCLUSION: Education is one strategy towards prevention of complications of prone positioning. Accessible education could assist clinicians unfamiliar with prone positioning or current clinicians requiring refresher training to safely manage patients in this position.
|
|
| 19. |
|
|
| 20. |
- Gillespie, Brigid M., et al.
(författare)
-
Incidence of wound dehiscence in patients undergoing laparoscopy or laparotomy: a systematic review and meta-analysis
- 2023
-
Ingår i: JOURNAL OF WOUND CARE. - 0969-0700. ; 32
-
Forskningsöversikt (refereegranskat)abstract
- Surgical wound dehiscence (SWD) is a serious complication- with a 40% estimated mortality rate-that occurs after surgical intervention. Since the implementation of advanced recovery protocols, the current global incidence of SWD is unknown. This systematic review and meta-analysis estimated the worldwide incidence of SWD and explored its associated factors in general surgical patients. Eligible full-text cross-sectional, cohort and observational studies in English, between 1 January 2010 to 23 April 2021, were retrieved from MEDLINE, CINAHL, EMBASE and the Cochrane Library. Data extraction and quality appraisal were undertaken independently by three reviewers. Random effects meta-analytic models were used in the presence of substantial inconsistency. Subgroup, meta-regression and sensitivity analyses were used to explore inconsistency. Publication bias was assessed using Hunter's plots and Egger's regression test. Of 2862 publications retrieved, 27 studies were included in the final analyses. Pooled data from 741,118 patients across 24 studies were meta-analysed. The 30-day cumulative incidence of SWD was 1% (95% Confidence Interval (CI): 1-1%). SWD incidence was highest in hepatobiliary surgery, at 3% (95% CI: 0-8%). Multivariable meta-regression showed SWD was significantly associated with duration of operation and reoperation (F=7.93 (2-10); p=0.009), explaining 58.2% of the variance. Most studies were retrospective, predated the agreed global definition for SWD and measured as a secondary outcome; thus, our results likely underestimate the scope of the problem. Wider uptake of the global definition will inform the SWD surveillance and improve the accuracy of reporting. Declaration of interest: The authors have no conflicts of interest.
|
|
| 21. |
- Gottrup, Finn, et al.
(författare)
-
Antimicrobials and Non-Healing Wounds. Evidence, controversies and suggestions-key messages
- 2014
-
Ingår i: Journal of Wound Care. - : Mark Allen Group. - 0969-0700 .- 2052-2916. ; 23:10, s. 477-477
-
Tidskriftsartikel (refereegranskat)abstract
- This article constitutes an extraction of key messages originally presented in the Document:Antimicrobials and Non-Healing Wounds. Evidence, controversies and suggestions written by the European Wound Management Association (EWMA), and originally published by the Journal of Wound Care in 2013.All sections are shortened and some not included. For further details please refer to in the original document which can be downloaded via www.ewma.org.
|
|
| 22. |
- Gunningberg, Lena, et al.
(författare)
-
Effect of visco-elastic foam mattresses on the development of pressure ulcers in patients with hip fractures
- 2000
-
Ingår i: Journal of Wound Care. - 0969-0700 .- 2052-2916. ; 9:10, s. 455-460
-
Tidskriftsartikel (refereegranskat)abstract
- This study had three aims: to investigate if visco-elastic foam mattresses are more effective than standard hospital mattresses in reducing the incidence of pressure ulcers in patients with hip fractures; to compare pressure ulcer grade and location and documented nursing prevention and treatment interventions in patients using the two types of mattresses; and to identify possible predictors of pressure ulcer development. Using a prospective randomised controlled trial design 101 patients (mean age: 84 years) were randomly allocated either a visco-elastic foam mattress or a standard mattress. There was no significant difference in the incidence of pressure ulcers between the two groups, but patients on standard mattresses tended to develop more severe pressure ulcers. Furthermore, according to the documentation, patients with grade I pressure ulcers who were allocated a standard mattress received more preventive interventions, which may have reduced the differences in outcomes between the two groups. The researchers conclude that the results support the use of the test mattress. Significant predictors of pressure ulcer development were long waiting times for surgery and low haemoglobin levels at hospital admission.
|
|
| 23. |
|
|
| 24. |
- Gunningberg, Lena, 1954-
(författare)
-
Risk, prevalence and prevention of pressure ulcers in three Swedish healthcare settings
- 2004
-
Ingår i: Journal of Wound Care. - 0969-0700 .- 2052-2916. ; 13:7, s. 286-290
-
Tidskriftsartikel (refereegranskat)abstract
- Prevalence of pressure ulcers was higher than expected. Results relating to both prevalence of pressure ulcers (grade I excluded) and the preventive care given to patients at risk or with pressure ulcers accord with those of a larger Dutch study. Attention must focus on the appropriate risk-assessment skills, highlighting grade I as pressure damage, and the use of appropriate preventive strategies, based on the level of risk.
|
|
| 25. |
- Hjelm, K., et al.
(författare)
-
Influence of beliefs about health and illness on self-care and care-seeking in foreign-born people with diabetic foot ulcers : Dissimilarities related to origin
- 2016
-
Ingår i: Journal of Wound Care. - : Mark Allen Group. - 0969-0700 .- 2052-2916. ; 25:11, s. 602-616
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To describe beliefs about health and illness among foreign-born people with diabetic foot ulcers that might affect selfreported self-care and health-care seeking and to study whether there are dissimilarities related to origin. Method: Qualitative descriptive study. Semi-structured interviews with people aged 38-86 years; 13 born in European and 13 in non-European countries (all except one in the Middle East). All resident in Sweden for 7-60 years (median: 18.5 years). Results: Most believed foot ulcers were unavoidable and difficult to detect. Foot problems were mainly believed to be due to internal factors (diabetes), sometimes combined with external factors (inappropriate footwear, hot water, or barefoot walking). Health was described as freedom from illness and health professionals were seen as important sources of information. Perceived health deteriorated after the onset of the foot problems due to immobility and pain. People from the Middle East differed from other respondents as they discussed the importance of adapting to the will of Allah, leading to even poorer quality of life and a more negative view of future health. They also described more foot problems and perceived religion (Islam) with ritual washing of the feet to be important for health. However, they were regularly monitored to a lesser extent than European migrants. Economy affected health, more so in Europeans, due to expenses for medications and shoes. Many described limited activity in self-care, few had sought help for their problems and then solely among professionals, and had limited knowledge about the influence of glycaemic control on diabetes and foot status. Conclusion: Foreign-born people felt unable to prevent the incidence of foot ulcers, experienced problems with detection, and had limited knowledge of self-care. Dissimilarities in beliefs related to origin negatively influenced self-care of the feet, so it is important to assess individual beliefs and plan care and education accordingly.
|
|
| 26. |
- Jebril, W, et al.
(författare)
-
Topical oxygen treatment relieves pain from hard-to-heal leg ulcers and improves healing: a case series
- 2022
-
Ingår i: Journal of wound care. - : Mark Allen Group. - 0969-0700 .- 2052-2916. ; 31:1, s. 4-11
-
Tidskriftsartikel (refereegranskat)abstract
- Managing painful hard-to-heal leg ulcers is challenging with current therapeutic options. Wounds are prone to being hypoxic, and the subsequent pain is often related to hypoxia. Hyperbaric oxygen therapy (HBOT) is used to treat hard-to-heal leg wounds by delivering 100% oxygen at a pressure 2–3 times higher than atmospheric pressure. Unfortunately, most patients cannot be offered HBOT because it is costly and needs to be applied at specialised centres. Therefore, topical continuous oxygen therapy (TCOT) is a novel alternative for continuous local oxygen delivery to wounds and is associated with improved wound healing; however, its effect on painful wounds is unknown. This retrospective study was conducted on 20 patients, of whom 17 had painful hard-to-heal leg ulcers. In 13 patients (76%) with painful ulcers, TCOT was associated with rapid and substantial pain alleviation. Also, eight (40%) of the patients' wounds healed entirely with TCOT. This study suggests that TCOT may represent a novel pain management device for hard-to-heal wounds.
|
|
| 27. |
- Lagerin, Annica, et al.
(författare)
-
An educational intervention for district nurses : use of electronic records in leg ulcer management.
- 2007
-
Ingår i: Journal of Wound Care. - : Mark Allen Group. - 0969-0700 .- 2052-2916. ; 16:1, s. 29-32
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate district nurses' management of leg ulcer patients and the effects of an in-service education programme led by district nurses as local educators at primary health-care centres.METHOD: Data were collected from electronic patient records (EPRs), both before and after the educational intervention. Nineteen district nurses undertook a one-day course focusing on four themes: Doppler assessment and measurement of ankle brachial pressure index; compression treatment; patient education; nursing documentation. Fourteen acted as in-service educators; 12 educators completed the intervention. The EPRs were scrutinised with an audit tool.RESULTS: The documentation on the selected key areas for the management of patients with leg ulcers was generally sparse, although the educational intervention resulted in statistically significant effects on documentation in three areas.CONCLUSION: Further improvements in care are necessary, as are qualitative and quantitative studies to explore the large discrepancies between guidelines and everyday clinical practice in this field.
|
|
| 28. |
|
|
| 29. |
- Lindholm, Christina, et al.
(författare)
-
Diagnosis and treatment impacts on wound care efficiency drivers : Real-world analysis
- 2021
-
Ingår i: Journal of Wound Care. - : Mark Allen Group. - 0969-0700 .- 2052-2916. ; 30:7, s. 534-542
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: The prevalence and economic burden of wounds are growing. Any wound has the potential to become hard-to-heal and require frequent care. Clinicians need to find ways to absorb demand on services without compromising outcomes. Drivers of wound care efficiency-time-to-heal, frequency of dressing change and the incidence of complications-can be evaluated to shape future wound management. A survey of wound care was conducted by clinicians from five centres in Sweden over a one-week period, during which clinicians documented every wound once. At the time of surveying, 49% of wounds were considered to be improving, infection incidence was 11.7% and dressings were changed a mean of 2.2 times per week, with highly exuding wounds changed 6.9 times per week. The data highlighted the importance of diagnosing patient and wound characteristics in selecting treatments and organising care. Recognised gaps in diagnoses potentially identify opportunities to influence healing, complication incidence and intensity of nursing, thus reducing demand on resources. In conclusion, this survey highlights opportunities to reduce the burdens these drivers present. Through improved diagnosis and alignment to recognised care pathways, there is potential to improve patient outcomes and alleviate the strains placed upon wound care providers.
|
|
| 30. |
- Lindholm, Christina, et al.
(författare)
-
Wounds scrutiny in a Swedish hospital : prevalence, nursing care and bacteriology, including MRSA
- 2005
-
Ingår i: Journal of Wound Care. - : Mark Allen Group. - 0969-0700 .- 2052-2916. ; 14:7, s. 313-9
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To identify all wounds, wound types and wound characteristics; to identify bacteria in all wounds, particularly MRSA, VRE and multi-resistant Gram-negative rods;. METHOD: All patients admitted to or visiting hospital clinics were examined. If the patient had a wound, a questionnaire was filled in by a nurse, and if the wound met the inclusion criteria swabs were taken. RESULTS: A total of 2172 patients were admitted to or visited the hospital; 408 (19%) had a total of 668 wounds. Of this number, 248 were cultured. Thirty-seven patients had pressure ulcers, 83 had leg and foot ulcers and 288 patients had other types of wounds. Nursing care varied according to wound type and ward. Fifty-eight different types of wound dressings were used. Cleansing was performed with saline in 58% of the wounds. The mean number of dressing changes was once daily. Wounds were painful in 37% of the cases, with a predominance of leg and foot ulcers (51%). Many patients did not receive analgesia. MRSA was identified in two patients. No VRE was identified, and there was a low prevalence of multi-resistance in Enterobacteriaceae and Pseudomonas aeruginosa. CONCLUSION: The study provided important information for future improvement of wound care in a university hospital. Fewer resistant bacteria, particularly MRSA, were identified than expected.
|
|
| 31. |
|
|
| 32. |
- Löndahl, Magnus, et al.
(författare)
-
A prospective study: hyperbaric oxygen therapy in diabetics with chronic foot ulcers
- 2006
-
Ingår i: Journal of Wound Care. - 0969-0700. ; 15:10, s. 457-459
-
Tidskriftsartikel (refereegranskat)abstract
- Research suggests that hyperbaric oxygen therapy may have beneficial effects on ulcer healing and amputation rates in diabetic patients. This paper describes the design of a study that is evaluating its effects on chronic diabetic foot ulcers.
|
|
| 33. |
- Löndahl, Magnus, et al.
(författare)
-
Is chronic diabetic foot ulcer an indicator of cardiac disease?
- 2008
-
Ingår i: Journal of Wound Care. - 0969-0700. ; 17:1, s. 12-16
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate presence and severity of cardiac disease in individuals with chronic diabetic foot ulcers using echocardiography. METHOD: Eighty consecutive patients with chronic foot ulcers attending the multidisciplinary diabetes foot clinic at Helsingborg Hospital underwent clinical examination, toe blood pressure measurement and a standard echocardiographic examination. RESULTS: Sixty-nine percent of the patients had a history of myocardial infarction and/or hypertension and/or heart failure; 78% had signs of left ventricular dysfunction and/or left ventricular hypertrophy and/or diastolic dysfunction; 76% of the patients without a history of cardiovascular disease had signs of cardiac dysfunction on echocardiography. CONCLUSION: Cardiac dysfunction is a common occurrence present in patients with chronic diabetic foot ulcers, even in those without known cardiac disease or hypertension. Echocardiography may be recommended as a screening procedure in the management of diabetic patients with chronic foot ulcers. The present study supports the view that diabetic chronic foot ulcers ought to be seen as a sign of cardiac disease, although further research is needed to elucidate this issue.
|
|
| 34. |
- Löndahl, Magnus, et al.
(författare)
-
Use of an autologous leucocyte and platelet-rich fibrin patch on hard-to-heal DFUs: a pilot study.
- 2015
-
Ingår i: Journal of Wound Care. - : Mark Allen Group. - 0969-0700 .- 2052-2916. ; 24:4, s. 172-178
-
Tidskriftsartikel (refereegranskat)abstract
- Leucopatch is a leukocyte and platelet-rich fibrin patch that provides concentrated blood cells and signal substances to the surface of an ulcer. It is produced by centrifugation of the patient's own venous blood. The aim of this pilot multicentre cohort study was to evaluate effects of the leucocyte patch in patients with hard-to-heal diabetic foot ulcers (DFUs).
|
|
| 35. |
- Malmsjö, Malin, et al.
(författare)
-
Green foam, black foam or gauze for NWPT: effects on granulation tissue formation.
- 2011
-
Ingår i: Journal of Wound Care. - 0969-0700. ; 20:6, s. 294-299
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare the effects of green foam with black foam and gauze during negative pressure wound therapy (NPWT), with regard to wound bed appearance and granulation tissue formation, and monitoring of wound exudate. METHOD: Wounds on the backs of eight pigs underwent 72 hours of NPWT plus either green polyurethane foam with an open pore structure, black polyurethane foam with an open pore structure or saline-moistened AMD gauze. Sections of biopsies from the wound bed, including the overlying dressing, were examined histologically with regard to microdeformation of the wound bed and granulation tissue formation. The force required to remove the wound fillers was measured. RESULTS: Wound exudate and bleeding could be easily seen when using gauze and green foam, but were not visible under the black foam. Such visibility facilitates monitoring of the wound status. No difference was found in the quantity or characteristics of the granulation tissue formed under the green foam or black foam. Both green foam and black foam resulted in more pronounced granulation tissue formation than gauze under negative pressure. There was also more leucocyte infiltration and tissue disorganisation under green foam and black foam than under gauze. All three wound fillers created microdeformation within the wound bed surface. Similar forces were required to remove green foam and black foam (5.0 ± 0.6 N for green foam and 4.0 ± 0.4 N for black foam), while less force was needed for gauze (2.1 ± 0.2 N). This may be a result of tissue ingrowth into the foam (357 ± 12µm for green foam and 362 ± 14µm for black foam), but not into gauze (0µm), as shown by examination of biopsy sections from the wound bed. CONCLUSION: Green foam and black foam have similar biological effects on the wound bed. Bleeding and exudate can be more easily monitored when using green foam or gauze. Differences in the wound bed tissue morphology when using foam or gauze plus NPWT support clinical observations that granulation tissue under foam is thick but fragile, whereas that under foam is thinner but denser. CONFLICT OF INTEREST: The study was supported by Mölnlycke Health Care AB
|
|
| 36. |
- Marczak, J., et al.
(författare)
-
Patient experiences of living with chronic leg ulcers and making the decision to seek professional health-care
- 2019
-
Ingår i: Journal of Wound Care. - 0969-0700. ; 28:1
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of the study was to elucidate how patients experience living with chronic leg ulcers before consulting a health professional, and to determine the reasons behind the decision to visit a health-care centre. Method: A qualitative interview study was carried out. There were 11 participants, five men and six women (age range: 27-83 years old). All participants in the study were patients visiting the public primary medical centre in western Sweden for the first time for a chronic leg ulcer. The data was obtained by recorded interviews. Systematic text condensation (STC) by Malterud was applied to the analysis. Results: The analysis identified five main categories of the issues relating to ulcers to their ulcers: convictions, pain, emotions,strategies, and health-care treatment. At first, patients accepted the inconvenience of a leg ulcer. Gradually, they focused more on strategies dealing with the ulcer, and withdrew from their social context, while their fears increased. Many needed support in the decision to seek professional care. Conclusion: Despite pain, anxiety, emotional lability, and disappointment, they had strategies to cope with ulcers on their own. A social network seems crucial for the decision to seek professional health care and greater knowledge of leg ulcers, particularly in the elderly population, is needed.
|
|
| 37. |
|
|
| 38. |
- Monsen, Christina, et al.
(författare)
-
A randomised study of NPWT closure versus alginate dressings in peri-vascular groin infections : quality of life, pain and cost
- 2015
-
Ingår i: Journal of Wound Care. - : Informa Healthcare. - 0969-0700 .- 2052-2916. ; 24:6, s. 252-258
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to compare the vacuum assisted wound closure (VAC) system (negative pressure wound therapy; NPWT) and alginate wound dressings in terms of quality of life (QoL), pain resource use and cost in patients with deep peri-vascular groin infection after vascular surgery. METHOD: Patients with deep peri-vascular groin infection (Szilagyi grade III) were included and randomised to NPWT or alginate therapy. EuroQol 5D (EQ-5D) and brief pain inventory (BPI) were used to evaluate QoL and pain, respectively. RESULTS: Wound healing time until complete skin epithelialisation was shorter in the NPWT (n=9) compared to the alginate group (n=7), median 57 and 104 days, respectively (p=0.026). No difference was recorded in QoL and pain between the groups at study start and the second assessment. QoL analysis within groups between time points, showed that patients in NPWT groups improved in EQ-5D domains, 'self-care' (p= 0.034), 'usual activities' (p=0.046); EQ-5D index value (p=0.046) and EQ-VAS (p=0.028). Patients in the NPWT group reported significantly less pain 'affecting their relations with other people' and 'sleep' between time points. The NPWT group had significantly fewer dressing changes compared to the alginate group (p<0.001). The median frequency of wound dressing changes outside hospital was 20 (IQR 6-29) in the NPWT group (n=9), compared to 48 (IQR 42-77) in the alginate group (n=8; p=0.004). The saved personnel time for wound care in the first week for the NPWT group, compared with the alginate group, was 4.5 hours per week per nurse. The total hospitalised care cost was 83-87% of the total cost in both groups. CONCLUSION: NPWT therapy in patients with deep peri-vascular groin infection can be regarded as the dominant strategy due to improved clinical outcome with equal cost and quality of life measures.
|
|
| 39. |
- Murphy, Christine, et al.
(författare)
-
Defying hard-to-heal wounds with an early antibiofilm intervention strategy : 'Wound hygiene'
- 2019
-
Ingår i: Journal of Wound Care. - : Mark Allen Group. - 0969-0700 .- 2052-2916. ; 28:12, s. 818-822
-
Tidskriftsartikel (refereegranskat)abstract
- Biofilm has been implicated as a barrier to wound healing and it is widely accepted that the majority of wounds not following a normal healing trajectory contain biofilm. Therefore, strategies that inform and engage clinicians to reduce biofilm and optimise the wound tissue environment to enable wound progression are of interest to wound care providers. In March 2019, an advisory board was convened where experts considered the barriers and opportunities to drive a broader adoption of a biofilm-based approach to wound care. Poor clarity and articulation of wound terminology were identified as likely barriers to clinical adoption of rigorous and proactive microbial decontamination that is supportive of wound healing advancement. A transition to an intuitive term such as 'wound hygiene' was proposed to communicate a comprehensive wound decontamination plan with an associated message of expected habitual routine. 'Wound hygiene', is a relatable concept that supports meticulous wound practice that addresses barriers to wound healing, such as biofilm, while aligning with antimicrobial stewardship programmes..
|
|
| 40. |
- Norkus, A, et al.
(författare)
-
Use of a hydrocapillary dressing in the management of highly exuding ulcers; a comparative study
- 2005
-
Ingår i: Journal of Wound Care. - 0969-0700. ; 14:9, s. 129-432
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate the safety and performance of Alione Hydrocapillary dressing (Coloplast A/S) in the management of highly exuding chronic venous leg ulcers and compare it with two hydropolymer dressings, Tielle and Tielle Plus (Johnson & Johnson). Method: A comparative clinical trial was conducted on 97 patients with an ankle brachial pressure index ?0.8 and a highly exuding leg ulcer. Ulcer duration was at least four weeks. Treatment continued until healing or for a maximum of 12 months. Results: There was no statistically significant difference in healing time or wound area reduction between the two treatment protocols. The test dressing (Alione Hydrocapillary) had better absorption capacity and was more comfortable for the patients than the comparator dressings (Tielle/Tielle Plus) and adhered less to the wound bed. Also, more patients preferred the test dressing to their previous treatment. Although severe leakage and maceration were observed more frequently in the comparator group compared with the test group, this was not statistically significant. Conclusion: Both treatment protocols were safe and effective in treating highly exuding chronic venous leg ulcers. The test dressing performed as well as or better than the comparator dressings for all study parameters and more patients preferred the test dressing to their previous dressing compared with the comparator dressings.
|
|
| 41. |
- Oien, R F, et al.
(författare)
-
Measuring the size of ulcers by planimetry: a useful method in the clinical setting
- 2002
-
Ingår i: Journal of Wound Care. - 0969-0700. ; 11:5, s. 165-168
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to compare four measurement methods. Digital planimetry was compared with mechanical planimetry, placing the film over graph paper and counting the squares (grid tracing), and multiplying the two maximal perpendicular diameters of the ulcer (diameter product). METHOD: Twenty patients with 50 chronic leg ulcers of various aetiology and sizes (20 ulcers were < or = 3 cm2, 15 ulcers were > 3 cm2 and < or = 10 cm2, and 15 ulcers were > 10 cm2) were enrolled consecutively into this study. Ulcer area was calculated from film transparency tracings using a digital planimeter, a mechanical planimeter, grid tracing and diameter product. RESULTS: The mean difference of digital planimetry versus mechanical planimetry, grid tracing and diameter product was 0.51 cm2, 0.72 cm2 and -5.38 cm2, respectively. For all methods difference tended to increase with ulcer size. CONCLUSION: Digital and mechanical planimetry, together with grid tracing, appear to be appropriate means of obtaining accurate surface area measurements. Digital planimetry is a quick and practical method and could therefore be recommended in the clinical setting.
|
|
| 42. |
- Palin, L, et al.
(författare)
-
Topical oxygen treatment relieves pain from hard-to-heal leg ulcers and improves healing: a case report
- 2021
-
Ingår i: Journal of wound care. - : Mark Allen Group. - 0969-0700 .- 2052-2916. ; 30:3, s. 210-212
-
Tidskriftsartikel (refereegranskat)abstract
- Pain from hard-to-heal wounds is common and challenging to manage with current therapies. Most hard-to-heal wounds show some degree of hypoxia that impairs healing and contributes to pain. Regular oxygen therapy is given in hyperbaric oxygen chambers and is costly, time-consuming and cannot be offered to most patients. Moreover, hyperbaric oxygen therapy (HBOT) only increases tissue oxygen for a short time and is given only for a few hours per week. Topical oxygen therapy (TOT) was introduced as an alternative and in this report we focus on topical continuous oxygen therapy (TCOT), which has been shown to be associated with healing of hard-to-heal ulcers. We report on a patient with type 1 diabetes with a painful hard-to-heal lower leg ulcer that failed to heal with standard wound dressings and that had insufficient response to pharmacological analgesia. The patient was on three different analgesics before treating the wound with TCOT. As the wound was considered hypoxic, due to longstanding diabetes and probable microangiopathy, TCOT was commenced. Within one week of treatment starting, the patient spontaneously ceased all his analgesics as he was free of pain; and after 2.5 months, the ulcer healed. The patient reported no adverse effects. In addition to promoting healing, TCOT may also be considered for its potential analgesic effects in hard-to-heal wound management.
|
|
| 43. |
- Paulander, Ann-Sofie, et al.
(författare)
-
Use of person-centred music to manage wound dressing-related pain : a mixed method case study
- 2024
-
Ingår i: Journal of Wound Care. - 0969-0700 .- 2052-2916. ; 33:Sup4a, s. cxxx-cxxxix
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To determine whether person-centred music (PCMusic) contributes to reducing pain during painful leg ulcer dressing change procedures indicated by: decreased levels of indicators related to stress; decreased pain scores; and a more favourable treatment climate during the dressing change procedure.Method: A case study of a 51-year-old female patient with chronic inherited disease weakening her connective tissues. Quantitative data entailed temporal measurements of stress indicators including: heart pulse rate; oxygen saturation (SpO2); saliva cortisol; and a visual analogue scale (VAS). Qualitative data comprised phenomenological treatment descriptions and patient/licensed practical nurse (LPN) questionnaires.Results: The patient's body temperature remained steady throughout all treatments. Blood pressure was excluded due to missing data. No significant pulse rate differences in relation to music/no music could be observed during treatment. Comparing PCMusic to the patient's own other music (POOM), the pulse rate was greater in both magnitude and variation when the patient listened to POOM. Oxygen saturation showed no significant difference between PCMusic and music/no music. No significant difference was observed pre-/post-debridement with music. Similarly, no significant difference was observed pre-/post-debridement with no music. Treatment with no music showed the highest VAS score; PCMusic treatments had the lowest scores. Qualitative data showed that both patient and LPNs found that PCMusic decreased pain during dressing change.Conclusion: The results of this case study indicate that PCMusic is a suitable complementary treatment to decrease patient pain. Patients' general health status is important when using quantitative stress/pain marker measurements. For cohort selection in future studies, we suggest healthy patients undergoing slightly painful or unpleasant treatments, patients in postoperative care and obstetric care.
|
|
| 44. |
- Rönner, Anna-Clara, 1971, et al.
(författare)
-
Adhesion of meticillin-resistant Staphylococcus aureus to DACC-coated dressings
- 2014
-
Ingår i: Journal of Wound Care. - : Mark Allen Group. - 0969-0700 .- 2052-2916. ; 23:10, s. 484-8
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this in vitro study was to demonstrate the binding capacity of multiple meticillin-resistant Staphylococcus aureus (MRSA) strains and compare the binding capacity to meticillin-sensitive Staphylococcus aureus. Method: The binding of Staphylococcus aureus to a surface was assessed by bioluminescent monitoring of the bacterial ATP levels. This assay can be used as an in vitro diagnostic model for bacteria binding in a critically colonised wound. Results: Eleven strains of Staphylococcus aureus were examined including MRSA, all of which efficiently and equally adhered to the dialkyl carbamoyl chloride (DACC)-coated dressing (Sorbact; Abigo Medical AB). The binding capacity was all in the same range 0.7-2.9x10(6) CFU/cm(2). regardless of the antibiotic resistance properties of the specific strain. Conclusion: The decrease of wound bioburden of Staphylococcus aureus including MRSA is the result of the high binding capacity shown in this study and by earlier data. The findings in this study strengthen the held view that development of antibiotic resistance has minimal impact on the surface structures of the microorganisms in wounds.
|
|
| 45. |
- Susilo, Y. B., et al.
(författare)
-
Significant and rapid reduction of free endotoxin using a dialkylcarbamoyl chloride-coated wound dressing
- 2022
-
Ingår i: Journal of wound care. - : Mark Allen Group. - 0969-0700 .- 2052-2916. ; 31:6, s. 502-509
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: Endotoxin causes inflammation and can impair wound healing. Conventional methods that reduce bioburden in wounds by killing microorganisms using antibiotics, topical antimicrobials or antimicrobial dressings may induce endotoxin release from Gram-negative bacteria. Another approach is to reduce bioburden by adsorbing microorganisms, without killing them, using dialkylcarbamoyl chloride (DACC)-coated wound dressings. This study evaluated the endotoxin-binding ability of a DACC-coated wound dressing (Sorbact Compress, Abigo Medical AB, Sweden) in vitro, including its effect on the level of natural endotoxin released from Gram-negative bacteria. Method: Different concentrations of purified Pseudomonas aeruginosa endotoxin and a DACC-coated dressing were incubated at 37 degrees C for various durations. After incubation, the dressing was removed and endotoxin concentration in the solution was quantified using a Limulus amebocyte lysate (LAL) assay. The DACC-coated dressing was also incubated with Pseudomonas aeruginosa cells for one hour at 37 degrees C. After incubation, the dressing and bacterial cells were removed and shed endotoxin remaining in the solution was quantified. Results: Overnight incubation of the DACC-coated wound dressing with various concentrations of purified Pseudomonas aeruginosa endotoxin (96-11000 EU/ml) consistently and significantly reduced levels of free endotoxin by 93-99% (p<0.0001). A significant endotoxin reduction of 39% (p<0.001) was observed after five minutes. The DACC-coated dressing incubated with clinically relevant Pseudomonas aeruginosa cells also reduced shed endotoxin by >99.95% (p<0.0001). Conclusion: In this study, we showed that a DACC-coated wound dressing efficiently and rapidly binds both purified and shed endotoxin from Pseudomonas aeruginosa in vitro. This ability to remove both endotoxin and bacterial cells could promote the wound healing process.
|
|
| 46. |
- Tati, Ramesh, et al.
(författare)
-
Biological wound matrices with native dermis-like collagen efficiently modulate protease activity
- 2018
-
Ingår i: Journal of Wound Care. - : Mark Allen Group. - 0969-0700 .- 2052-2916. ; 27:4, s. 199-209
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: When the delicate balance between catabolic and anabolic processes is disturbed for any reason, the healing process can stall, resulting in chronic wounds. In chronic wound pathophysiology, proteolytic imbalance is implicated due to elevated protease levels mediating tissue damage. Hence, it is important to design appropriate wound treatments able to control and modulate protease activity directly at the host/biomaterial interface. Here, we investigate collagen-based wound dressings with the focus on their potential to adsorb and inactivate tissue proteases. Method: We examined the effect of six collagen-based dressings on their ability to adsorb and inactivate different granulocyte proteases, plasmin, human neutrophil elastase (HLE), and matrix metalloproteases (MMP)-1, -2, -8, and -9, by an integrated approach including immunoelectron microscopy. Results: We observed a reduction of the proteolytic activities of plasmin, HLE, and MMP-1, -2, -8, and -9, both on the biomaterial surface and in human chronic wound fluid. The most pronounced effect was observed in collagen-based dressings, with the highest content of native collagen networks resembling dermis structures. Conclusion: Our data suggest that this treatment strategy might be beneficial for the chronic wound environment, with the potential to promote improved wound healing. Declaration of interest: The authors have no conflicts of interest with the contents of this article. This work was supported by grants from the Swedish Research Council (project 7480), the Swedish Foundation for Strategic Research (K2014-56X-13413-15-3), the Foundations of Crafoord, Johan and Greta Kock, Alfred Österlund, King Gustav V Memorial Fund, and the Medical Faculty at Lund University.
|
|
| 47. |
- Törnvall, Eva, 1956-, et al.
(författare)
-
Quality of Nursing care from the perspective of patients with leg ulcers
- 2010
-
Ingår i: Journal of Wound Care. - 0969-0700 .- 2052-2916. ; 19:9, s. 388-395
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate and analyse the quality of nursing care in a primary care setting from the perspective of patients with leg ulcers and determine the subjective importance that patients attach to various aspects of quality of care. • Method: All of the patients with leg ulcers at 15 primary care centres in the south east of Sweden were invited to participate.They were given the short version of the Quality from the Patient's Perspective questionnaire (QPP) to fill in.This included a number of closed and open questions relating to their perceptions of the quality of their nursing care and the importance of this care to them. • Results: Overall, the patients in this study perceived that the quality of nursing care was high. However, important areas for improvement were revealed, including the need for an increase in patient-focused care, continuity of care and better pain relief. • Conclusion: To address the weak points highlighted by the study, we recommend that nurses explore patient perceptions of pain in greater detail and invite patients take a more active role in the management of their leg ulcers. • Conflict of interest: None.This study was funded by the county council of Östergötland and by Linköping University, Sweden. Objective: To investigate and analyse the quality of nursing care in a primary care setting from the perspective of patients with leg ulcers and determine the subjective importance that patients attach to various aspects of quality of care. Method: All of the patients with leg ulcers at 15 primary care centres in the south east of Sweden were invited to participate. They were given the short version of the Quality from Patient’s Perspective questionnaire (QPP) to fill in. This included a number of closed and open questions relating to their perceptions of the quality of their nursing care and the importance of this care to them. Results: Overall, the patients in this study perceived that the quality of nursing care was high. However, important areas for improvement were revealed, including the need for an increase in patient-focused care, continuity of care and better pain relief. Conclusion: To address the weak points highlighted by the study, we recommend that nurses explore patient perceptions of pain in greater detail and invite patients take a more active role in the management of their leg ulcers.
|
|
| 48. |
- Velickovic, Vladica M., et al.
(författare)
-
Cost-effectiveness of superabsorbent wound dressing versus standard of care in patients with moderate-to-highly exuding leg ulcers
- 2020
-
Ingår i: Journal of Wound Care. - : Mark Allen Group. - 0969-0700 .- 2052-2916. ; 29:4, s. 235-246
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To determine the cost-effectiveness/utility of a superabsorbent wound dressing (Zetuvit Plus Silicone) versus the current standard of care (SoC) dressings, from the NHS perspective in England, in patients with moderate-to-high exudating leg ulcers.Method: A model-based economic evaluation was conducted to analyse the cost-effectiveness/utility of a new intervention. We used a microsimulation state-transition model with a time horizon of six months and a cycle length of one week. The model uses a combination of incidence base and risk prediction approach to inform transition probabilities. All clinical efficiency, health-related quality of life (HRQoL), cost and resource use inputs were informed by conducting a systematic review of UK specific literature.Results: Treatment with the superabsorbent dressing leads to a total expected cost per patient for a six month period of 2887 pound, associated with 15.933 expected quality adjusted life weeks and 10.9% healing rate. When treated with SoC, the total expected cost per patient for a six month period is 3109 pound, 15.852 expected quality adjusted life weeks and 8% healing rate. Therefore, the superabsorbent dressing leads to an increase in quality-adjusted life weeks, an increase in healing rate by 2.9% and a cost-saving of 222 pound per single average patient over six months. Results of several scenario analyses, one-way deterministic sensitivity analysis, and probabilistic sensitivity analysis confirmed the robustness of base-case results. The probabilistic analysis confirmed that, in any combination of variable values, the superabsorbent dressing leads to cost saving results.Conclusion: According to the model prediction, the superabsorbent dressing leads to an increase in health benefits and a decrease in associated costs of treatment.
|
|
| 49. |
- Wickström, Hanna, et al.
(författare)
-
Pain and analgaesics in patients with hard-to-heal ulcers : using telemedicine or standard consultations
- 2020
-
Ingår i: Journal of Wound Care. - : MA Healthcare Ltd. - 0969-0700 .- 2052-2916. ; 29:Suppl 8, s. S18-S27
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To compare consultations carried out via video with those performed in person for patients with painful, hard-to-heal ulcers, with a focus on ulcer pain and pain treatment. A further aim was to investigate predictors for pain and pain treatment. Method: This was a register-based, quasi-experimental study based on data from the Swedish Registry of Ulcer Treatment (RUT). A total of 100 patients with hard-to-heal ulcers diagnosed via video consultation were compared with 1888 patients diagnosed in person with regard to pain assessment, intensity and treatment. Ulcer pain intensity was assessed by the visual analogue scale (VAS). Normally distributed variables (age, VAS) were compared between consultation groups using Student's t-test. Non-normally distributed variables (ulcer size, ulcer duration) were compared using the Mann-Whitney U-test, except for healing time, which was analysed with a log-rank test. Categorical variables (gender, ulcer aetiology and prescribed analgesics) were compared using Pearson's chi-square test (chi(2)). A p value of less than 0.05 was considered to indicate statistical significance. Predictors for pain and pain treatment were analysed in multiple regression analyses. Results: The results showed a high presence of pain; 71% of patients with pain reported severe ulcer pain. There was no significant difference in ability to assess pain by VAS in the group diagnosed via video consultation (90%) compared with the group diagnosed in person (86%) (chi(2), p=0.233). A significantly higher amount of prescribed analgesics was found for patients diagnosed via video (84%) compared with patients diagnosed by in-person assessment (68%) (chi(2), p=0.044). Predictors for high-intensity pain were female gender or ulcers due to inflammatory vessel disease, while the predictors for receiving analgesics were older age, longer healing time and being diagnosed via video consultation. Conclusion: To identify, assess and treat ulcer pain is equally possible via video as by in-person consultation. The results of this study confirm that patients with hard-to-heal ulcers suffer from high-intensity ulcer pain, with a discrepancy between pain and pain relief. Further well-designed randomised controlled studies are necessary to understand how best to deploy telemedicine in ulcer pain treatment.
|
|
| 50. |
- Wickström, Hanna, et al.
(författare)
-
Pain and analgesics in patients with hard-to-heal ulcers : using telemedicine or standard consultations
- 2021
-
Ingår i: Journal of Wound Care. - : Mark Allen Group. - 0969-0700 .- 2052-2916. ; 30:Sup6, s. S23-S32
-
Tidskriftsartikel (refereegranskat)abstract
- Objective:To compare consultations carried out via video with those performed in person for patients with painful, hard-to-heal ulcers, with a focus on ulcer pain and pain treatment. A further aim was to investigate predictors for pain and pain treatment.Method:This was a register-based, quasi-experimental study based on data from the Swedish Registry of Ulcer Treatment (RUT). A total of 100 patients with hard-to-heal ulcers diagnosed via video consultation were compared with 1888 patients diagnosed in person with regard to pain assessment, intensity and treatment. Ulcer pain intensity was assessed by the visual analogue scale (VAS). Normally distributed variables (age, VAS) were compared between consultation groups using Student's t-test. Non-normally distributed variables (ulcer size, ulcer duration) were compared using the Mann–Whitney U-test, except for healing time, which was analysed with a log-rank test. Categorical variables (gender, ulcer aetiology and prescribed analgesics) were compared using Pearson's chi-square test (χ2). A p value of less than 0.05 was considered to indicate statistical significance. Predictors for pain and pain treatment were analysed in multiple regression analyses.Results:The results showed a high presence of pain; 71% of patients with pain reported severe ulcer pain. There was no significant difference in ability to assess pain by VAS in the group diagnosed via video consultation (90%) compared with the group diagnosed in person (86%) (χ2, p=0.233). A significantly higher amount of prescribed analgesics was found for patients diagnosed via video (84%) compared with patients diagnosed by in-person assessment (68%) (χ2, p=0.044). Predictors for high-intensity pain were female gender or ulcers due to inflammatory vessel disease, while the predictors for receiving analgesics were older age, longer healing time and being diagnosed via video consultation.Conclusion:To identify, assess and treat ulcer pain is equally possible via video as by in-person consultation. The results of this study confirm that patients with hard-to-heal ulcers suffer from high-intensity ulcer pain, with a discrepancy between pain and pain relief. Further well-designed randomised controlled studies are necessary to understand how best to deploy telemedicine in ulcer pain treatment.
|
|
