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Πέμπτη, 22 Αυγούστου 2019

Advances in Skin & Wound Care

Peer Reviewers: A Vital Part of the Publication Process
imageNo abstract available
Reviewer Thank You
No abstract available
Call for Peer Reviewers
No abstract available
Are You Appropriately Coding and Billing Medicare Part B for Disposable Negative-Pressure Wound Therapy?
imageNo abstract available
Pressure Injuries in the Pediatric Population: A National Pressure Ulcer Advisory Panel White Paper
imageGENERAL PURPOSE To review what is known about pediatric pressure injuries (PIs) and the specific factors that make neonates and children vulnerable. TARGET AUDIENCE This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES After participating in this educational activity, the participant should be better able to: 1. Identify the scope of the problem and recall pediatric anatomy and physiology as it relates to PI formation. 2. Differentiate currently available PI risk assessment instruments. 3. Outline current recommendations for pediatric PI prevention and treatment. Pediatric patients, especially neonates and infants, are vulnerable to pressure injury formation. Clinicians are steadily realizing that, compared with adults and other specific populations, pediatric patients require special consideration, protocols, guidelines, and standardized approaches to pressure injury prevention. This National Pressure Advisory Panel white paper reviews this history and the science of why pediatric patients are vulnerable to pressure injury formation. Successful pediatric pressure injury prevention and treatment can be achieved through the standardized and concentrated efforts of interprofessional teams.
A Prospective, Multicenter, Single-Arm Clinical Trial for Treatment of Complex Diabetic Foot Ulcers with Deep Exposure Using Acellular Dermal Matrix
imageOBJECTIVE This prospective, multicenter study evaluated the efficacy and safety of an acellular dermal matrix allograft, DermACELL (D-ADM; LifeNet Health, Virginia Beach, Virginia), in the treatment of large, complex diabetic foot ulcers (DFUs) that probed to tendon or bone. METHODS Inclusion criteria were Wagner grade 3 or 4 DFUs between 4 weeks and 1 year in duration. All participants received one application of D-ADM at baseline and could receive one additional application if wound healing arrested. Ulcers were assessed weekly for 16 weeks using a laser measuring device. RESULTS Sixty-one participants were enrolled, with an average wound area of 29.0 cm2; 59 of these ulcers showed exposed bone. The entire per-protocol population (n = 47) achieved 100% granulation. The mean time to 100% granulation was 4.0 weeks with an average of 1.2 applications of D-ADM. Mean percent wound area reduction was 80.3% at 16 weeks. Those DFUs 15 cm2 or smaller were substantially more likely to close than DFUs larger than 29 cm2 (P = .0008) over a 16-week duration. No complications were associated with the use of the studied matrix. CONCLUSIONS The D-ADM demonstrated the ability to rapidly reduce the size of large, complex DFUs with exposed bone. Some wounds did not completely heal by 16 weeks; however, the significant reduction in size suggests that these large, complex wounds may heal if given more time.
Aurix Gel Is an Effective Intervention for Chronic Diabetic Foot Ulcers: A Pragmatic Randomized Controlled Trial
imageBACKGROUND Autologous platelet-rich plasma products can significantly vary with respect to platelet concentration, the presence of additional cellularity, and the use of additives. Therefore, the utility of each formulation for treating chronic wounds needs to be established. OBJECTIVE To establish the efficacy of up to 12 weeks of treatment with Aurix hematogel for healing diabetic foot ulcers against usual and customary care including any wound modality in 129 patients using a Medicare Coverage with Evidence Development paradigm. METHODS This pragmatic randomized controlled trial was conducted in 28 real-world outpatient wound care sites using an inclusive design that included participants with various health risks, comorbidities (eg, peripheral arterial disease, smoking), and any wound severity (Wagner 1–4). RESULTS Kaplan-Meier analysis showed a significant (log-rank P = .0476) time-to-heal advantage, with 48.5% of wounds healing with Aurix hematogel compared with 30.2% with usual and customary care. A higher percentage of healing was observed for Aurix across all wound severities (Wagner grade 1–4). Subgroup analysis revealed a significant healing advantage for Aurix when treating wounds accompanied by peripheral arterial disease and a demonstrated advantage for smokers. CONCLUSIONS This first Coverage with Evidence Development study in wound care demonstrates the effectiveness of Aurix for treating diabetic foot ulcers in Medicare beneficiaries.
Pyoderma Gangrenosum Associated with Sunitinib: A Case Report
imagePyoderma gangrenosum (PG) is an inflammatory neutrophilic dermatosis that presents with painful, sterile ulcers. Drug-induced PG is a rare condition; propylthiouracil, granulocyte colony-stimulating factor, and sunitinib are drugs that have been implicated to date. This article presents a case of PG associated with sunitinib.
Focusing on Wound Care Documentation and Audits
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Pressure Injuries in the Pediatric Population: A National Pressure Ulcer Advisory Panel White Paper
No abstract available

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