-
BMC Complementary Medicine and Therapies Mar 2022The use of complementary and alternative medicine (CAM) therapies has increased in recent years throughout the world and in Iran. Nonetheless, there are limited data...
BACKGROUND
The use of complementary and alternative medicine (CAM) therapies has increased in recent years throughout the world and in Iran. Nonetheless, there are limited data about the prevalence of their use. This study aimed to assess the prevalence of using CAM therapies among patients with pressure ulcer (PU).
METHODS
This cross-sectional study was conducted in 2019-2020. Participants were 299 patients with PU conveniently selected from wound clinics and healthcare settings in Shiraz, Iran. A demographic questionnaire and the International Questionnaire to Measure Use of CAM were used for data collection. The data were analyzed using the SPSS software (v. 22.0).
RESULTS
All 299 participants completed the study. Their mean age was 59.56 ± 18.76 years. The most common CAM therapies used for PU management were herbal products (100%), vitamin supplementation therapy (45.2%), spiritual therapies (21.7%), wet cupping therapy (16.4%), leech therapy (9.4%), acupuncture (1.7%), dry cupping therapy (1.3%), and massage therapy (1.3%). The most common herbal product used for PU management was Pistacia atlantica gum either alone or in combination with other herbal products (15.5%). The use of CAM therapies had significant relationship with participants' age, underlying conditions, and PU stage (P < 0.05) and the most significant predictor of using herbal products for PU was educational level (P < 0.05, OR = 5.098).
CONCLUSIONS
The use of CAM therapies, particularly herbal products, for PU management is high in Iran. Quality public education and close professional supervision are needed for the safe use of these products.
Topics: Adult; Aged; Complementary Therapies; Cross-Sectional Studies; Humans; Middle Aged; Pressure Ulcer; Prevalence; Surveys and Questionnaires
PubMed: 35346164
DOI: 10.1186/s12906-022-03573-6 -
Annals of Palliative Medicine Oct 2021Pressure ulcers (PU) refer to local tissue ulceration and necrosis caused by long-term compression and friction brought on by tissue ischemia and hypoxia. Diabetic...
BACKGROUND
Pressure ulcers (PU) refer to local tissue ulceration and necrosis caused by long-term compression and friction brought on by tissue ischemia and hypoxia. Diabetic wounds do not easily heal, and once a pressure ulceration occurs, it is difficult to deal with. The purpose of this study was to analyze the current research status of PUs in diabetic patients.
METHODS
The Science Citation Index Expanded (SCI-E) database was searched with terms of "Pressure Ulcer" and "Diabetes". Citespace software was used to analyze the annual distribution of the number of target documents and the distribution of countries, institutions, journals, authors, and keywords used in these works.
RESULTS
In all, 1271 documents were retrieved, with a total citation frequency of 47,081, and an h-index of 101. The top 5 countries in terms of the number of publications were the United States, the United Kingdom, China, Australia, and the Netherlands; the top 5 countries in centrality were the Netherlands, the United States, Canada, Japan, and France. The institutions with the greatest number of publications were the University of Amsterdam, Cardiff University, The University of Washington, and the University of Manchester. The institutions with the highest centrality were the University of Amsterdam, the University of Groningen, the University of Washington, the University of Adelaide, Baylor College of Medicine, and Queensland University of Technology. The authors with a highest number of publications were Bus SA, Apelqvist J, and the International Working Group on the Diabetic Foot, and Hinchliffe RJ. Only 2 authors had a centrality score above 0.01. Journals such as Diabetes Metabolism Research and Reviews, Diabetes Care, and Journal of Wound Care showed considerable influence in this field. Keyword analysis indicated that the use of keywords in this field is not uniform, and the focus of research on PUs in diabetic patients lies the risk and management of foot ulcers.
CONCLUSIONS
There are few studies concerning PUs in patients with diabetes and little collaboration between authors. The current focus in this field is on the risk and management of foot ulcers.
Topics: Bibliometrics; China; Diabetes Mellitus; Humans; Pressure Ulcer; United Kingdom; United States
PubMed: 34763498
DOI: 10.21037/apm-21-2757 -
The Surgeon : Journal of the Royal... Aug 2022The utilisation of prone positioning has been vital during the COVID-19 pandemic, however risks the development of anterior pressure ulcers. An observational study was... (Observational Study)
Observational Study
The utilisation of prone positioning has been vital during the COVID-19 pandemic, however risks the development of anterior pressure ulcers. An observational study was performed to examine the prevalence of pressure ulcers in this population and define risk factors. Eighty-seven patients admitted to critical care were studied. Of 62 patients with >1 day in prone position, 55 (88.7%) developed anterior pressure ulcers, 91% of which were anterior. The most commonly affected site were the oral commisures (34.6%), related to endotracheal tube placement. Prone positioning (p < .001) and the number of days prone (OR 3.11, 95% CI 1.46-6.62, p = 0.003) were a significant risk factors in development of an anterior ulcer. Prone positioning is therefore a significant cause of anterior pressure ulcers in this population.
Topics: COVID-19; Humans; Pandemics; Patient Positioning; Pressure Ulcer; Prone Position
PubMed: 34373210
DOI: 10.1016/j.surge.2021.07.001 -
Computational Intelligence and... 2022Pressure ulcers are a type of injury that causes tissue ischemia, a deficiency of nutrition and oxygen to the tissues, and, eventually, tissue necrosis when an area of...
Pressure ulcers are a type of injury that causes tissue ischemia, a deficiency of nutrition and oxygen to the tissues, and, eventually, tissue necrosis when an area of skin is placed under constant pressure for an extended length of time. With the acceleration of the aging process, the problem of providing care for pressure ulcers for the bedridden elderly becomes increasingly urgent. This study conducts a field survey based on the research status of 221 disabled elderly in 16 communities on 7 typical streets in Beijing, focusing on the problem of pressure ulcer complications caused by bedridden. An automatic inflatable airbag mattress is designed according to anthropometric dimensions of bedridden elderly, pressure ulcer-prone areas, and the decompression standard, so that the airbag mattress can reduce the pressure in its initial shape. To achieve accurate control of the pressure in the pressure-prone areas of an airbag, air pressure control system is proposed which can control airbags individually and link multiple airbags, evaluating the safety of pressure ulcer points based on the data from sensors and making corresponding air pressure changes to reduce the possibility of generating pressure ulcers. The proposed pressure ulcer preventing system will be an efficient healthcare tool for families who had elderly bedridden patients, patients with chronic degenerative disease side effects, and terminal and postsurgical patients, as well as femur fractures, in their homes.
Topics: Aged; Beds; Beijing; Humans; Pressure Ulcer
PubMed: 35942465
DOI: 10.1155/2022/4895038 -
Sensors (Basel, Switzerland) Mar 2023Visual diagnosis and rejuvenation are methods currently used to diagnose and treat pressure ulcers, respectively. However, the treatment process is difficult. We...
Visual diagnosis and rejuvenation are methods currently used to diagnose and treat pressure ulcers, respectively. However, the treatment process is difficult. We developed a biophotonic sensor to diagnose pressure ulcers and, subsequently, developed a pressure ulcer care device (PUCD.) We conducted animal and clinical trials to investigate the device's effectiveness. We confirmed the accuracy of the pressure ulcer diagnosis algorithm to be 91% and we observed an 85% reduction in immune cells when using the PUCD to treat pressure ulcer-induced mice. Additionally, we compared the treatment group to the pressure ulcer induction group to assess the PUCD's effectiveness in identifying immune cells through its nuclear shape. These results indicate a positive effect and suggest the use of PUCD as a recovery method for pressure ulcer diagnosis and treatment.
Topics: Animals; Mice; Pressure Ulcer; Electric Impedance; Algorithms
PubMed: 37050680
DOI: 10.3390/s23073620 -
Cells Jul 2023Although the proportion of ulcer patients with medical problems among the elderly has increased with the extension of human life expectancy, treatment efficiency is...
Although the proportion of ulcer patients with medical problems among the elderly has increased with the extension of human life expectancy, treatment efficiency is drastically low, incurring substantial social costs. MSCs have independent regeneration potential, making them useful in clinical trials of difficult-to-treat diseases. In particular, ADMSCs are promising in the stem cell therapy industry as they can be obtained in vast amounts using non-invasive methods. Furthermore, studies are underway to enhance the regeneration potential of ADMSCs using cytokines, growth factors, and gene delivery to generate highly functional ADMSCs. In this study, key regulators of wound healing, SOCS-1, -3, and -5, were combined to maximize the regenerative potential of ADMSCs in pressure ulcer treatments. After transfecting SOCS-1, -3, -5, and SOCS-com into ADMSCs using a non-viral method, the expression of the inflammatory factors TNF-alpha, INF-gamma, and IL-10 was confirmed. ADMSCs transfected with SOCS-com showed decreased overall expression of inflammatory factors and increased expression of anti-inflammatory factors. Based on these results, we implanted ADMSCs transfected with SOCS-com into a pressure ulcer mouse model to observe their subsequent wound-healing effects. Notably, SOCS-com improved wound closure in ulcers, and reconstruction of the epidermis and dermis was observed. The healing mechanism of ADMSCs transfected with SOCS-com was examined by RNA sequencing. Gene analysis results confirmed that expression changes occurred in genes of key regulators of wound healing, such as chemokines, MMP-1, 9, CSF-2, and IL-33, and that such genetic changes enhanced wound healing in ulcers. Based on these results, we demonstrate the potential of ADMSCs transfected with SOCS-com as an ulcer treatment tool.
Topics: Mice; Animals; Humans; Aged; Adipose Tissue; Ulcer; Pressure Ulcer; Wound Healing; Disease Models, Animal
PubMed: 37508509
DOI: 10.3390/cells12141840 -
International Wound Journal Jun 2024To assess all published studies which describe what happens to the delivery of pressure ulcer/injury (PI/PU) care pathways as a result of detecting raised sub-epidermal... (Review)
Review
To assess all published studies which describe what happens to the delivery of pressure ulcer/injury (PI/PU) care pathways as a result of detecting raised sub-epidermal moisture (SEM) delta (∆ ≥ 0.6). We undertook a systematic review of the literature, and included original research studies using either a prospective or retrospective study design that report the impact that assessment using SEM assessments have on healthcare practitioners' delivery of PI/PU care pathways in adults at risk of developing PI/PUs. The review protocol was registered on PROSPERO (CRD42023416975). A literature search was conducted in May 2023, using PubMed, CINAHL, Scopus, Cochrane, EMBASE, Web of Science and Science Direct databases. Data were extracted using a data extraction tool including elements such as country, setting, sample size, intervention, control and quality appraisal was undertaken using the Evidence-based Librarianship. We identified nine papers published between 2017 and 2022. The majority of these studies were conducted in England (n = 6; 67%). The systematic review included studies conducted across multiple care settings including acute care, medical-surgical units, and palliative care, highlighting the importance of PI/PU prevention and management across diverse patient populations. The PI/PU care pathways implemented in the studies varied, but commonly included elements such as the application or increased use of pressure-redistributing mattresses/cushions, implementation of repositioning plans, management of incontinence and moisture, regular skin inspection, and assessment of patient mobility. Out of the nine studies identified, seven reported PI/PU incidence. A meta-analysis of seven studies (N = 18 451) demonstrated a statistically significant reduction in visual PI/PU development in favour of SEM-guided care pathways compared to usual care (the odds ratio = 0.36 [95% confidence interval: 0.24-0.53, p < 0.00001]). This systematic review provides evidence that implementing SEM assessments in patients at risk of developing PI/PUs prompts anatomy-specific clinical actions. The subsequent implementation of enhanced and targeted skin care interventions leads to consistent and sustained reductions in hospital-acquired PU incidence. The findings emphasise the importance of incorporating SEM assessments as part of comprehensive PI/PU prevention strategies in all care settings and patient populations. This systematic review is limited by the predominance of observational studies and variable study quality. Future research should focus on randomised trials in different care settings that monitor the efficacy of preventive interventions and their impact in reducing PI/PU incidence when implemented based on SEM assessments.
Topics: Pressure Ulcer; Humans; Male; Female; Middle Aged; Aged; Adult; Aged, 80 and over; Critical Pathways; Delivery of Health Care
PubMed: 38832363
DOI: 10.1111/iwj.14928 -
International Wound Journal Feb 2022The aim of this correlational, cross-sectional study was to assess the pressure ulcer prevention attitudes of the nursing staff and to identify factors associated with...
The aim of this correlational, cross-sectional study was to assess the pressure ulcer prevention attitudes of the nursing staff and to identify factors associated with it both in primary and special health care. The study was conducted with nursing staff (N = 554) working in primary and special health care units in two hospital districts in Finlandin 2018 to 2019. Attitude towards Pressure ulcer Prevention instrument was used for data collection. Demographic data, Pressure Ulcer Prevention Knowledge test, and Pressure Ulcer Prevention Practice instrument were used as background variables. Data were analysed with statistical tests. Nursing staff working in primary care (n = 327) had more positive attitudes towards pressure ulcer prevention than those in specialised care (n = 209; P = .047). Working as a wound care nurse (P = .0005), working experience after graduation (P = .0017), self-reported pressure ulcer prevention and early detection skills (P < .0001), pressure ulcer prevention knowledge (P = .0002), and views about the realisation of their unit's pressure ulcer prevention practices (P < .0001) independently explained variation in participants' attitudes. Attention should be placed on the pressure ulcer prevention attitudes of nurses who are less experienced or less skilled and who have lower pressure ulcer prevention knowledge. Positive organisational culture towards evidence-based pressure ulcer prevention practices should be promoted.
Topics: Attitude of Health Personnel; Cross-Sectional Studies; Health Knowledge, Attitudes, Practice; Humans; Nursing Staff; Pressure Ulcer; Surveys and Questionnaires
PubMed: 34121328
DOI: 10.1111/iwj.13641 -
Computational and Mathematical Methods... 2023Pressure injuries (PIs) impose a substantial burden on patients, caregivers, and healthcare systems, affecting an estimated 3 million Americans and costing nearly $18...
BACKGROUND
Pressure injuries (PIs) impose a substantial burden on patients, caregivers, and healthcare systems, affecting an estimated 3 million Americans and costing nearly $18 billion annually. Accurate pressure injury staging remains clinically challenging. Over the last decade, object detection and semantic segmentation have evolved quickly with new methods invented and new application areas emerging. Simultaneous object detection and segmentation paved the way to segment and classify anatomical structures. In this study, we utilize the Mask-R-CNN algorithm for segmentation and classification of stage 1-4 pressure injuries.
METHODS
Images from the eKare Inc. pressure injury wound data repository were segmented and classified manually by two study authors with medical training. The Mask-R-CNN model was implemented using the Keras deep learning and TensorFlow libraries with Python. We split 969 pressure injury images into training (87.5%) and validation (12.5%) subsets for Mask-R-CNN training.
RESULTS
We included 121 random pressure injury images in our test set. The Mask-R-CNN model showed overall classification accuracy of 92.6%, and the segmentation demonstrated 93.0% accuracy. Our F1 scores for stages 1-4 were 0.842, 0.947, 0.907, and 0.944, respectively. Our Dice coefficients for stages 1-4 were 0.92, 0.85, 0.93, and 0.91, respectively.
CONCLUSIONS
Our Mask-R-CNN model provides levels of accuracy considerably greater than the average healthcare professional who works with pressure injury patients. This tool can be easily incorporated into the clinician's workflow to aid in the hospital setting.
Topics: Humans; Deep Learning; Pressure Ulcer; Algorithms; Image Processing, Computer-Assisted
PubMed: 36778787
DOI: 10.1155/2023/3858997 -
International Wound Journal Aug 2022The use of consistent and evidence-based practices is essential in terms of patient safety and quality of care. The purpose of this study was to describe the use of...
The use of consistent and evidence-based practices is essential in terms of patient safety and quality of care. The purpose of this study was to describe the use of consistent practices in PU prevention based on international care guidelines and to assess the validity and reliability of the pressure ulcer prevention practice (PUPreP) instrument. The data (n = 554) were collected between 2018 and 2019 from nursing professionals working at two hospital districts in Finland using the PUPreP instrument. The instrument consisted of 42 items assessing participants' perceptions of the frequencies of pressure ulcer prevention practices with the following scale: never, sometimes, often, always. The data were analysed using statistical analysis. According to the results, the use of pressure ulcer prevention practices was more frequently described as often. The most frequently used prevention practice was repositioning, and the least frequently used practice was nutrition. Factors related to nursing professionals' pressure ulcer prevention practices were the working sector, education and working frequency in pressure ulcer prevention, and early identification of pressure ulcers. The study results suggest that the evidence-based pressure ulcer prevention practices were followed at a moderate level by nurses. The PuPreP instrument demonstrated validity and reliability, but further development is needed.
Topics: Cross-Sectional Studies; Humans; Pressure Ulcer; Reproducibility of Results; Risk Assessment; Skin Care
PubMed: 34761513
DOI: 10.1111/iwj.13710