Ulcer Management

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Jos M G A Schols - One of the best experts on this subject based on the ideXlab platform.

Marylou Guihan - One of the best experts on this subject based on the ideXlab platform.

  • pressure Ulcer Management and research priorities for patients with spinal cord injury consensus opinion from sci queri expert panel on pressure Ulcer research implementation
    Journal of Rehabilitation Research and Development, 2011
    Co-Authors: Kristi M Henzel, Kath M Bogie, Marylou Guihan
    Abstract:

    OVERVIEW Pressure Ulcers (PUs) are a serious and costly complication for many individuals with reduced mobility and sensation. Some populations, such as those with spinal cord injury and disease (SCI/D), remain at high risk throughout their lifetimes. Clinical observations and research have demonstrated staggering costs and human suffering because of PUs, including profound negative effect on general physical health, socialization, financial status, body image, and level of independence and control [1-2]. The International Pressure Ulcer Prevalence Study from 2006 to 2009 demonstrated a change in PU prevalence in the U.S. healthcare facility population. Overall, PU prevalence was slightly lower in 2009 than in 2006, but prevalence of suspected deep-tissue injuries (DTIs) increased during the same period [3]. Further investigation into the cause of these changes is warranted. DTI diagnosis frequency may have been affected by the addition of suspected DTI to the revised National Pressure Ulcer Advisory Panel (NPUAP) staging definitions in 2007 and rule changes for Centers for Medicare and Medicaid reimbursement. Consideration of current evidence-based practice (EBP) is vitally important in the development and implementation of prevention, treatment, and rehabilitation strategies for PUs. A wealth of basic science is available, and early clinical trials are being carried out in the field of PU research; many of these trials were presented at the inaugural International Evidence Based Practice in Wound Care conference in 2006. The focus of the 2nd International Conference on Evidence Based Practice in Wound Care: The Effective Implementation of Pressure Ulcer Clinical Practice Guidelines (held in 2009) was the apparent "disconnect" between these early-stage research efforts and their implementation as routine clinical practice, as documented in current clinical practice guidelines (CPGs). EBP and expert opinion are frequently combined during the formulation of CPGs. The balance of expert opinion and EBP in a given CPG depends on the maturity and depth of the research base. Currently, there are multiple CPGs for Ulcer prevention and treatment, including the Consortium for Spinal Cord Medicine Clinical Practice Guidelines on Pressure Ulcer Prevention and Treatment (SCICPG) [4]. The common goal of these CPGs is to reduce the incidence and prevalence of PUs. Unfortunately, Thomason et al. found that although SCI physicians and nurses generally agreed with the SCICPG recommendations as written, they did not believe that these recommendations were fully implemented in their respective clinical settings. Furthermore, clinical personnel identified lack of knowledge and organizational factors--such as communication difficulties across teams, shifts, and hospital departments--as the biggest barriers to implementing CPGs [5]. The effective selection and implementation of evidence-based guidelines for PU are critically important to improving rehabilitative and lifetime outcomes for people at risk for PU development. Education in the use and implementation of CPGs is an ongoing need. Additionally, a critical need exists to identify the remaining research gaps and pathways to effective implementation of research efforts in clinical practice. An invited expert panel met in Cleveland, Ohio, on June 4, 2009, in conjunction with the 2nd International Conference on Evidence Based Practice in Wound Care, to develop a research agenda based on critical knowledge gaps regarding PUs in individuals with SCI and on implementation of advanced clinical practice. We report a literature-based discussion of the consensus panel conclusions. The meeting was sponsored by the Department of Veterans Affairs (VA) SCI Quality Enhancement Research Initiative (SCI QUERI). The SCI QUERI works closely with the VA's SCI/D Strategic Health Group to identify the critical, time-sensitive issues important for Veterans Health Administration operations as part of the SCI QUERI mission: promotion of patient health, functioning, and quality of life through the implementation of evidence-based methods for enhancing patient self-Management and disease prevention in the context of multidisciplinary care. …

Nicole Mittmann - One of the best experts on this subject based on the ideXlab platform.

  • the average cost of pressure Ulcer Management in a community dwelling spinal cord injury population
    International Wound Journal, 2013
    Co-Authors: Brian Chan, Natasha Nanwa, Nicole Mittmann, Dianne Bryant, Peter C Coyte, Pamela E Houghton
    Abstract:

    Pressure Ulcers (PUs) are a common secondary complication experienced by community dwelling individuals with spinal cord injury (SCI). There is a paucity of literature on the health economic impact of PU in SCI population from a societal perspective. The objective of this study was to determine the resource use and costs in 2010 Canadian dollars of a community dwelling SCI individual experiencing a PU from a societal perspective. A non-comparative cost analysis was conducted on a cohort of community dwelling SCI individuals from Ontario, Canada. Medical resource use was recorded over the study period. Unit costs associated with these resources were collected from publicly available sources and published literature. Average monthly cost was calculated based on 7-month follow-up. Costs were stratified by age, PU history, severity level, location of SCI, duration of current PU and PU surface area. Sensitivity analyses were also carried out. Among the 12 study participants, total average monthly cost per community dwelling SCI individual with a PU was $4745. Hospital admission costs represented the greatest percentage of the total cost (62%). Sensitivity analysis showed that the total average monthly costs were most sensitive to variations in hospitalisation costs.

Kath M Bogie - One of the best experts on this subject based on the ideXlab platform.

  • pressure Ulcer Management and research priorities for patients with spinal cord injury consensus opinion from sci queri expert panel on pressure Ulcer research implementation
    Journal of Rehabilitation Research and Development, 2011
    Co-Authors: Kristi M Henzel, Kath M Bogie, Marylou Guihan
    Abstract:

    OVERVIEW Pressure Ulcers (PUs) are a serious and costly complication for many individuals with reduced mobility and sensation. Some populations, such as those with spinal cord injury and disease (SCI/D), remain at high risk throughout their lifetimes. Clinical observations and research have demonstrated staggering costs and human suffering because of PUs, including profound negative effect on general physical health, socialization, financial status, body image, and level of independence and control [1-2]. The International Pressure Ulcer Prevalence Study from 2006 to 2009 demonstrated a change in PU prevalence in the U.S. healthcare facility population. Overall, PU prevalence was slightly lower in 2009 than in 2006, but prevalence of suspected deep-tissue injuries (DTIs) increased during the same period [3]. Further investigation into the cause of these changes is warranted. DTI diagnosis frequency may have been affected by the addition of suspected DTI to the revised National Pressure Ulcer Advisory Panel (NPUAP) staging definitions in 2007 and rule changes for Centers for Medicare and Medicaid reimbursement. Consideration of current evidence-based practice (EBP) is vitally important in the development and implementation of prevention, treatment, and rehabilitation strategies for PUs. A wealth of basic science is available, and early clinical trials are being carried out in the field of PU research; many of these trials were presented at the inaugural International Evidence Based Practice in Wound Care conference in 2006. The focus of the 2nd International Conference on Evidence Based Practice in Wound Care: The Effective Implementation of Pressure Ulcer Clinical Practice Guidelines (held in 2009) was the apparent "disconnect" between these early-stage research efforts and their implementation as routine clinical practice, as documented in current clinical practice guidelines (CPGs). EBP and expert opinion are frequently combined during the formulation of CPGs. The balance of expert opinion and EBP in a given CPG depends on the maturity and depth of the research base. Currently, there are multiple CPGs for Ulcer prevention and treatment, including the Consortium for Spinal Cord Medicine Clinical Practice Guidelines on Pressure Ulcer Prevention and Treatment (SCICPG) [4]. The common goal of these CPGs is to reduce the incidence and prevalence of PUs. Unfortunately, Thomason et al. found that although SCI physicians and nurses generally agreed with the SCICPG recommendations as written, they did not believe that these recommendations were fully implemented in their respective clinical settings. Furthermore, clinical personnel identified lack of knowledge and organizational factors--such as communication difficulties across teams, shifts, and hospital departments--as the biggest barriers to implementing CPGs [5]. The effective selection and implementation of evidence-based guidelines for PU are critically important to improving rehabilitative and lifetime outcomes for people at risk for PU development. Education in the use and implementation of CPGs is an ongoing need. Additionally, a critical need exists to identify the remaining research gaps and pathways to effective implementation of research efforts in clinical practice. An invited expert panel met in Cleveland, Ohio, on June 4, 2009, in conjunction with the 2nd International Conference on Evidence Based Practice in Wound Care, to develop a research agenda based on critical knowledge gaps regarding PUs in individuals with SCI and on implementation of advanced clinical practice. We report a literature-based discussion of the consensus panel conclusions. The meeting was sponsored by the Department of Veterans Affairs (VA) SCI Quality Enhancement Research Initiative (SCI QUERI). The SCI QUERI works closely with the VA's SCI/D Strategic Health Group to identify the critical, time-sensitive issues important for Veterans Health Administration operations as part of the SCI QUERI mission: promotion of patient health, functioning, and quality of life through the implementation of evidence-based methods for enhancing patient self-Management and disease prevention in the context of multidisciplinary care. …

Matthias Weck - One of the best experts on this subject based on the ideXlab platform.

  • autologous derived platelet rich plasma gel in the treatment of nonhealing diabetic foot Ulcer a case report
    Therapeutic Advances in Endocrinology and Metabolism, 2012
    Co-Authors: Torsten Slesaczeck, Hartmut Paetzold, Thomas Nanning, Andreas Reichel, Andreas Barthel, Stefan R Bornstein, Matthias Weck
    Abstract:

    Nonhealing diabetic foot Ulcers are a major complication in patients with diabetes. In an unacceptably high number of cases, the final treatment result is lower extremity amputation, which might have been avoided if an aggressive therapy had been carried out earlier. Emerging cellular therapies such as platelet-rich plasma gel provide completely new Ulcer Management options that might help to avoid limb loss [Driver, 2006].