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Related Concept Videos

Peptic Ulcer Disease V: Surgical Management and Nursing Care01:25

Peptic Ulcer Disease V: Surgical Management and Nursing Care

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During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
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Following injury, the integrity of the injured tissues must be reestablished. For example, in skin tissue, wound repair involves coordination among resident skin cells, blood mononuclear cells, extracellular matrix, growth factors, and cytokines to complete the healing cascade.
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Minced Tissue in Compressed Collagen: A Cell-containing Biotransplant for Single-staged Reconstructive Repair
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Reconstructive surgery for treating pressure ulcers.

Gill Norman1, Jason Kf Wong2,3, Kavit Amin2,3

  • 1Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.

The Cochrane Database of Systematic Reviews
|October 13, 2022
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Summary
This summary is machine-generated.

Limited randomized evidence exists for reconstructive surgery in pressure ulcer management. More research is needed to understand the benefits and harms of surgical interventions for pressure injuries.

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Area of Science:

  • Wound healing and reconstructive surgery
  • Clinical trial methodology
  • Evidence-based medicine

Background:

  • Pressure ulcers, also known as pressure injuries, can be managed through various interventions, including pressure-relieving measures and reconstructive surgery.
  • Surgical intervention is typically reserved for severe, non-healing wounds with full-thickness skin loss and exposure of deeper tissues.
  • The comparative effectiveness and safety of different surgical techniques for pressure ulcers remain unclear.

Purpose of the Study:

  • To evaluate the effects of different reconstructive surgical approaches for pressure ulcers (category/stage II or above).
  • To compare surgical treatments against no surgery or alternative surgical methods.
  • To synthesize evidence from randomized controlled trials (RCTs) in any care setting.

Main Methods:

  • A comprehensive search of published and unpublished RCTs was conducted using standard Cochrane search methods, with the latest search in January 2022.
  • Two independent reviewers selected studies, extracted data, assessed risk of bias, and performed GRADE assessments.
  • One RCT involving 20 participants with stage IV ischial or sacral pressure ulcers was identified and analyzed.

Main Results:

  • The single RCT compared conventional flap surgery with cone of pressure flap surgery for stage IV pressure ulcers.
  • Data for complete wound healing, wound dehiscence, pressure ulcer recurrence, and wound infection were limited and of very low certainty.
  • No data were available for other relevant outcomes.

Conclusions:

  • There is a significant lack of high-quality randomized evidence regarding the efficacy of reconstructive surgery for pressure ulcer management.
  • Reconstructive surgery for pressure ulcers is a priority research area.
  • Further rigorous research is essential to clarify the role and outcomes of surgical interventions for pressure injuries.