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Related Concept Videos

Urinary Tract Calculi VI: Surgical Management01:25

Urinary Tract Calculi VI: Surgical Management

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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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Urinary Tract Calculi III: Medical Management01:30

Urinary Tract Calculi III: Medical Management

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The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
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Urinary Tract Infection IV: Nursing Management01:17

Urinary Tract Infection IV: Nursing Management

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In managing urinary tract infections (UTIs) in nursing, a comprehensive assessment is essential. Begin by gathering subjective data, such as the patient’s complaints of dysuria (painful urination), urinary frequency, urgency, suprapubic pain, and any lower abdominal discomfort. This information can be complemented by questions regarding previous UTIs, sexual activity, and personal hygiene practices, which can provide insight into risk factors. Objective assessment should focus on signs...
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Urinary Tract Calculi V: Nursing Management01:28

Urinary Tract Calculi V: Nursing Management

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AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
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Urinary Tract Calculi I: Introduction01:28

Urinary Tract Calculi I: Introduction

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Renal calculi, or kidney stones, are solid deposits of minerals and salts formed inside the kidneys. In medical terminology, "calculus" refers to the stone itself, while "lithiasis" describes the process of stone formation. Depending on their location within the urinary system, these stones may be classified as either urolithiasis, when situated within the urinary tract, or nephrolithiasis, when located within the kidneys. Each term signifies the specific impact of the stone.Predisposition...
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Imaging Studies II: Ultrasonography01:24

Imaging Studies II: Ultrasonography

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IntroductionUltrasonography, or renal ultrasound, is a noninvasive medical imaging technique that uses high-frequency sound waves to visualize the kidneys, ureters, bladder, and surrounding tissues.Indications for Urinary System UltrasonographyUrinary system ultrasonography is indicated in various clinical scenarios, such as:Kidney Stones (Urolithiasis): To detect and monitor the size and presence of kidney or urinary tract stones.Hydronephrosis: To assess the dilation of the renal pelvis and...
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Updated: Jul 22, 2025

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Jet Lavage Irrigation Resolves Stage 4 Pelvic Pressure Injury Undermining.

James B Stiehl1

  • 1James B. Stiehl, MD, MBA, is Orthopedic Surgeon, St Mary's Hospital, Centralia, Illinois, USA, and Founder/CEO of Stiehl Tech. The author has disclosed no financial relationships related to this article. Submitted November 19, 2022; accepted in revised form January 23, 2023.

Advances in Skin & Wound Care
|July 20, 2023
PubMed
Summary
This summary is machine-generated.

Low-pressure jet lavage irrigation effectively reduced undermined cavities in stage 4 pressure injuries. This outpatient treatment improved wound conditions and patient satisfaction, despite challenges with patient survival.

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Area of Science:

  • Wound Care
  • Regenerative Medicine
  • Medical Devices

Background:

  • Stage 4 pressure injuries with large, undermined cavities present significant treatment challenges and often necessitate palliative care.
  • Surgical reconstruction options are frequently limited for these complex wounds, leading to stalled healing.
  • Jet lavage irrigation in an outpatient setting is explored as a viable alternative treatment.

Purpose of the Study:

  • To assess the efficacy of low-pressure jet lavage irrigation as a treatment for stalled, stage 4 pelvic pressure injuries with undermined cavities.
  • To evaluate wound healing outcomes and patient satisfaction with this alternative therapeutic approach.

Main Methods:

  • A case series of five high-risk patients (Charlson Comorbidity Index ≥ 5) with stalled wound healing was identified.
  • Patients received bedside irrigation with 3 L of saline, 3-5 times weekly, using a specialized long tip for undermined cavities.
  • Digital planimetry assessed wound size changes, and autofluorescence imaging evaluated bacterial contamination.

Main Results:

  • Undermined cavities showed early reduction within 3 weeks of treatment.
  • Four out of five patients experienced undermining resolution.
  • No patients developed wound sepsis; bacterial contamination was monitored.
  • One patient died from COVID-19 despite wound improvement.

Conclusions:

  • Low-pressure jet lavage irrigation demonstrated clear benefits in reducing undermining and improving wound characteristics.
  • The treatment resulted in high patient and family satisfaction due to painless and odor-free wound management.
  • While effective for wound healing, overall patient survival remained a critical factor, with only one patient completing healing.