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BACKGROUND: The mechanisms underlying the occurrence of pressure injuries are complex, and it is not entirely clear which factors play a central role in the development of pressure injuries and how these factors operate. OBJECTIVE: To investigate the relationship between Piezo-type mechanosensitive ion channel component 1 (Piezo1) and the occurrence of pressure injuries. METHODS: (1) Cellular experiment: Human immortalized keratinocytes (HaCaT) were treated with Yoda1, a Piezo1 agonist, at different concentrations. Cell viability, calcium ion influx, Piezo1, and apoptosis-related protein expression were detected. (2) Animal experiment: Twelve Sprague-Dawley rats were randomly divided into a control group and three experimental groups, with three rats in each group. The control group was not subjected to pressure, while in the three experimental groups, magnets with a thickness of 1, 2, and 3 mm were used to press on both sides of the rats’ back for 1 hour, respectively, to establish the animal models of pressure injuries. After modeling, all traumatic tissues were excised and subjected to hematoxylin-eosin, Masson, immunofluorescence staining and western blot assay. RESULTS AND CONCLUSION: Cellular experiments: The results of live/dead cell staining showed that HaCaT cell apoptosis increased with the increase of Yoda1 concentration (0, 2.5, 5, and 10 μmol/L), and calcium ion influx increased with the increase of Yoda1 concentration (0, 5, and 10 μmol/L), as well as with the prolongation of treatment time. Western blot assay results showed an increase in the expression of BAX, TG2, and PIEZO1 and a decrease in the expression of the expression of Bcl-2 protein in HaCaT cells in 5 and 10 μmol/L Yoda1 groups compared with the control group (0 μmol/L Yoda1). Animal experiments: The results of hematoxylin-eosin and Masson staining showed that the skin structure of the three experimental groups was damaged at the compression site, there was subcutaneous fat liquefaction and necrosis, and collagen was sparse and disorganized, and damage to the skin structure at the compression site was aggravated with the increase of magnet thickness. Immunofluorescence staining and western blot results showed that compared with the control group, the expression of BAX, TG2, Yap1 and PIEZO1 proteins was elevated, and the expression of Bcl-2 proteins was lowered in the three experimental groups. Moreover, the expression of related proteins showed more significant changes with the increase of magnet thickness (pressure). To conclude, skin compression activates PIEZO1, leading to a significant influx of calcium ions. As the pressure increases, this ultimately results in cell apoptosis due to calcium overload. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: Clinical application of autologous platelet-rich plasma is limited by the condition of patients and by the quantity and activity of platelets. Transfusable platelet component blood platelet concentrates, collected and prepared by blood collection and supply agencies, are widely available, can be standardized and are effective in the clinic. OBJECTIVE: To review the factors influencing the preparation of platelet concentrate by the buffy-coat method for the treatment of chronic refractory wounds. METHODS: A computer search of the PubMed, CNKI, and WanFang databases for platelet-related articles from January 2000 to April 2023 was conducted using the Chinese and English search terms “allogeneic platelets(concentrate), buffy-coat method, skin ulcer, refractory wounds”. The titles and abstracts were screened, and the full text was reviewed, resulting in the inclusion of 51 articles that met the subject criteria. RESULTS AND CONCLUSION: (1) Platelet concentrates supplied by blood collection and supply agencies are effective in the treatment of diabetic foot wounds, pressure sores, lower limb venous ulcers and other chronic refractory wounds: reducing the size of the ulcer and shortening the wound healing time, especially in the first two weeks, with significant healing-promoting effects. (2) The storage conditions of the raw material used to prepare platelet concentrates (whole blood overnight/buffy-coat overnight, shaking/resting (time)), centrifugation conditions (centrifugation parameters, canning method) and the structure of the blood bag can affect the concentration of platelet concentrates, indirectly affecting the efficacy of allogeneic platelet concentrates. (3) There are also some problems with studies of allogeneic platelet concentrates for the treatment of chronic refractory wounds, such as the sample size of the available evidence is small, the results lack the optimal preparation parameters, optimal dose and treatment regimen for platelet concentrates to promote healing of different wounds are unknown, so more randomized multicenter clinical studies are needed. [ABSTRACT FROM AUTHOR]

Objective To summarize the nursing experience of osteopathic robot-assisted vascularized fibular transplantation in the treatment of patients with avascular necrosis of femoral head (ANFH). Methods From September 2016 to November 2020, there were 17 ANFH patients (21 hips) in Beijing Jishuitan Hospital undergoing vascularized fibular graft assisted by orthopedic robots. After operation, the patients were given vasodilator, anticoagulant, anti-infective and related nursing care, as well as functional rehabilitation guidance. Results The operation was successful in 21 hips. All patients had no complications such as donor nerve injury and postoperative lower limb venous thrombosis. There was no weight-bearing activity within 3 months postoperatively and partial weight-bearing on crutches between 3 and 6 months. Among 10 patients (12 hips) followed for an average of 15 months, the hip function recovered well in 9 patients, and one bilateral ANFH patient, in whom the right side recovered smoothly, but the left hip joint was painful and restricted. No intra-articular infection and fibular head protrusion were found by arthroscopic exploration in this patient, and the symptoms were relieved after treatment of acetabular osteophyte. Conclusion For the treatment of ANFH with robot-assisted vascularized transplantation, nursing should focus on whether there is nerve injury in the donor area and on postoperative survival of the transplanted fibula. Postoperative functional exercise is an important part of the recovery for limb function.

Objective To observe the clinical manifestations and treatment outcomes of 40 patients with Fournier’s gangrene (FG), and to explore the application prospects of modified negative pressure drainage and irrigation technique in the treatment of FG. Methods A retrospective analysis on the clinical data of 40 FG patients collected in our department was conducted. The patients were treated with surgical debridement combined with negative pressure irrigation technique. The etiology, complications, clinical manifestations, pathological examination results, laboratory examination results, wound bacterial culture, and postoperative hospital stay of the patients were recorded; and the wound healing and long-term follow-up outcomes of the patients were observed. Results Among these 40 patients, there were 35 males and 5 females, whose age were from 22 to 81 years old. There were 28 cases with perianal infection, 11 cases of diabetes, 5 cases of trauma, 1 case of pressure sore due to paraplegia, and 6 cases with no obvious cause. The pathological examination results showed the chronic suppurative inflammation with abscess formation. The surgical debridement was performed, and the wound treatment was carried out by covering the wound with negative pressure and modified drainage and irrigation technique based on the wound condition. All the patients were cured and discharged without recurrence. The average hospital stay was 24.65 d. Among the 25 patients with perianal abscess, no obvious stenosis occurred after surgery; 8 patients with involvement of the scrotum recovered well with normal appearance and function; 7 patients with skin grafting had good growth of the grafts; 2 patients with flap repair had good blood supply to the flaps without redness or rupture; 8 patients with involvement of the lower limbs had good recovery of motor and sensory function without obvious disabilities or hypertrophic scars. Conclusion The use of surgical debridement combined with negative pressure drainage and irrigation technique in the treatment of FG is beneficial for the observation of the changes in the wound, reducing dressing changes, shortening the hospital stay, improving the cure rate, and is worthy of clinical promotion. [ABSTRACT FROM AUTHOR]

Objective To systematically evaluate the preventive effect of cluster nursing on pressure ulcers in intensive care unit (ICU) patients, and to provide evidence-based support for the clinical application of cluster nursing.Methods The China National Knowledge Infrastructurec (CNKI),VIP,Wangfang, PubMed, Embase and Web of Science were searched for randomized controlled trials of cluster nursing intervention on pressure ulcers in ICU patients.The retrieval time was from the establishment of the databases to April 2022.After literature search and quality evaluation, meta-analysis was performed using Stata16.0.Results A total of 19 studies including 2 166 ICU patients were included.The results of meta-analysis showed that cluster nursing intervention could effectively reduce the incidence of pressure ulcers in ICU patients [RR=0.85,95%CI (0.82,0.88),P＜0.01].It could effectively reduce the length of ICU stay [MD=-1.51,95%CI (-2.02,-1.01),P＜0.01],improve the anxiety status of patients [MD=-2.14,95%CI (-3.24,-1.05),P＜0.01],reduce the incidence of depressive symptoms [MD=-1.69,95%CI (-2.24,-1.14),P＜0.01],improve nursing satisfaction of ICU patients [MD=5.23,95%CI (4.67,5.77),P＜0.01].Conclusion Cluster nursing is helpful to reduce the incidence of pressure ulcers in ICU patients, reduce the length of stay in ICU,improve patients′ anxiety, depression and other bad emotions, and improve the nursing satisfaction of ICU patients. [ABSTRACT FROM AUTHOR]

Objective To observe the clinical effect and safety of pricking blood cupping technique on patients with stage 2-3 pressure ulcers. Methods A total of 48 patients with stage 2-3 pressure ulcers from this hospital from May 2019 to March 2021 were selected and divided into the routine care group and the cupping group according to the order of enrollment, with 24 cases in each group. The routine care group received conventional surgical aseptic dressing change, while the cupping group patients received pricking blood cupping based on the conventional surgical aseptic dressing change. Treatment was performed once every 1-3 days for a total of three weeks according to the wound condition. The local visual analogue scale(VAS) scores, the condition of wound healing [the scores of Pressure Ulcer Scale for Healing (PUSH)], the expression level of tumor necrosis factor-α and interleukin-1β in serum were observed in the two groups. Results After one, two and three weeks of treatment in two groups patients, the scores of VAS,PUSH and the expression level of tumor necrosis factor-α and interleukin-1β decreased gradually and were much lower compared with pre-treatment, and the indexes in the cupping group were significantly lower than those in the routine care group after two and three weeks of treatment, with statistical significance(P <0.05).Conclusion For patients with stage 2-3 pressure ulcers, pricking blood cupping technique can effectively relieve wound pain, promote wound healing, inhibit inflammation reaction, and improve the cure rate. [ABSTRACT FROM AUTHOR]

Whether receiving acute, long-term, or home care, patients at the end of life may experience skin failure due to hemodynamic changes and insufficient perfusion of skin tissue. Skin failure begins as superficial ulcers that can quickly become full-thickness lesions, which are referred to as Kennedy terminal ulcers. Skin lesions commonly occur in the final 6 weeks of life and can occur even in the presence of a comprehensive care plan. The pathogenesis of Kennedy terminal ulcers is often misunderstood and these ulcers are commonly misdiagnosed as pressure injuries. This confusion may lead to aggressive care with subpar clinical outcomes that cause further psychological and emotional distress to patients and family members. Patients at the end of life must be provided care focused on their comfort rather than wound healing. To provide the highest quality of care to patients, four end-of-life strategies should be used, including: taking account of the preferences of patients and families, protecting the skin, describing the wound, and preserving a high quality of care. The terms, pathophysiological and clinical manifestations, and nursing treatments related to skin failure at the end of life described in the literature are introduced in this paper. Furthermore, monitoring indicators of nursing quality are provided. [ABSTRACT FROM AUTHOR]

Objective To explore the clinical classification and surgical strategy for gluteal-sacral deep pressure ulcer. Meth原 ods From October 2019 to December 2021, summary the clinical data of 45 patients (72 places) with gluteal-sacral deep pressure ulcer were chosen from Department of Burns and Plastic Surgery of Taihe Hospital Affiliated to Hubei University of Medicine. They were divided into 3 types according to the characteristics of the wound. There were 28 sinus sores, 20 ulcer sores and 24 mixed sores. According to different types of pressure ulcer, the first stage include methylene blue marker, debride deep pressure under tumescent anasthesia, coverage cacuum sealing drainger (VSD), the second stage was used again with the same procedure, local skin metastasis and muscle flap filling the cavity, and muscle flap and flap were designed separately. The base of the cavity was ciosed for about 2 weeks, and the donor area was directly closed or skin graft. Results All the 72 deep pressure ulcers around the gluteal-sacral were healed by operation in 64 places, 4 places had poor healing after three operations, the patients gave up treatment, 4 places had poor healing around, healed after dressing change. Conclusion The depth of pressure ulcer classification is advantageous to the reasonable choice of different surgical methods, principles and theoperation principle of deeptreatment of pressure ulcers can greatly enhance the cure rate of pressure ulcers. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper summarized the nursing management of pressure ulcers in a patient with diabetes and Alzheimer‘s disease. In addition to routine care for pressure ulcers, efforts were made to enhance the skin hygiene and wound care. The patient was asked to take exercise under the guidance, and health education was carried out to improve knowledge and awareness of preventing pressure ulcers. Comprehensive interventions including regular exercise, shortening bedridden time and enhancing the skin management are effective to improve the wound healing of the patient with diabetes and Alzheimer‘s disease. (总结1例糖尿病合并阿尔茨海默症患者的压疮护理措施。在完善常规压疮护理的基础上, 护理人员加强受压部位皮肤清洁和伤口护理, 嘱患者规律运动, 同时开展健康宣教, 增加患者及其家属压疮预防相关知识。针对阿尔茨海默症合并糖尿病的压疮患者, 规律运动、减少卧床以及重视皮肤护理对促进压疮创面愈合具有积极意义。)

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: Reduction of sacrococcygeal pressure is the most direct and effective method to prevent the early sacrococcygeal pressure injury. Currently, there are a variety of materials in the market, but there is still insufficient evidence for the correct selection of pressure-relieving mattress in clinical practice. OBJECTIVE: To measure the sacrococcygeal pressure value, sacrococcygeal skin temperature value and observe the change of skin color of healthy people lying supine on three kinds of mattresses at different periods, in order to explore a medical mattress with better decompression effect. METHODS: Totally 33 healthy subjects were selected from First Affiliated Hospital of Guangzhou University of Chinese Medicine aged 18 to 35 years old, body mass index of 18.5-23.9 kg/m². At 1, 2, and 3 days of the experiment, subjects were recumbent in latex mattresses, static pressure ulcers prevention mattresses, and ordinary mattress. At set time points (0, 0.5, 1.0, 1.5, 2.0 hours), the sacral pressure value, the tail in the cauda equina compression of color, and skin temperature were detected. RESULTS AND CONCLUSION: (1) After 0.5-2 hours of test, the sacrotail pressure of latex mattress group was lower than that of static pressure ulcers prevention mattresses group and ordinary mattress group (P < 0.05). (2) There was no significant difference in the temperature values of the compression parts of the three mattress groups during 0-0.5 hours (P=0.587). During 0.5-2.0 hours of the test, the temperature of pressure position in latex mattress group was lower than that in static pressure ulcers prevention mattresses group and ordinary mattress group (P < 0.05). (3) During 0.5-1.5 hours of the test, the color of the sacrococcygeal compression parts of the subjects in the three mattress groups did not change. During the experiment of 1.5-2.0 hours, the color of the sacrococcygeal compression site of the subjects in the latex mattress group did not change, while that of the static pressure ulcers prevention mattresses group altered in one case, and that of the ordinary mattress group altered in two cases. (4) The results showed that, compared with the other two mattresses, the latex mattress can effectively reduce the sacrococcygeal pressure, and has good heat dissipation and air permeability, and plays an effective role in preventing the early pressure injury. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nutritional Sciences Journal is the property of Nutrition Society of Taiwan and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper summarized the nursing measures of integrated traditional Chinese and Western medicine for a diabetic patient with stage II pressure ulcers. Based on the systemic treatment such as local decompression, blood glucose control and nutrition intervention, targeted therapy and nursing of integrated traditional Chinese and Western medicine were carried out at different stage of wound surface healing, aiming to relieve the pain and shorten the healing time of wound surface. (本文总结1例糖尿病合并II期压疮患者的中西医结合护理体会。在局部减压、控制血糖、营养干预等全身治疗的基础上, 结合伤口愈合不同阶段的特点, 实施针对性治疗和中西医结合护理干预, 以减轻患者痛苦, 缩短压疮创面愈合时间。)

Objective To observe the clinical efficacy of bone cement combined with vacuum sealing drainage (VSD) and pedicled posterior thigh musculocutaneous flap transplantation in the treatment of stage IV ischial tubercle pressure ulcers. Methods From February 2016 to May 2020, 8 patients with stage IV sacrococcygeal pressure ulcers in our department were selected as research subjects. All patients were treated with bone cement combined with VSD and pedicled posterior thigh musculocutaneous flap transplantation. The wound reinfection, reoperation and wound healing time of all patients were retrospectively analyzed. Results These wounds were repaired with pedicled posterior thigh musculocutaneous flap after 1 to 2 times of bone cement and VSD treatment. Seven cases of flaps survived, and one distal part of epidermis was necrotic with an area of 2.0 cm x 2.5 cm. The wounds healed after dressing change. The healing time ranged from 37 to 79 days. One case healed at 79 days after operation due to fecal contamination. All patients were followed up for 1 year, no reinfection or pressure ulcers occurred in 8 patients. Conclusion The bone cement combined with VSD and pedicled posterior thigh musculocutaneous flap has reliable clinical efficacy. This is an effective method to treat stage IV ischial tubercle pressure ulcers of high paraplegia. [ABSTRACT FROM AUTHOR]

Objective: To analyze the clinical effect and safety of modified bilateral V-Y flap in the treatment of stage IV sacrococcygeal pressureulcers. Methods: From March 2015 to March 2019, modified bilateral V-Y flap was used to treat stage IV sacrococcygeal pressureulcers. There were 15 males and 13 females with an average age of 54 years (range, 49-65 years) with a course of more than 6 months and poor efficacy of conservative treatment. All patients were treated by operation and repaired with modified bilateral V-Y flap. The healing rate and recurrence rate of flap were observed regularly after operation. Results: All the 28 patients were followed up for 12-24 months with an average of 13.2 months. All the wounds healed in the first stage after operation. Conclusion: The modified bilateral V-Y flap is an effective treatment for stage IV sacrococcygeal pressure injury. [ABSTRACT FROM AUTHOR]

The incidence rate of pressure injury in our department was low; however, when a pressure injury occurred, it seems that wound healing was prolonged. Promoting wound healing requires a multi-pronged approach for pressure injury care form an essential part. We did a research and identified the following problems: 1.Lack of adequate training in pressure injury care, and 2.Inadequacy of protocol for managing pressure injury. After setting up a project team and discussing about the improvement plans, we designed an image illustrated decision-making system, revised guidance and wound care tools, established nursing wound care guideline, and held pressure injury on-the-job training class. After implementation of the project, the accuracy of pressure injury management improved from 68.4% to 97.3%. This project effectively improved accuracy of pressure injury care and may be considered and referenced by relevant medical organizations. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To explore the clinical efficacy of modified rotation skin flap with similar shape in the repair of skin defects caused by trauma, bedsore and tumor resection. Methods From March 2014 to May 2019, 27 patients with skin defects caused by trauma of the head and face, bedsore, pigmented nevus and tumor resection were repaired by modified rotation skin flap with similar shape. After the pathological tissue was completely excised during the operation, the modified rotation skin flap with similar shape was designed to repair the wounds at suitable layer after sufficient free tissue was formed. Results No blood circulation disorder was found in all patients after operation. The flaps survived and the incisions healed by first intention. No obvious local deformation was found and patients were satisfied with the efficacy. Conclusion The modified rotation skin flap with similar shape has the advantages of high survival rate of skin flap, complete local physiological curvature, short length of scar, low local tension, concealed scar and good efficacy of repair. [ABSTRACT FROM AUTHOR]

This paper reported the nursing experience of an 80-year-old patient with gastric cancer complicated with up gastrointestinal bleeding. The patient was critically ill and required multiple life support and multidisciplinary cooperation. Key nursing issues included the establishment and nursing of venous access, observation and nursing of digestive tract bleeding; dynamic monitoring of nutritional status and prevention of pressure ulcers, psychological nursing. (本文报告1例80岁胃癌患者并发消化道出血的护理经验。患者病情危重, 需多种生命支持与多学科合作。护理重点包括静脉通路的建立与护理, 消化道出血的病情观察与护理, 动态监测患者营养状况, 预防压疮, 重视心理护理等。)

Objective: To investigate the effect of Shengjiyuhong ointment combined with Kangfuxin liquid in treating non-healing wounds of skin flap necrosis after radical mastectomy. Methods: Selected 80 cases of patients with non-healing wounds of skin flap necrosis after radical mastectomy from January 2016 to December 2020, divided into two groups randomly. The control group was treated with Kangfuxin liquid alone, and the observation group was treated with Shengjiyuhong ointment. Compared with the wound surface improvement time of the two groups, the serum tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6), vascular endothelial growth factor (VEGF) and interleukin-8 (IL-8) levels were detected and recorded The wound area and VAS pain score of the two groups. Results: The time of carrion shedding, the appearance of new epithelium, the time of draining the drainage tube, the time of wound healing, the time of hospitalization and the time of upper limb rehabilitation activities in the observation group were significantly shorter than those in the control group (P<0.05); After treatment, the levels of serum IL-6, TNF-αand IL-8, wound area and VAS pain score of the two groups were significantly lower than before treatment, while the VEGF level was significantly increased (P<0.05). And the above indicators of the observation group were significantly improved compared with the control group (P<0.05). Conclusion: Shengjiyuhong ointment combined with Kangfuxin liquid has a significant effect on the non-healing of skin flap necrosis wound after radical mastectomy. It can improve the serum inflammatory reaction level of the patient, thereby further reducing the pain of the patient's wound and promoting healing. [ABSTRACT FROM AUTHOR]

Objective: To explore the effect of anterolateral thigh perforator flap and thoracoabdominal pedicled flap on the repair of hand traumatic tissue defect and the effect on wound healing. Methods: A total of 119 patients with hand trauma tissue defects admitted in our hospital from December 2018 to December 2020 were selected as the research objects, and they were randomly divided into 2 groups. They were the control group (n=59, using thoracic-abdominal pedicle flap repair) and the observation group (n=60, using anterolateral thigh perforator flap repair). The excellent and good rates of the two groups were compared. The hand wound area, wound healing degree and tissue healing time before and after treatment were compared between the two groups. The scores of Jamar grip strength, TAM and dash were compared between the two groups. The flap survival rate, flap crisis rate and vascular anastomosis time of the two groups were compared. Results: By comparing the excellent and good rate of the two groups, it was found that the number of excellent patients in the observation group was 21 cases, the number of good patients was 35 cases, the excellent and good rate was 93.33%, the number of excellent patients in the control group was 16 cases, the number of good patients was 30 cases, the excellent and good rate was 77.97%, the observation group was higher than the control group (P<0.05); After treatment, compared with the control group, the hand wound area, tissue healing time and DASH score of the observation group were significantly reduced, and the degree of wound healing and TAM and Jamar grip strength were significantly increased(P<0.05). By comparing the flap survival rate, postoperative flap crisis rate and vascular anastomosis time of the two groups, it was found that there was no significant difference in the flap crisis rate and vascular anastomosis time of the two groups (P>0.05), but the flap survival rate of the two groups was significantly different, and the observation group was significantly higher than the control group (P< 0.05). Conclusion: The application of anterolateral thigh perforator flap and thoracoabdominal pedicled skin flap in the repair of hand trauma tissue defect has obvious repair effect, but the application of anterolateral thigh perforator flap can improve the treatment effect, improve the wound healing degree, reduce the healing time, improve the hand movement of patients, and improve the survival rate of postoperative flap, which is worthy of clinical application and promotion. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: Studies have reported that platelet-rich plasma (PRP) can promote accelerated healing of pressure injury. OBJECTIVE: To explore the effect of PRP on pressure injury of patients with spinal cord injury. METHODS: From July 2017 to December 2019, 40 patients with spinal cord injury complicated by stage 3 and stage 4 pressure ulcers were randomly divided into a PRP group (n=20) and a control group (n=20) using a random number table. Patients in the control group were given routine wound care and standardized rehabilitation treatment, whereas those in the PRP group received PRP treatment based on routine wound care and standardized rehabilitation treatment once a week. The surface area, wound type and exudate volume were assessed by pressure ulcer scale for healing (PUSH) before treatment and 2, 4, 6, 8 weeks after treatment. The total PUSH score, score of each item in the PUSH scale, and clinical efficacy were compared between the two groups. An ethical approval was obtained from the Biomedical Ethics Committee of West China Hospital of Sichuan University, with an approval No. 2019(622). RESULTS AND CONCLUSION: The total PUSH score and scores in terms of wound area, type, and exudate volume were significantly reduced after treatment in the PRP group (P < 0.01), while those scores in the control group were also significantly reduced at 6 and 8 weeks after treatment (P < 0.01). Compared with the control group, the total PUSH score and scores on exudate volume were significantly lower in the PRP group at 4, 6, and 8 weeks after treatment, and the scores on wound type were significantly lower in the PRP group at 6 and 8 weeks after treatment. The healing rate in the PRP group was 100% after treatment, which was significantly higher than that in the control group (35%; P < 0.001). These findings indicate that PRP treatment contributes to the recovery of pressure injury in patients with spinal cord injury. [ABSTRACT FROM AUTHOR]

The objective of this article is to describe the perioperative nursing experience of a patient with oral cancer undergoing flap reconstruction surgery. From October 26, 2017 to November 10, we collected the data of the patient according to Gordon's 11-itemed functional health patterns with resect to preoperative visits, intraoperative care, postoperative education, observation, and visiting methods. As a result, we were able to determine the patient's main health problems over the course of care. In the preoperative phase, the major problem was anxiety. During the operative phase, the major nursing problem was the potential risk of pressure sores. In the postoperative nursing care phase, the major problem was the body image disorder. Preoperative visits assist patients in facing the disease. Preoperative preparation process aims to reduce their anxiety and maintain the patient's safety during operation. Postoperative visits aims to assess the patient's needs, accompany them through the period of change in appearance, encourage family support and companionship to enhance the patient's self-confidence, share experiences through continuous care mode, and implement the perioperative nursing methods for overall care. This study can serve as a reference for nursing similar patients and to improve the quality of the perioperative nursing. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To study the effect of cluster management based on Enhanced Recovery After Surgery ( ERAS ) in the perioperative period of liver transplantation for hepatocellular carcinoma. Methods 109 patients with hepatocellular carcinoma who underwent liver transplantation in Shenzhen Third People's Hospital from June 2018 to November 2019 were selected and divided into a control group (n =54 ) and an observation group (n =55 ) by the random number table method. The control group was given routine preoperative management, and the observation group was given ERAS-based cluster management. The operation time, intraoperative blood loss, blood transfusion volume, the incidence of hypothermia, the incidence of pressure ulcers, length of hospital stay, tumor-related indicators, half-year postoperative survival rate and incidence of complications were compared between the two groups. Results The operation time and hospital stay in the observation group were significantly shorter than those in the control group (both P < 0. 05 ). The volume of intraoperative blood loss and blood transfusion in the observation group were significantly less than that in the control group (both P < 0. 05 ). The incidence of hypothermia and pressure ulcers in the observation group were significantly lower than that in the control group (both P < 0. 05 ). Serum alpha-fetoprotein, glutamine transpeptilase and abnormal prothrombin in the observation group were significantly lower than those in the control group (all P <0. 05). The half-year survival rate of the observation group was significantly higher than that of the control group (P <0. 05). The total incidence of postoperative complications in the observation group was significantly lower than that in the control group (P <0. 05). Conclusion The application of cluster management based on ERAS in liver transplantation for hepatocellular carcinoma during the perioperative period can improve the surgical indicators of patients, improve the half-year survival rate after operation and reduce the incidence of complications. [ABSTRACT FROM AUTHOR]

BACKGROUND: There are many kinds of dressings for external use in treating pressure ulcer. Selecting a kind of dressing which is convenient, safe and effective can effectively increase the healing rate of pressure ulcer. OBJECTIVE: To evaluate the effects of five common dressings on the treatment of pressure ulcer. METHODS: A systematic search of Embase, PubMed, VIP, Elsevier, WanFang and CNKI were carried out with an end-point of July 2018. Randomized controlled trials about the therapeutic effects of different dressings on pressure ulcer were collected. All data were screened, extracted and assessed by two researchers independently. The ADDIS 1.16.8 software was adopted lor data analysis. RESULTS AND CONCLUSION: A total of 24 randomized control trials (1201 patients) which involved 5 kinds of dressings were included. The results of network Meta-analysis showed that the effect of hydrocolloid dressing and foam dressing were superior to aseptic gauze and vaseline gauze in treating pressure ulcer (P < 0.05). There was no difference in the therapeutic effect between the resting dressings (P > 0.05). Based on the probability ranking table, the therapeutic effects of five kinds of dressings in pressure ulcer were ranked as follows: hydrocolloid dressing > foam dressing > hydrogel dressing > sterile gauze > vaseline gauze. Hydrocolloid dressing and foam dressing were superior to the other dressings in the treatment of pressure ulcer. [ABSTRACT FROM AUTHOR]

Objective: To study the effects of urine stem cells on bladder function and expression of Notch1 and Jagged1 proteins in neurogenic bladder rats. Methods: 60 healthy female clean SD rats were included as the study subjects, and they were divided into normal control group, study group and injury group by random lottery, with 20 rats in each group. Neurogenic bladder models were established in the study group and the injury group, and urine stem cells were injected into the tail vein after successful modeling in the study group. After 28 days, the levels of indicators related to bladder function, bladder wet mass and bladder wet mass/body mass, protein expression levels of Notch1 and Jagged1 in the three groups of rats were compared. Results: The contraction time, urine output and bladder peak pressure in the injury group were lower than those in the normal control group, while the contraction time, urine output and bladder peak pressure in the study group were higher than those in the injury group (all P＜0.05). The bladder basal pressure in the injury group was higher than that in the normal control group, while the bladder basal pressure in the study group was lower than that in the injury group (all P＜0.05). The wet bladder mass and wet bladder mass/body mass in the injury group were higher than those in the normal control group, while the wet bladder mass and wet bladder mass/body mass in the study group were lower than those in the injury group (all P＜0.05). The protein expression levels of Notch1 and Jagged1 in the injury group were higher than those in the normal control group, while the protein expression levels of Notch1 and Jagged1 in the study group were lower than those in the injury group (all P＜0.05). Conclusion: The application of urine stem cells can significantly improve the bladder function of neurogenic bladder rats, and it can down-regulate the protein expression levels of Notch1 and Jagged1. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To explore the efficacy of Longzhu ointment combined with three-level pressure ulcer therapy in the prevention and treatment of pressure ulcers in patients with a high risk of stroke and pressure ulcers > 60 years old. METHODS: Totally 82 patients with stroke complicated with out-of-hospital pressure ulcer admitted into Beijing Luhe Hospital Affiliated to Capital Medical University from Jun. 2017 to Jun. 2020 were selected and divided into control group and observation group by random number table method, with 41 cases in each group. With no intervention on the treatment of patients, the control group was treated and intervened by the charge nurse according to pressure ulcer staging and assessment; while the observation group received Longzhu ointment on the traumatic surface with the procedure of tertiary therapy of pressure ulcer. The clinical efficacy of pressure ulcer, the distribution of pressure ulcers in different grades after treatment, the diameter of pressure ulcer surface before and after treatment, the recurrence rate of pressure ulcer within 6 months of discharge and the satisfaction rate were compared between two groups. RESULTS: The total effective rate of pressure ulcer treatment in the observation group was 97. 56% (40/41), which was higher than 85. 37% (35/41) in the control group, and the difference was statistically significant (P <0. 05). After treatment, the distribution of pressure ulcers in the observers was better than that in the control group, and the difference was statistically significant (P < 0. 05). After 7, 14, 21 and 30 days of treatment, the diameter of the pressure sore of the observer patients was significantly smaller than that of the control group, and the difference was statistically significant (P < 0. 05). Within 6 months of discharge, the recurrence rate of pressure ulcers in the observer patients was 9. 76% (4/41), which was lower than 26. 83% (11/41) in the control group, and the difference was statistically significant (P < 0. 05). The total satisfaction of the observer patients was 100% (41/41), which was higher than 78. 05% ( 32/41) of the control group, and the difference was statistically significant (P < 0. 05). CONCLUSIONS: The application of Longzhu ointment combined with tertiary therapy of pressure ulcer is beneficial to the prevention and treatment of pressure ulcer in elderly patients with stroke who are in long-term bedridden, with obvious intervention effect and high clinical application value. [ABSTRACT FROM AUTHOR]

Stanford type A aortic dissection refers to the dissection involving the ascending aorta, which is a life-threatening conditions with a high mortality rate and need for emergency surgical treatment. This paper reviewed the progress of postoperative nursing of patients with Stanford type A aortic dissection from six aspects: circulatory system, mechanical ventilation management, enteral nutrition, body temperature management, pressure ulcer prevention, and prevention of deep vein thrombosis. [ABSTRACT FROM AUTHOR]

Medical Device Related Pressure Injury was incorporated into the redefinition of pressure injuries during the National Pressure Ulcer Advisory Panel 2016 Staging Consensus Conference. It is evident that this type of iatrogenic injury is gradually receiving more attention. Unlike pressure injuries over a bony prominence, which may be alleviated by repositioning different body parts, injuries that require non-retractable medical devices to be securely fastened to an injury site carry a higher risk of causing pressure injuries and of requiring subsequent care in a clinical setting. Furthermore, facial skin and mucosal membranes are the most common sites of Medical Device Related Pressure Injuries. Once these injuries occur, they easily result in damage to appearance, loss of function, and even bone exposure and infection, which may lead to medical disputes. Therefore, in recent years, research and exploration in this field has increased in many countries. However, discussions regarding Medical Device Related Pressure Injuries in Taiwan are still lacking. Thus, the aim of this article is to discuss the definition, risk factors, damage classification, and prevention strategies of Medical Device Related Pressure Injuries by combining domestic and international literature reviews and clinical verifications for the purpose of providing knowledge to medical staffs in hopes of reducing the incidence of Medical Device Related Pressure Injuries and degree of damage. [ABSTRACT FROM AUTHOR]

Objective: To explore and analyze the current status and causes of medical device-related pressure injuries(MDR PIs)in 7 Class Ⅲ Grade A hospitals in Hainan Province, and put forward corresponding intervention measures. Methods: Using the survey tools in Europe and the United States, a cross-sectional survey of inpatients in 7 Class Ⅲ Grade A hospitals was conducted by trained qualified investigators, and the data was statistically analyzed using SPSS 17.0 software. Results: Among the 7248 hospitalized patients,there were 30 cases of pressure injuries caused by medical devices, and the prevalence rate was 0.41 %, including 18 cases of medical device-related pressure injuries, the prevalence rate was 0.25 %, and 12 cases of mucosal membrane pressure injuries, which prevalence rate was 0.17 %. 83.33 % of the medical device-related pressure injuries were acquired by the hospital, and 82.22 % of the pressure injuries at the bone eminence were present on admission; Patients with intensive care and enteral nutrition are more likely to get pressure injuries from medical devices(P< 0.05). Nurses will be more conscious about using decompression dressings for patients with pressure injuries at the bone eminence(P< 0.05); Nasogastric tube(51.60 %) was the most common cause of medical device-related pressure injuries, followed by oxygen inhalation tube(19.35 %). Mucosal membrane pressure injury could not be staged according to the system,accounting for 38.71 %. Medical device-related pressure injuries mainly concentrated in stage 1 and stage 2, accounting for 51.61 %. The ear(22.58 %) was the most common site of medical device-related pressure injuries, while the nasal mucosa(35.47 %) was the most common site of mucosal membrane pressure injuries. Conclusions: Managers and clinical nurses of Class Ⅲ Grade A hospitals in Hainan Province have already recognized and actively prevented such pressure injuries, but they still need to further strengthen training and regulation, organize regular investigation and continuous monitoring, and build a Continuous care model; for departments, people and specific parts of the relatively high risk of medical device-related pressure injuries, early prevention, identification and protection should be provided. Medical devices should be used correctly, preventive medical device-related pressure injuries should be reduced proactively;At the same time, we actively pay attention to the main causes, sites, stages and progress of medical device-related pressure injuries, and adopt comprehensive intervention measures to establish an organizational structure for pressure injuries early warning management to form a cluster management. [ABSTRACT FROM AUTHOR]

Copyright of Nursing of Integrated Traditional Chinese & Western Medicine is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article described a nursing experience of a patient with acute respiratory distress syndrome who was treated with prone ventilation to improve oxygenation. The nursing period was from June 24th to July 24th, 2016. The case evaluation utilized Gordon's 11 Functional Health Patterns Assessment as framework, and data were gathered through observation, interview and physical assessment. The identified nursing problems were impaired gas exchange due to lung inflammation and alveolar ventilation abnormalities, high risk for impaired skin integrity-pressure sores- due to prone ventilation and sedatives, and anxiety due to change in environment, frequent stimulation and poor health. The following measures were implemented to address the nursing problems: placing the patient in prone position to improve oxygenation and therefore maintaining adequate ventilation, applying water cushions under bony prominences while the patient was in prone position to prevent pressure sores, and complying with sterile principles to prevent secondary infections. With the collaborative effort of the medical team, the patient was successfully weaned from the ventilator and was transferred to the respiratory ward for subsequent treatment. We hope that this nursing experience can serve as a reference for nursing staff with patients receiving prone ventilation. [ABSTRACT FROM AUTHOR]

Background & Problem: Pressure injuries increase the cost of medical care and prolong hospitalization. The incidence of pressure injury at the target coronary care unit (CCU) from January to August 2016 was 1.1%, which was significantly higher than the 0.4% defined in the 2015 Taiwan Clinical Performance Indicators (TCPI) system. Medical device related pressure injury (MDRPI) accounted for 73.1% of the pressure injuries (incidence: 0.8%). The main causes of the high incidence of MDRPI were: (1) inadequate decompression dressing and restraint equipment, (2) incomplete implementation of prevention interventions in the CCU, (3) inadequate knowledge of MDRPI prevention among nurses, (4) deficient standards for preventing MDRPI, (5) ineffective MDRPI-related education, and (6) insufficient auditing frequencies. Purpose: To reduce the incidence of MDRPI in the target CCU to 0.4% or less. Resolution: Promote a seed-teacher system and a care bundle that "increased skin tolerance, decompression, medical dressing, change, and removal" using education, the adoption of PE-foam binding gloves, and regular audits. Results: The incidence of MDRPI was reduced from 0.8% to 0.3% between October 2016 and April 2017 and further reduced to 0.1% during the maintenance phase between May and July 2017. Conclusions: The results indicate that the improvement program effectively reduced the incidence of MDRPI and thus increased the quality of nursing care. Therefore, the use of a care bundles should be promoted in intensive care units. [ABSTRACT FROM AUTHOR]

Objective To explore the clinical efficacy of bilateral superior and inferior gluteal artery perforator flaps in the repair of large sacrococcygeal pressure ulcers. Methods A local rotation flap was designed, pedicled with the bilateral superior and inferior gluteal artery perforator. The area of the flaps was from 30 cm × 18 cm to 45 cm × 25 cm. For 8 patients with large sacrococcygeal pressure ulcers (15 cm × 9 cm to 18 cm × 12 cm), the wound was covered by flaps. Results All flaps survived, of which 6 cases were healed in the first stage and 2 cases in which healing was delayed. All patients were followed up from 1 to 3 months. There was no recurrence of pressure ulcers, the elasticity of the flaps was good, and bilateral buttocks were symmetrical. Conclusion The application of bilateral superior and inferior gluteal artery perforator flaps was a simple and feasible method in the repair of large sacrococcygeal pressure ulcers. [ABSTRACT FROM AUTHOR]

Copyright of Nursing of Integrated Traditional Chinese & Western Medicine is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nursing of Integrated Traditional Chinese & Western Medicine is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)