scholarly journals Treatment of partial thickness burns of the face with Acticoat7™

2020 ◽  
Author(s):  
Jakob Nedomansky ◽  
Alan Oramary ◽  
Stefanie Nickl ◽  
Gunther Fuchs ◽  
Christine Radtke ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Bacterial Colonization ◽  
Burn Trauma ◽  
Partial Thickness ◽  
Partial Thickness Burn ◽  
Increased Risk ◽  
The Face ◽  
Colonization Potential ◽  
Partial Thickness Burns

Summary Background The face is affected in more than 50% of patients with extensive burn trauma. Effective treatment is of importance to avoid hypertrophic scarring, functional impairment and social stigmatization. Material and methods All patients treated with Acticoat7™ due to superficial and deep partial thickness burns of the face between 2008 and 2017 at the intensive care unit (ICU) for burn trauma at the Department for Plastic and Reconstructive Surgery of the Medical University of Vienna were retrospectively analyzed. Patients were evaluated for the number of required dressing changes until complete re-epithelialization, bacterial colonization, potential complications and the need for primary and secondary surgery. Results A total of 100 patients were analyzed. It took a median dressing change rate of 1 (range 0–5) in the superficial partial thickness and 3 (range 1–11) in the deep partial thickness group. Conservative treatment of deep partial thickness wounds was possible in 79% and 17% of these patients required secondary scar revision. Although bacterial colonization of the wounds frequently occurred, wound infections were rarely observed. Conclusion Acticoat7™ is a valuable dressing for treating superficial and deep partial thickness burn wounds of the face in an intensive care unit setting. It enables extended time intervals between dressing changes without an increased risk for complications.

Journey to Zero Central Line-Associated Bloodstream Infections: An Intensive Care Unit's Story of Sustained Success and Quality Improvement

2016 ◽  
Vol 21 (2) ◽  
pp. 76-80 ◽  
Author(s):  
Leighann Jock ◽  
Laurie Emery ◽  
Lorri Jameson ◽  
Phyllis A. Woods
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Bloodstream Infections ◽  
Central Line ◽  
Chlorhexidine Gluconate ◽  
Staff Education ◽  
Increased Risk ◽  
The Face ◽  
Sustained Success ◽  
Clabsi Rate

Abstract Background: Patients who have a central line (CL) are at increased risk for developing a CL-associated bloodstream infection (CLABSI), which increases morbidity, length of stay, and cost. Our goal is zero CLABSI infections. Methodology: In 2009 our organization implemented a CL bundle to prevent CLABSIs, and staff education was introduced in 2012. In 2013 a 2% chlorhexidine gluconate (CHG) wipe was introduced and used to clean around CL dressings. In 2014 a new CL dressing was adopted and during 2015 the organization began using a 3.15% CHG/70% alcohol swab for disinfection of needleless connectors. A final intervention was put into place in 2015 called “nose to toes” in which a patient is bathed from nose to toes (excluding the face) using 2% CHG wipes. Results: Before implementation of the above methods, our intensive care unit had an average infection rate of 1.9/1000 CL-days in 2009. Incidence of CLABSIs continued to decrease as the organization implemented the additional products and practices. In the 15 months following implementation, the ICU has been able to consistently maintain a zero CLABSI rate. Conclusions: The implementation of these changes in practice along with bringing in new products has made it possible to achieve the goal of reaching and maintaining zero infections. Due to the successful results in our intensive care unit, we have implemented these changes to all patient care areas in the hospital for use on all CLs.

scholarly journals Randomized Control Trial Comparing Moist Exposed Burn Ointment and Honey as Dressings Agents in Patients with Second -Degree Burns

1970 ◽  
Vol 2 (1) ◽  
Author(s):  
Anastasia Dessy Harsono ◽  
Aditya Wardhana
Keyword(s):  
Rating Scale ◽  
Bacterial Colonization ◽  
Cost Effective ◽  
Numeric Rating Scale ◽  
Complete Healing ◽  
Partial Thickness ◽  
Partial Thickness Burn ◽  
Partial Thickness Burns ◽  
The Cost ◽  
Numeric Rating

Background: Many  topical  agents  are  available  for  the treatment  of  partial  thickness  burns.  We examined  Moist  Exposed  Burn  Ointment  (MEBO)  and  honey  as  dressing  agents;  regarding  their natural antibacterial, anti-inflammatory, and wound healing properties. They have also been proven to be superior than silver sulphadiazine in treating burn wound.Methods: A  total  of  34  patients  were  randomly  allocated  into  MEBO  group  and  Indonesian  local honey group. The dressings are changed  daily, with corresponding interventions applied. The depth and extent of burn wounds were assessed upon patient’s admission and once a week for two weeks. Pain  level was  evaluated  using  the Numeric  Rating  Scale  (NRS).  The  wound  swabs  were  cultured weekly to obtain microorganisms profile. The cost-per-day of each group were counted.Result: Acute  partial  thickness  burn  in  MEBO  group  showed  faster  healing  compared  to  honey group. NRS  scores for  pain were also lower in MEBO group. MEBO was found  to be more effective in decreasing bacterial colonization. Cost of  treating wound  using MEBO until complete healing was also lesser than local honey.Conclusions: As  topical agent  to  treat  partial  thickness burns,  MEBO  is  superior  compared  to  local honey due to faster healing, better pain relief, fewer bacterial colonization and the more cost-effective usage.

scholarly journals Considerations in the provision of teleconsultations for outpatient obstetric anaesthesia care during the Covid-19 pandemic

2021 ◽  
pp. 201010582199117
Author(s):  
Leonard Wei Wen Loh ◽  
Yingke He ◽  
Hairil Rizal Abdullah ◽  
Kai Lee Ng ◽  
Un Sam Mok
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Severe Illness ◽  
Continuing Care ◽  
Short Report ◽  
Obstetric Anaesthesia ◽  
Increased Risk ◽  
Process And Outcome ◽  
Risk Of Exposure ◽  
Anaesthesia Care

Evidence has emerged that pregnant women who contract coronavirus disease 2019 (Covid-19) are at increased risk of certain forms of severe illness as well as complications requiring intensive care unit admission and resultant mortality. Teleconsultations can facilitate continuing care for obstetric patients during the Covid-19 pandemic while reducing their risk of exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this short report, we share our experience in the provision of teleconsultations for ambulatory obstetric anaesthesia patients in our high-risk obstetric anaesthesia clinic during the Covid-19 pandemic. Appropriate labour analgesia or anaesthesia plans were able to be formulated and communicated to the patients by teleconsultation, resulting in no delay or compromise in their peripartum care. Both patients and clinicians reported satisfaction with the teleconsultation process and outcome. The considerations and challenges in setting up a teleconsultation service as well as the factors in favour of teleconsultation are also explored.

scholarly journals Increased Risk of Death, in the Hospital and Outside the Intensive Care Unit, for Patients With Cirrhosis After Cardiac Arrest

2017 ◽  
Vol 15 (11) ◽  
pp. 1808-1810 ◽  
Author(s):  
Megan E. Reinders ◽  
Gabriel Wardi ◽  
Ricki Bettencourt ◽  
Daniel Bouland ◽  
Jessica Bazick ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Arrest ◽  
Intensive Care ◽  
Risk Of Death ◽  
Increased Risk

BACTERIAL COLONIZATION OF NEWBORN INFANTS IN A NEONATAL INTENSIVE CARE UNIT

1982 ◽  
Vol 71 (5) ◽  
pp. 779-783 ◽  
Author(s):  
M. ERIKSSON ◽  
B. MELÉN ◽  
K.-E. MYRBÄCK ◽  
B. WINBLADH ◽  
R. ZETTERSTRÖM
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Bacterial Colonization ◽  
Newborn Infants

Bacterial colonization and infection in an intensive care unit

1988 ◽  
Vol 14 (1) ◽  
pp. 34-38 ◽  
Author(s):  
B. Nyström ◽  
H. Frederici ◽  
C. von Euler
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Bacterial Colonization

scholarly journals The effectiveness and safety of the use of antithrombotic therapy in COVID-19

2021 ◽  
Vol 18 (2) ◽  
pp. 17-30
Author(s):  
K. V. Lobastov ◽  
O. Ya. Porembskay ◽  
I. V. Schastlivtsev
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Increased Risk ◽  
Severe Infections ◽  
Thrombotic Complications ◽  
Risk Of Disease ◽  
Anticoagulant Prophylaxis ◽  
Discharge From Hospital ◽  
Outpatient Settings

The article is a non-systematic review of the literature, addressing the effectiveness, safety and appropriateness of antithrombotic drugs for COVID-19 in patients undergoing treatment in different settings: in the hospital phase, including the intensive care unit, in the outpatient phase after discharge from hospital, in primary outpatient treatment. The issues of thrombotic complications during vaccination and the necessity of their prevention are discussed. The studies confirm the importance of prophylactic doses of anticoagulants in all hospitalized patients. The use of increased doses has proven ineffective in patients with a severe course of the disease who are being treated in the intensive care unit. In moderately severe infections, there is a clear benefit of increased doses of anticoagulants in reducing the risk of organ failure, but definitive conclusions can only be drawn after the final results of the studies have been published. Prolonged pharmacological prophylaxis after hospital discharge may be useful in individual patients, but the overall risk of thrombotic complications in the long-term period does not appear to be high. The available data do not support the use of anticoagulants in the treatment of coronavirus disease in the outpatient settings, since the risk of thrombotic complications is not increased in such patients, and the safety of anticoagulant use has not been evaluated. Sulodexide may be useful in selected outpatients at increased risk of disease progression. Vaccination may provoke the development of atypical localized thrombosis by immune mechanisms, but the risk of such complications is lower in the coronavirus disease itself. Anticoagulant prophylaxis during vaccine administration is not indicated.

An Outbreak of Multidrug-ResistantPseudomonas AeruginosaAssociated with Increased Risk of Patient Death in an Intensive Care Unit

2002 ◽  
Vol 23 (8) ◽  
pp. 441-446 ◽  
Author(s):  
Geir Bukholm ◽  
Tone Tannæs ◽  
Anne Britt Bye Kjelsberg ◽  
Nils Smith-Erichsen
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Multidrug Resistant ◽  
University Hospital ◽  
Bacterial Isolates ◽  
Patient Death ◽  
Antibiotic Policy ◽  
Outbreak Period ◽  
Increased Risk ◽  
Gastric Tubes

Objective:To investigate an outbreak of multidrug-resistantPseudomonas aeruginosain an intensive care unit (ICU).Design:Epidemiologic investigation, environmental assessment, and ambidirectional cohort study.Setting:A secondary-care university hospital with a 10-bed ICU.Patients:All patients admitted to the ICU receiving ventilator treatment from December 1,1999, to September 1, 2000.Results:An outbreak in an ICU with multidrug-resistant isolates ofP. aeruginosabelonging to one amplified fragment-length polymorphism (AFLP)–defined genetic cluster was identified, characterized, and cleared. Molecular typing of bacterial isolates with AFLP made it possible to identify the outbreak and make rational decisions during the outbreak period. The outbreak included 19 patients during the study period. Infection with bacterial isolates belonging to the AFLP cluster was associated with reduced survival (odds ratio, 5.26; 95% confidence interval, 1.14 to 24.26). Enhanced barrier and hygiene precautions, cohorting of patients, and altered antibiotic policy were not sufficient to eliminate the outbreak. At the end of the study period (in July), there was a change in the outbreak pattern from long (December to June) to short Quly) incubation times before colonization and from primarily tracheal colonization (December to June) to primarily gastric or enteral Quly) colonization. In this period, the bacterium was also isolated from water taps.Conclusion:Complete elimination of the outbreak was achieved after weekly pasteurization of the water taps of the ICU and use of sterile water as a solvent in the gastric tubes.

Neonatal Outcomes Associated with Noncephalic Presentation at Delivery in Preterm Birth

2018 ◽  
Vol 35 (12) ◽  
pp. 1131-1137
Author(s):  
Annalisa Post ◽  
Geeta Swamy ◽  
Chad Grotegut ◽  
Amber Wood
Keyword(s):  
Intensive Care Unit ◽  
Multivariate Analysis ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Mode Of Delivery ◽  
Secondary Analysis ◽  
Neonatal Outcomes ◽  
Risk Of Death ◽  
Increased Risk ◽  
Stratified Analysis

Objective The objective of this study is to evaluate the effect of noncephalic presentation on neonatal outcomes in preterm delivery. Study Design In this study a secondary analysis of the BEAM trial was performed. It included women with singleton, liveborn, and nonanomalous fetuses. Neonatal outcomes were compared in noncephalic versus cephalic presentation. Adjusted odds ratios and 95% confidence intervals were calculated for each outcome with logistic regression while controlling for possible confounders. A stratified analysis by mode of delivery was also performed in this study. Results A total of 458 noncephalic deliveries were compared with 1,485 cephalic deliveries. In multivariate analysis, noncephalic presentation was associated with increased risk of death in the neonatal intensive care unit (NICU) or death at <15 months corrected gestational age (cGA), and a decreased risk of IVH. The risk of death persisted in stratified analysis, with increased risk of death at <15 months cGA in noncephalic neonates born via cesarean delivery. In the vaginal delivery group, there was an increased risk of death at <15 months cGA and NICU death. Conclusion After controlling for possible confounders, neonates who are noncephalic at delivery have higher risk for death <15 months cGA and death in the NICU while their risk of IVH is reduced. The risk of death persisted in stratified analyses by mode of delivery.

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