The Use of Vacuum-Assisted Closure Therapy for the Treatment of a Large Infected Facial Wound

2006 ◽  
Vol 72 (2) ◽  
pp. 129-131 ◽  
Author(s):  
Rob Schuster ◽  
Arash Moradzadeh ◽  
Kenneth Waxman
Keyword(s):  
Health Care Providers ◽  
Granulation Tissue ◽  
Chronic Wounds ◽  
Care Providers ◽  
Vacuum Assisted Closure ◽  
Vac Therapy ◽  
First Case ◽  
Facial Wound ◽  
The Face ◽  
New Treatment

Chronic wounds in difficult locations pose constant challenges to health care providers. Negative-pressure wound therapy is a relatively new treatment to promote wound healing. Laboratory and clinical studies have shown that the vacuum-assisted closure (VAC) therapy increases wound blood flow, granulation tissue formation, and decreases accumulation of fluid and bacteria. VAC therapy has been shown to hasten wound closure and formation of granulation tissue in a variety of settings. Accepted indications for VAC therapy include the infected sternum, open abdomen, chronic, nonhealing extremity wounds and decubitus ulcers. We report the first case of VAC therapy successfully used on a large infected wound to the face to promote healing.

scholarly journals Successful Treatment of Anterior Tracheal Necrosis after Total Thyroidectomy Using Vacuum-Assisted Closure Therapy

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Grégory Philippe ◽  
Nicolas Pichon ◽  
Justine Lerat ◽  
Jean Bernard Amiel ◽  
Marc Clavel ◽  
...  
Keyword(s):  
Total Thyroidectomy ◽  
Granulation Tissue ◽  
Closure Device ◽  
Vacuum Assisted Closure ◽  
Good Opportunity ◽  
Vac Therapy ◽  
First Case ◽  
Adjacent Structures ◽  
Vacuum Assisted Closure Therapy ◽  
Ongoing Infection

Total thyroidectomy involving the adjacent structures of the trachea can cause tracheal damage such as early tracheal necrosis. The authors describe the first case of anterior tracheal necrosis following total thyroidectomy treated using vacuum-assisted closure device. After two weeks of VAC  therapy, there was no evidence of ongoing infection and the trachea was partially closed around a tracheotomy cannula, removed after 3 months. The use of a VAC  therapy to reduce and close the tracheal rent and to create a rapid granulation tissue over tracheal structure appeared as a good opportunity after anterior tracheal necrosis.

scholarly journals Experiences of Patients With COVID-19 Admitted to the Intensive Care Units: A Qualitative Study

2021 ◽  
Vol 8 ◽  
pp. 237437352110073
Author(s):  
Reza Norouzadeh ◽  
Mohammad Abbasinia ◽  
Zahra Tayebi ◽  
Ehsan Sharifipour ◽  
Alireza Koohpaei ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Health Care Providers ◽  
Spiritual Support ◽  
Care Providers ◽  
Structured Interviews ◽  
Icu Patients ◽  
Life Challenges ◽  
Care Models ◽  
The Face

This study aimed to describe the experiences of patients with COVID-19 admitted to the intensive care units (ICU). The data were analyzed by content analysis on 16 ICU patients with COVID-19. Data were collected by semi-structured interviews. Three categories were identified: (a) captured by a challenging incident with subcategories: perceived sudden and challenging death, fear of carelessness in overcrowding, worry about the family, and frustration with stigmatizing; (b) the flourishing of life with subcategories: spiritual-awakening, resilience in the face of life challenges, promoting health behaviors, and striving for recovery; and (c) honoring the blessings with subcategories: understanding the importance of nurses, realizing the value of family, and realizing the value of altruism. COVID-19 survivors experienced both positive and negative experiences. The results of this study could help health care providers identify the needs of ICU patients with COVID-19, including psychological, social, and spiritual support and design care models.

scholarly journals Massive Spontaneous Hemothorax as a Complication of Apixaban Treatment

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
M. Abu Hishmeh ◽  
P. Srivastava ◽  
Q. Lougheide ◽  
M. Srinivasan ◽  
S. Murthy
Keyword(s):  
Pleural Effusion ◽  
Health Care Providers ◽  
Rare Complication ◽  
Pigtail Catheter ◽  
Care Providers ◽  
Nonvalvular Atrial Fibrillation ◽  
Vein Thrombosis ◽  
Spontaneous Hemothorax ◽  
First Case ◽  
Iatrogenic Trauma

Introduction. Hemothorax is usually related to chest or iatrogenic trauma from procedures such as central lines and thoracentesis. Spontaneous hemothorax is defined as pleural fluid hematocrit greater than 50% of serum hematocrit in absence of natural or iatrogenic trauma affecting the lung or pleural space. Coagulopathy secondary to anticoagulant use has been associated with spontaneous hemothorax. We present a case of spontaneous hemothorax in a patient taking apixaban for venous thromboembolism disease. To our knowledge, this is the first case report of apixaban as a cause of spontaneous hemothorax. Case Presentation. A 56-year-old woman with end-stage renal disease (ESRD) was diagnosed with upper extremity deep vein thrombosis (DVT) one month prior to presentation and was started on apixaban presented with dyspnea and left-sided pleuritic chest pain for two weeks. She was found to have left-sided large pleural effusion which was diagnosed as hemothorax. Other etiologies for spontaneous hemothorax were excluded and drainage by 12-French pigtail catheter achieved total resolution of hemothorax in three days. Discussion. Apixaban is a DOAC used to prevent stroke or thromboembolic events in patients with nonvalvular atrial fibrillation and to prevent recurrent venous thromboembolic disease. Events such as gastrointestinal, intracranial, and soft tissue bleeding have been well-documented. However, bleeding manifestation as hemothorax is seldom reported. Our patient presented with isolated left-sided large pleural effusion which was diagnosed as spontaneous hemothorax. 12-Fr pigtail catheter drainage was effective in the management of our patient and provided total resolution in three days. Conclusion. Spontaneous hemothorax is a rare complication of anticoagulant therapy and might not exhibit the usual radiological signs of traumatic hemothorax. Health care providers should have high index of suspicion for spontaneous hemothorax when evaluating new pleural effusion in patients receiving DOACs therapy. Drainage by small bore pigtail catheter might be as effective as larger chest tubes.

Community-Associated Methicillin-Resistant Staphylococcus Aureus–Infected Chronic Scalp Wound With Exposed Dura in a 10-Year-Old Boy: Vacuum-Assisted Closure Is a Feasible Option: Case Report

Neurosurgery ◽  
2011 ◽  
Vol 68 (5) ◽  
pp. E1481-E1484 ◽  
Author(s):  
Ulrike Subotic ◽  
Wolfram Kluwe ◽  
Valérie Oesch
Keyword(s):  
Staphylococcus Aureus ◽  
Granulation Tissue ◽  
Pediatric Patients ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Chronic Wound ◽  
Bony Defect ◽  
Vacuum Assisted Closure ◽  
Methicillin Resistant ◽  
Vac Therapy ◽  
Mentally Disabled

Abstract BACKGROUND AND IMPORTANCE: Since the introduction of vacuum-assisted closure (VAC) in 1997, it has been used successfully in treating difficult wounds, including spinal wounds and wounds in pediatric patients. There are no reports on VAC therapy in pediatric patients on the scalp, especially with exposed dura. This report describes a 10-year-old boy with a chronic wound of the scalp with exposed dura after multiple neurosurgical interventions who was treated successfully with VAC. CLINICAL PRESENTATION: A 10-year-old mentally disabled boy with Apert syndrome suffered from a chronic wound with community-associated methicillin-resistant Staphylococcus aureus (MRSA) infection after multiple neurosurgeon operations. For wound closure, VAC therapy was initiated on the bony defect with exposed dura. The wound healed successfully, and the MRSA disappeared. CONCLUSION: The aims of VAC therapy are formation of new granulation tissue, wound cleansing, and bacterial clearance. In this case, the VAC device was excellent for temporary coverage of the defect and for wound cleaning, and it allowed a thick bed of granulation tissue to form over the dura, even with minimal constant negative pressure. The application and management were feasible even in a mentally disabled child. With this experience, we are encouraged to use the VAC device in difficult wounds, even in the head and neck area in children, and to bring this treatment into the outpatient clinic.

scholarly journals Queering whole person care in a pandemic

2022 ◽  
Vol 9 (1) ◽  
pp. 56-57
Author(s):  
Jane Shulman ◽  
David Kenneth Wright
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Care Providers ◽  
The Past ◽  
Health Care Experiences ◽  
The People ◽  
Whole Person ◽  
Care Approach ◽  
The Face ◽  
Nursing Educator

How can health care providers (HCPs) working with 2SLGBTQ+ patients enact a whole person care approach during the SARS-CoV-2 pandemic and its aftermath, and in such desperate times, is it even reasonable to expect them to? In this presentation, a nurse/nursing educator and a health care researcher/frequent patient discuss their observations and experiences of whole person care during the SARS-CoV-2 pandemic. The conversation highlights that in the immediate chaos early on, and in the face of exhaustion, trauma, and burnout as the pandemic progressed, attending to the whole personhood of patients was/is paramount for HCPs and for the people they treat. The presenters reflect on the amplified significance of a whole person approach for 2SLGBTQ+ people who may have had negative health care experiences in the past, and may fear that they will not receive equitable care in the chaotic context of a pandemic. A whole person care approach is perhaps most necessary when it is also most difficult. In a period of such profound distress, a deeper sense of connectedness to patients may help HCPs manage feelings of helplessness they are likely to encounter, and surely helps the people they treat. The goal of this presentation is to begin a discussion about the ways that whole person approaches benefit 2SLGBTQ+ patients as well as their HCPs, with the hope that it will spark ideas for attendees to develop in their own practices.

scholarly journals Pharmacist’s Intervention Considering the Prognosis for a Terminal Cancer Patient: A Case Report

Pharmacy ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 212
Author(s):  
Masahiro Okada ◽  
Kazuko Okazaki ◽  
Keisuke Kimura ◽  
Hiroki Sugihara ◽  
Fumiyoshi Murakami ◽  
...  
Keyword(s):  
Case Report ◽  
Health Care Providers ◽  
Prognostic Index ◽  
Oral Intake ◽  
Sigmoid Colon Cancer ◽  
Care Providers ◽  
Abdominal Wall Metastasis ◽  
First Case ◽  
Prognostic Prediction ◽  
Loss Of Appetite

Prognostic prediction has been reported to affect the decision of doctors and non-physician health care providers such as nurses, social workers, pastors, and hospice volunteers on the selection of appropriate medical interventions. This was a case of a 65-year-old woman who presented with a poor oral intake. The patient had a history of sigmoid colon cancer with abdominal wall metastasis and peritoneal dissemination. On the day of admission, nausea, anorexia, and malaise were noted, requiring immediate intervention. The patient’s prognosis was predicted using the Palliative Prognostic Index. The pharmacist suggested the use of dexamethasone tablets in order to alleviate the patient’s symptoms. Indeed, the administration of dexamethasone alleviated the symptoms of nausea, loss of appetite, and malaise. To the best of our knowledge, this is the first case report to demonstrate that prognosis prediction is important not only for other medical staff but also for pharmacists when deciding the need to initiate a treatment and continue such treatment, and when providing pharmacist interventions.

User Fees for Health Care: Why a Bad Idea Keeps Coming Back (Or, What's Health Got to Do With It?)

1995 ◽  
Vol 14 (2) ◽  
pp. 360-390 ◽  
Author(s):  
Robert G. Evans ◽  
Morris L. Barer ◽  
Greg L. Stoddart
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Health Care Costs ◽  
Health Care Providers ◽  
Final Analysis ◽  
User Fees ◽  
Care Providers ◽  
Positive Effects ◽  
The Face ◽  
Care Costs

ABSTRACTCalls for user fees in Canadian health care go back as far as the debate leading up to the establishment of Canada's national hospital insurance program in the late 1950s. Although the rationales have shifted around somewhat, some of the more consistent claims have been that user fees are necessary as a source of additional revenue for a badly underfunded system, that they are necessary to control runaway health care costs, and that they will deter unnecessary use (read abuse) of the system. But the real reasons that user fees have been such hardy survivors of the health policy wars, bear little relation to the claims commonly made for them. Their introduction in the financing of hospital or medical care in Canada would be to the benefit of a number of groups, and not just those one usually thinks of. We show that those who are healthy, and wealthy, would join health care providers (and possibly insurers) as net beneficiaries of a reintroduction of user fees for hospital and medical care in Canada. The flip side of this is that those who are indigent and ill will bear the brunt of the redistribution (for that is really what user fees are all about), and seniors feature prominently in those latter groups. Claims of other positive effects of user fees, such as reducing total health care costs, or improving appropriateness or accessibility, simply do not stand up in the face of the available evidence. In the final analysis, therefore, whether one is for or against user fees reduces to whether one is for or against the resulting income redistribution.

Plastic chronic wound management with Cellutome

Phlebologie ◽  
2016 ◽  
Vol 45 (02) ◽  
pp. 100-105
Author(s):  
G. U. Seip
Keyword(s):  
Health Care Providers ◽  
Chronic Wounds ◽  
Donor Site ◽  
Skin Grafting ◽  
Minimal Invasive ◽  
Wound Management ◽  
Wound Treatment ◽  
Care Providers ◽  
Patients With Diabetes ◽  
Chronic Wound Management

SummaryChronic wounds continue to present a significant challenge to health-care providers around the globe. Unlike acute wounds, chronic wounds do not proceed through an orderly process of repair. In recent years many new modalities of modern wound treatment systems have been promoted. However, until recently there were few modalities designed to promote epithelialisation of a fully granulated wound. Mesh graft procedures have long been the gold standard for the management of acute wounds and chronic wounds but have also many disadvantages like discomfort associated with the donor site and the creation of a second painful wound (donor site).The increase of chronical wounds in Germany due to the average age of patients, the aggressiveness of medical treatment and increase of numbers of patients with diabetes and severe polymorbidity requires specialized wound treatment and plastic surgery. Since 2014 there was a new innovative system introduced in the market called Cellutome epidermal harvesting system. The Cellutome system is a epidermal harvesting system for skin grafting and can replace in many cases the traditional meshgraft procedure with a classic dermatoma. The skin donor section on the patient`s thigh heals within days without scarring. The system offers a precise, simplified and minimal invasive option for skin grafting in the treatment of especially chronic wounds.

scholarly journals Endometrial stromal sarcoma metastasis to the lumbar spine and sphenoid bone

Rare Tumors ◽  
2011 ◽  
Vol 3 (3) ◽  
pp. 86-89 ◽  
Author(s):  
Mary I. Huang ◽  
Robert L. DeBernardo ◽  
Mark Rodgers ◽  
David J. Hart
Keyword(s):  
Health Care Providers ◽  
Pelvic Exenteration ◽  
Femoral Nerve ◽  
Endometrial Stromal Sarcoma ◽  
Sphenoid Bone ◽  
Leg Pain ◽  
Subtotal Resection ◽  
Care Providers ◽  
Stromal Sarcoma ◽  
First Case

Endometrial stromal sarcoma (ESS) is typically associated with metastasis to the abdomen, pelvis, and lung. We found three case reports of ESS metastasis to the bone (two to the thoracic spine, and one to the parietal bone). Our objective is to review the literature on ESS spinal and intracranial metastases and, report the first case of ESS metastatic to the lumbar paraspinal region and sphenoid bone. A 53-year-old female with ESS status-post radiation, chemotherapy, and pelvic exenteration surgery presented with right hip weakness, back pain, and radicular leg pain that were explained by chemotherapy-induced neuropathy, radiation-induced lumbosacral plexopathy, and femoral nerve and obturator nerve injury during pelvic exenteration surgery. During routine positron emission tomography, we found metastasis to the L3 lumbar spinal region. L3 laminectomy and subtotal resection of the mass was performed with tumor residual in the neuroforamina and pedicles. One month later, magnetic resonance imaging (MRI) performed for persistent headaches revealed a large lesion in the sphenoid bone that was biopsied transsphenoidally with the same diagnosis, but no further surgery was performed. She is intolerant of chemotherapy and currently undergoing whole brain radiation. Delay in the diagnosis and management of lumbar paraspinal and sphenoid bone metastasis of ESS likely occurred because of the uniqueness of the location and aggressiveness of ESS metastasis. Health care providers should be aware of potentially aggressive metastasis of ESS to bone, in particular the unusual locations of the lumbar paraspinal region and sphenoid bone.

scholarly journals The magnitude and associated Factors of Postoperative Trichiasis among adults who underwent Trachomatous Trichiasis Surgery in Ambassel District, North-East Ethiopia

2020 ◽  
Author(s):  
Abdu Tabor Yimam ◽  
Gizachew Tadesse Wassie ◽  
Getu Degu Alene
Keyword(s):  
Health Care Providers ◽  
Associated Factors ◽  
Sampling Technique ◽  
Fiscal Year ◽  
High Recurrence Rate ◽  
Care Providers ◽  
Cross Sectional ◽  
North East ◽  
The Face ◽  
Trachomatous Trichiasis

Abstract Background In Trachoma endemic countries, many people who underwent Trichiasis surgery faced a recurrence of the disease. Postoperative Trichiasis is a significant problem for patients and health care providers because it puts the eye at renewed risk of sight loss. Despite the low utilization of Trachomatous Trichiasis (TT) surgery and high recurrence rate, evidences that elucidate why TT recurs after surgery are limited. This study was aimed to assess the magnitude and associated factors of postoperative Trichiasis among 18 years and above individuals who underwent Trachomatous Trichiasis surgery between 2006 and 2011 Ethiopian Fiscal year in Ambassel District, North-East Ethiopia, 2020. Methods The community-based cross-sectional study design was conducted from March 10 to March 23/2020 in selected kebeles of Ambassel District. The required sample size was calculated using EPI-INFO Version 7. A multi-stage sampling technique was used to employ a total of 506 individuals. Data were collected through the interviewer-administered structured pre-tested questionnaire and entered into EpiData version 3.1 and then exported to SPSS version 23.0. Bi-variable and multivariable logistic regression models were fitted to identify associated factors of Trachomatous Trichiasis recurrence. Results Four hundred ninety two individuals participated in this study with response rate of 97.2%. In Ambassel district the prevalence of postoperative Trichiasis was 23.8% (95%CI = 19.9–27.8). Among associated factors of postoperative Trichiasis age 50–59 AOR = 3.34 (CI = 1.38–8.1), 60–69 AOR = 3.24(CI = 1.38–7.61), ≥ 70 years AOR = 6.04 (CI = 2.23–16.41), duration since surgery AOR = 1.7(CI = 1.35–2.14), complication AOR = 2.98(CI = 1.24–7.2), washing the face two times AOR = 0.25(CI = 0.13–0.47), washing the face three and more times AOR = 0.1(CI = 0.41 − 0.25), taking Azithromycin following surgery AOR = 0.19(CI = 0.09–0.41), pre-operative epilation history AOR = 2.11, (CI = 1.14, 3.9)and having a knowledge about TrachomaTtrichiasis AOR = 0.21(CI = 0.08–0.58) showed a statistical significant association. Conclusions The prevalence of postoperative Trichiasis in Ambassel District was higher than most Ethiopian studies. Age, frequency of face washing, medication following surgery, duration since the last surgery, knowledge about trachoma, pre-operative epilation history and complication after surgery were identified to be independent factors. To minimize postoperative Trichiasis stakeholders need to consider health education for patients, provision of Azithromycin after surgery and proper training for IECWs.

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