scholarly journals Impact of COVID-19 pandemic (wave 2) and associated lockdown on wound care and the resultant increase in the number of amputations

2021 ◽  
Author(s):  
Lokesh M. G. ◽  
Chandrashekar S. ◽  
Vini Talwar
Keyword(s):  
General Surgery ◽  
Lower Limb ◽  
Wound Care ◽  
Foot Care ◽  
Preventive Actions ◽  
Time Period ◽  
Resultant Increase ◽  
Entire World ◽  
Pandemic Wave

Background: The COVID-19 pandemic has had an unparalleled impact on the socio-economic and healthcare structure of the entire world, including India. The risk of major amputations has increased during the COVID-19 lockdown.Aim of the study was to conduct a single-centered study on the prevalence of major amputations during the pre-pandemic and pandemic period to evaluate the indirect effect of the COVID-19 lockdown on people with lower limb cellulites and wounds. This study also emphasizes on the importance of easy and routine access to foot-care specialist.Methods: The data of patients attending the outpatient and emergency room of general surgery in K. R. Hospital with complaints of cellulites/wounds/ulcers during the months of March to July was evaluated. The number of amputations done during same time period was analyzed.Results: The patients attending outpatient department (OPD) during the lockdown had a fall, while cases and amputations immediately after lockdown had increased.Conclusions: The findings of the present study, reiterate the role of preventive actions in wound care and stress on the importance awareness of complications if such wounds are ignored.

Principles of wound care

2018 ◽  
pp. 105-114
Author(s):  
Abdullah Jibawi ◽  
Mohamed Baguneid ◽  
Arnab Bhowmick
Keyword(s):  
Wound Care ◽  
Healing Process ◽  
Cost Effective ◽  
Control Measures ◽  
Foot Care ◽  
Nice Guidelines ◽  
Infection Control Measures ◽  
Speed Up ◽  
Careful Assessment

It’s important to be aware of healing process, associated comorbidities, and the role of nutrition in wound care management. Assessment of the amount and type of wound exudate plays an important role in deciding the type of dressing used. Infection or underlying osteomyelitis needs careful assessment, further investigation, and administration of systemic/oral anti-microbial therapy. Early use of non-surgical or surgical debridement is necessary to speed up the healing process. Diagnostic criteria of surgical site infection are increasingly used in postoperative wounds in hospitals for audit of infection control measures. No one type of dressing appears superior over other. Dressings should be cost effective, acceptable to the patients, and easy to use. In addition, in recent decades newer non-surgical debriding method, e.g. larvae therapy and negative pressure wound therapy, are increasingly being used and supported by recent NICE guidelines, especially in diabetic foot care.

Foot care: who cares?

1998 ◽  
Vol 8 (3) ◽  
pp. 197-202
Author(s):  
N Gilbert ◽  
T Galloway ◽  
R Green
Keyword(s):  
Health Care ◽  
Elderly Patients ◽  
Elderly People ◽  
Lower Limb ◽  
Systemic Disease ◽  
Limb Amputation ◽  
Care Provision ◽  
Foot Care ◽  
Foot Problems

Foot disorders are common in elderly people and lead to significant difficulties in the form of immobility, pain and gait imbalance. Neuropathic changes associated with systemic disease, such as diabetes, carries the potential for ulcer development leading to possible foot or lower limb amputation. The role of the podiatric surgeon and the podiatrist/chiropodist in the prevention of foot problems in elderly patients is an important and often neglected element of health care for this group. Foot care is at present provided by podiatrists/chiropodists, nurses, orthotists, general practitioners, rheumatologists, geriatricians, casualty specialists, orthopaedic surgeons and podiatric surgeons. Sadly, foot care provision by these professionals is poorly co-ordinated. In most cases this is the result of the general lack of knowledge most professions have about the role of others; however, in at least one instance (orthopaedics), the issue is one of professional rivalry.

Experience of negative pressure wound therapy over sternal wound healing: A retrospective review

WCET Journal ◽  
2019 ◽  
Vol 39 (2) ◽  
pp. 9-18
Author(s):  
Wai Sze Ho ◽  
Wai Kuen Lee ◽  
Ka Kay Chan ◽  
Choi Ching Fong
Keyword(s):  
Wound Healing ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Assessment Tool ◽  
Wound Care ◽  
Wound Therapy ◽  
Treatment Pathways ◽  
Wound Assessment ◽  
One Year

Objectives The aim of this study was to retrospectively review the effectiveness of negative pressure wound therapy (NPWT) in sternal wound healing with the use of the validated Bates-Jensen Wound Assessment Tool (BWAT), and explore the role of NPWT over sternal wounds and future treatment pathways. Methods Data was gathered from patients' medical records and the institution's database clinical management system. Seventeen subjects, who had undergone cardiothoracic surgeries and subsequently consulted the wound care team in one year were reviewed. Fourteen of them were included in the analysis. Healing improvement of each sternal wound under continuous NPWT and continuous conventional dressings was studied. In total, 23 continuous NPWT and 13 conventional dressing episodes were analysed with the BWAT. Results Among conventional dressing episodes, sternal wound improvement was 2.5–3% over 10 days to 3.5 weeks, whereas 4–5% sternal healing was achieved in 5 days to 2 weeks with sternal wire presence. Better healing at 11% in 1 week by conventional dressing was attained after sternal wire removal. In NPWT episodes, 8–29%, 13–24%, and 15–46% of healing was observed in 2 weeks, 3.5 to 5 weeks and 6 to 7 weeks, respectively. Only 39% wound healing was acquired at the 13th week of NPWT in one subject. With sternal wire present, 6%–29% wound healing progress was achieved by NPWT in 1–4 weeks, and 16–23% wound improvement in 2 to 4.5 weeks by NWPT after further surgical debridement. After sternal wire removal, 6–34% sternal wound healing occurred by continuous NPWT for 1–2 weeks, and maximum healing at 46% after 2.5 weeks of NPWT were observed. Conclusions Better wound healing was achieved in the NPWT group in comparison to conventional dressings alone. However, suboptimal sternal wound healing by NPWT alone was observed. Removal of sternal wire may improve the effectiveness of NPWT. Successful tertiary closure after NPWT among subjects supports the important bridging role of NPWT in sternal wound healing. Factors causing stagnant sternal wound healing by NPWT alone are discussed.

The role of delayed lower limb embolectomy in patients with late ischemia

Chirurgia ◽  
2020 ◽  
Vol 32 (6) ◽  
Author(s):  
Walid M. Gamal ◽  
Abdrheem F. Mohamed ◽  
Zeniab M. Askary
Keyword(s):  
Lower Limb

scholarly journals Model-based evaluation of school- and non-school-related measures to control the COVID-19 pandemic

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Ganna Rozhnova ◽  
Christiaan H. van Dorp ◽  
Patricia Bruijning-Verhagen ◽  
Martin C. J. Bootsma ◽  
Janneke H. H. M. van de Wijgert ◽  
...  
Keyword(s):  
Reproduction Number ◽  
Additional Benefit ◽  
Transmission Model ◽  
Time Points ◽  
School Based ◽  
Admission Data ◽  
Age Structured ◽  
The Impact ◽  
Pandemic Wave

AbstractThe role of school-based contacts in the epidemiology of SARS-CoV-2 is incompletely understood. We use an age-structured transmission model fitted to age-specific seroprevalence and hospital admission data to assess the effects of school-based measures at different time points during the COVID-19 pandemic in the Netherlands. Our analyses suggest that the impact of measures reducing school-based contacts depends on the remaining opportunities to reduce non-school-based contacts. If opportunities to reduce the effective reproduction number (Re) with non-school-based measures are exhausted or undesired and Re is still close to 1, the additional benefit of school-based measures may be considerable, particularly among older school children. As two examples, we demonstrate that keeping schools closed after the summer holidays in 2020, in the absence of other measures, would not have prevented the second pandemic wave in autumn 2020 but closing schools in November 2020 could have reduced Re below 1, with unchanged non-school-based contacts.

scholarly journals Representations of Psychoactive Drugs’ Use in Mass Culture and Their Impact on Audiences

2021 ◽  
Vol 18 (11) ◽  
pp. 6000
Author(s):  
Marek A. Motyka ◽  
Ahmed Al-Imam
Keyword(s):  
Young People ◽  
Drug Use ◽  
Mass Culture ◽  
Film Music ◽  
Psychoactive Drugs ◽  
Frequent Contact ◽  
Preventive Actions ◽  
The Impact ◽  
Staying At Home

Drug use has been increasing worldwide over recent decades. Apart from the determinants of drug initiation established in numerous studies, the authors wish to draw attention to other equally important factors, which may contribute to augmenting this phenomenon. The article aims to draw attention to the content of mass culture, especially representations of drug use in mass media, which may influence the liberalization of attitudes towards drugs and their use. The role of mass culture and its impact on the audience is discussed. It presents an overview of drug representations in the content of mass culture, e.g., in film, music, literature, and the occurrence of drug references in everyday products, e.g., food, clothes, and cosmetics. Attention was drawn to liberal attitudes of celebrities and their admissions to drug use, particularly to the impact of the presented positions on the attitudes of the audience, especially young people for whom musicians, actors, and celebrities are regarded as authorities. Indications for further preventive actions were also presented. Attention was drawn to the need to take appropriate action due to the time of the COVID-19 pandemic when many people staying at home (due to lockdown or quarantine) have the possibility of much more frequent contact with mass culture content, which may distort the image of drugs.

scholarly journals The Role of Circulating Biomarkers in Peripheral Arterial Disease

2021 ◽  
Vol 22 (7) ◽  
pp. 3601
Author(s):  
Goren Saenz-Pipaon ◽  
Esther Martinez-Aguilar ◽  
Josune Orbe ◽  
Arantxa González Miqueo ◽  
Leopoldo Fernandez-Alonso ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Lower Limb ◽  
Prediction Models ◽  
Arterial Disease ◽  
Cardiac Damage ◽  
Thrombotic Occlusion ◽  
Medical Treatments ◽  
Peripheral Arterial ◽  
Inflammatory Molecules

Peripheral arterial disease (PAD) of the lower extremities is a chronic illness predominantly of atherosclerotic aetiology, associated to traditional cardiovascular (CV) risk factors. It is one of the most prevalent CV conditions worldwide in subjects >65 years, estimated to increase greatly with the aging of the population, becoming a severe socioeconomic problem in the future. The narrowing and thrombotic occlusion of the lower limb arteries impairs the walking function as the disease progresses, increasing the risk of CV events (myocardial infarction and stroke), amputation and death. Despite its poor prognosis, PAD patients are scarcely identified until the disease is advanced, highlighting the need for reliable biomarkers for PAD patient stratification, that might also contribute to define more personalized medical treatments. In this review, we will discuss the usefulness of inflammatory molecules, matrix metalloproteinases (MMPs), and cardiac damage markers, as well as novel components of the liquid biopsy, extracellular vesicles (EVs), and non-coding RNAs for lower limb PAD identification, stratification, and outcome assessment. We will also explore the potential of machine learning methods to build prediction models to refine PAD assessment. In this line, the usefulness of multimarker approaches to evaluate this complex multifactorial disease will be also discussed.

Possible Role of High-Dose Barbiturates and Early Administration of Parenteral Ketogenic Diet for Reducing Development of Chronic Epilepsy in Febrile Infection-Related Epilepsy Syndrome: A Case Report

2020 ◽  
Author(s):  
Shimpei Baba ◽  
Tohru Okanishi ◽  
Koichi Ohsugi ◽  
Rika Suzumura ◽  
Keiko Niimi ◽  
...  
Keyword(s):  
Continuous Infusion ◽  
Ketogenic Diet ◽  
Epilepsy Syndrome ◽  
High Dose ◽  
Early Administration ◽  
Chronic Epilepsy ◽  
Time Period ◽  
Irreversible Brain Damage ◽  
Electroencephalogram Eeg

AbstractWe describe the efficacy of high-dose barbiturates and early administration of a parenteral ketogenic diet (KD) as initial treatments for acute status epilepticus (SE) in an 8-year-old girl with febrile infection-related epilepsy syndrome (FIRES). The patient was admitted to our hospital with refractory focal SE. Abundant epileptic discharges over the left frontal region were observed on electroencephalogram (EEG). Treatment with continuous infusion of thiamylal for 4 hours, increased incrementally to 40 mg/kg/h, successfully ended the clinical SE, and induced a burst-suppression coma. The infusion rate was then gradually decreased to 4 mg/kg/h over the next 12 hours. Parenteral KD was administered from days 6 to 21 of illness. Continuous infusion of thiamylal was switched to midazolam on day 10 without causing seizures or EEG exacerbations. The patient has remained seizure free in the 15 months since hospital discharge. The effectiveness of KD for the treatment of FIRES has attracted attention amongst clinicians, but KD treatment may need to last for 2 to 4 days before it can stop SE, a time period that could cause irreversible brain damage. Considering the severity of SE in our patient and the dose of barbiturates needed to treat it, we consider this case to have had a good clinical outcome. The results suggest that rapid termination of seizure using high-dose barbiturates in conjunction with early administration of parenteral KD could reduce the development of chronic epilepsy in patients with FIRES.

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