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PRESSURE ULCER MANAGEMENT

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Pressure ulcer is the most prevalent health issue all around the world. For every 1,000,000 patients who developed Pressure ulcer 65,000 die from complications which presents a major challenge worldwide. Medical research is constantly striving to identify efficient ways for managing this long prevailing issue and reduce the fatality caused due to mismanagement of the pressure ulcers. Lets understand a little about what exactly are these pressure ulcers, how are they formed and what are the current methods in practice for management of pressure ulcers. What are Pressure Ulcers? Pressure Ulcer commonly known as bed sore is an area on the body where there is damage to the skin & underlying tissue due to prolonged pressure, sheer, friction or a combination of all these.   Fig1. Causes of  Pressure Ulcer Development   Pressure ulcers are commonly observed in the patients with decreased mobility like patients suffering with paralysis or the elderly. The ulcers c...

NEGATIVE PRESSURE WOUND THERAPY WITH IRRIGATION

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  The use of negative pressure wound therapy (NPWT) is well established in the treatment of chronic wounds. NPWT with instillation (NPWTi) combines traditional NPWT with the application of a topical irrigation solution within the wound bed. The addition of instillation feature with NPWT adds several potential benefits in dealing with complex wounds.   NPWT WITH IRRIGATION -MECHANISM OF ACTION Potential mechanisms of action include the removal of microorganisms from the wound surface, dilution of cytotoxic molecules, up-regulation of angiogenesis path ways, and maintenance of a moist wound environment. As we have extended our use of these devices to more complex wounds, we have taken advantage of and observed potential mechanisms of action, including facilitated removal of microorganisms, dilution of inflammatory and cytotoxic macromolecules, additional wound hydration, and enhanced angiogenesis through an intermittent application of NPWT.     Fig 2. N...

INTRODUCTION TO NPWT

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  The management of difficult to heal wounds has always been a cause of concern for the treating clinicians. There has been a tremendous increase in the number of patients presenting with difficult to heal wounds. The conventional techniques have been in use since a long time for the management of these wounds, yet desired results are not achieved always. Thus a newer novel technique which might be useful in the difficult to heal wounds and delivering at par or better results as compared to the conventional techniques is the need of the hour. Despite numerous advances, chronic and other difficult to manage wounds continue to be a challenge for the clinicians. The relatively newer technique negative pressure wound therapy ( NPWT ) is very promising and also useful in the management of difficult to heal wounds.   The use of controlled levels of negative pressure application has been shown to accelerate debridement and promote healing in various types of wounds. This optimum ...