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Objective. To compare the clinical effffects of modifified above-knee and conventional surgery with the stripping of the greatsaphenous vein of varicose veins of the lower extremities. Methods. Clinical data of patients with a varicose vein of the lower extremity from May 2016 to May 2018 were collected. A retrospective study was conducted on the patients receiving modifified above-knee and conventional surgery with the great saphenous vein stripping. The baseline characteristics and long-term follow-up data were compared between the groups. Results. There were no signifificant difffferences in baseline characteristics between the two groups (P > 0:05). The surgeries were successfully performed by the same group of surgeons under local anesthesia and neuraxial anesthesia. The hospital stay, operation time, intraoperative blood loss, total length, and number of incisions in the above-knee group were comparable to those in the conventional surgery group (P > 0:05). The incidence of saphenous nerve injury and subcutaneous hematoma in the above-knee group was lower than that in the conventional surgery group (P < 0:05). There were no signifificant difffferences in recurrent varicose vein incidences (P > 0:05). After surgery, the venous clinical severity score (VCSS) and chronic venous insuffiffifficiency questionnaire (CIVIQ-14) scores of both groups were higher than those before operation (P < 0:05). There was no signifificant difffference in VCSS score or CIVIQ-14 scores between the two groups postoperation (P > 0:05). At 24 months after surgery, the above-knee group (71.8%) and conventional surgery group (73.2%) resulted in changes of at least two CEAP-C clinical classes lower than baseline, respectively. Conclusion. The modifified above-knee technique can ensure clinical outcomes, reduce intraoperative blood loss and complication incidences, and shorten the operative time. This gives evidence that the modifified above-knee technique is worthy of clinical application.
Wound healing is one of the most complex physiological regulation mechanisms of the human body. Stem cell technology has had a signifificant impact on regenerative medicine. Adipose stem cells (ASCs) have many advantages, including their ease of harvesting and high yield, rich content of cell components and cytokines, and strong practicability. They have rapidly become a favored tool in regenerative medicine. Here, we summarize the mechanism and clinical therapeutic potential of ASCs in wound repair.
Keywords: adipose stem cells, wound healing, regenerative medicine, skin regeneration, inflflammation
Abstract:Sub-epidermal moisture is an established biophysical marker of pressure ulcer formation based on biocapacitance changes in affected soft tissues, which has been shown to facilitate early detection of these injuries. Artificial intelligence shows great promise in wound prevention and care, including in automated analyses of quantitative measures of tissue health such as sub-epidermal moisture readings acquired over time for effective, patient-specific, and anatomical-site-specific pressure ulcer prophylaxis.Here, we developed a novel machine learning algorithm for early detection of heel deep tissue injuries, which was trained using a database comprising six consecutive daily sub-epidermal moisture measurements recorded from 173 patients in acute and post-acute care settings. This algorithm was able to achieve strong predictive power in forecasting heel deep tissue injury events the next day, with sensitivity and specificity of 77% and 80%, respectively, revealing the clinical potential of artificial intelligence-powered technology for hospital-acquired pressure ulcer prevention. The current work forms the scientific basis for clinical implementation of machine learning algorithms that provide effective, early, and anatomy-specific preventive interventions to minimise the occurrence of hospital-acquired pressure ulcers based on routine tissue health status measurements.
KEYWORDS:artificial intelligence, predictive bioengineering modelling, pressure ulcer/injury prophylaxis, preventive interventions, SEM scanner
摘要 目的:调查护理人员医疗器械相关压力性损伤(MDRPI)认知现状,并分析其影响因素。方法:采用分层抽样法选取2020年5月—2020年7月清远市10所医院的1074名护理人员为调查对象,采用自行设计的问卷对其进行问卷调查,采用多重逐步回归分析研究护理人员 MDRPI认知的影响因素。结果:42.3%的护理人员知晓压力性损伤的最新分期,MDRPI知晓率为86.8%。绝大部分护理人员在为病人护理时选择合适的器械,固定适宜。48.0%的护理人员不会直接将器械放置在病人身上,大部分护理人员使用纱布/棉垫保护器械接触部位皮肤。约43%的护理人员每天2次或3次评估医疗器械接触部位皮肤,52.4%的护理人员每天2次清洁使用器械部位皮肤;气管插管被认为是最容易引起 MDRPI的原因。多重线性回归分析结果显示,职称、医院级别、培训次数为护理人员 MDRPI知识得分的影响因素(P<0.05)。结论:护理人员 MDRPI知识和行为水平有待提高,需加强护理人员 MDRPI相关知识的规范化培训,提高护理人员对 MDRPI的认知和护理行为水平,以降低病人的 MDRPI发生率。
关键词 医疗器械相关压力性损伤;护理人员;认知;影响因素