Sepsis associated with decubitus ulcers

Galpin, Jeffrey E.; Chow, Anthony W.; Bayer, Arnold S.; Guze, Lucien B.

doi:10.1016/0002-9343(76)90371-5

Cited by 169 publications

(72 citation statements)

References 8 publications

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“…This is also consistent with most studies, which discourage indiscriminate use of topical antibiotics (21). Topical antibiotics should only be used after culture and sensitivity results and only for a short duration so as to prevent bacterial resistance.…”

Section: Resultssupporting

confidence: 86%

Pressure ulcers presentations and management at Kenyatta National Hospital and Spinal Injury Hospital

Nangole¹,

Khainga²,

Kiboi³

2010

E Af Med Jrnl

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Objective: To determine the presentation and management of patients with pressure ulcers. Design: A prospective study. Setting: The Kenyatta National Hospital (KNH) and National Spinal Injury Hospital (NSIH). Subjects: One hundred and thirteen patients were evaluated. Ninety six patients from KNH and seventeen from NSIH. Patients admitted at Kenyatta National Hospital and National Spinal Injury Hospital with pressure ulcers during the study period. Results: Of the 113 patients, 77 (68.1%) were male and 36 (31.9%) were female. Mean age of the patients studied was 38.1 years while the range was between 12 and 74 years. Paraplegia was the main associated medical condition accounting for 35.4%, followed by HIV/AIDS with 27.4%. The most common anatomical site for pressure ulcers was tronchanteric region with 43% of the ulcers. Pressure ulcers of grade III and IV accounted for 66.4% of the ulcers. Two hourly turning was the most common method of pressure dispersion used. Gauze dressing was the most common method used in wound care while 67.3% of the patients had their wounds cleaned with povidoneiodine. Fasciocutaneous flaps were the most common surgical procedure performed (81.7%) for closure of pressure ulcers. Overall, 59.3% of surgical procedures had been successful at one month. This was, however, reduced to 48.1% at three months. Conclusion: Majority of patients with pressure ulcers were in a relatively young age group with a mean age of 38 years. Most of the ulcers were located along bony prominence points of the pelvic girdle and the proximal femur. Most of the ulcers in this study were treated conservatively, with only a few ulcers subjected to surgical interventions. For the ulcers treated with surgical interventions the early outcome was good, however studies need to be done to determine long term outcomes.

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Section: Resultssupporting

confidence: 86%

Pressure ulcers presentations and management at Kenyatta National Hospital and Spinal Injury Hospital

Nangole¹,

Khainga²,

Kiboi³

2010

E Af Med Jrnl

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“…This has facilitated a shift from conventional phenotypic methods for the detection of pathogens in clinical samples to the increased use of molecular approaches for both taxonomic and phylogenetic analysis (13). Conventional analysis of chronic wound communities has relied on traditional bacteriological culture methods (5,6,11,12,16,18), thereby completely missing the unculturable population that may be present (53) and thus strengthening the need for the application of such molecular techniques to wound ecology studies.…”

mentioning

confidence: 99%

Use of 16S Ribosomal DNA PCR and Denaturing Gradient Gel Electrophoresis for Analysis of the Microfloras of Healing and Nonhealing Chronic Venous Leg Ulcers

Davies

Hill

Wilson³

et al. 2004

J Clin Microbiol

133

130

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The bacterial microfloras of 8 healing and 10 nonhealing chronic venous leg ulcers were compared by using a combination of cultural analysis and denaturing gradient gel electrophoresis (DGGE) of PCR-amplified 16S rRNA gene products. Cultural analysis of the microflora revealed that the majority of both wound types carried the aerobes Staphylococcus and Pseudomonas spp. (89 and 80%, respectively). Sequencing of 16S ribosomal DNAs selected on the basis of DGGE profiling allowed the identification of strains not detected by cultural means. Of considerable interest was the finding that more than 40% of the sequences represented organisms not cultured from the wound from which they were amplified. DGGE profiles also revealed that all of the wounds possessed one apparently common band, identified by sequencing as Pseudomonas sp. The intensity of this PCR signal suggested that the bacterial load of nonhealing wounds was much higher for pseudomonads compared to healing wounds and that it may have been significantly underestimated by cultural analysis. Hence, the present study shows that DGGE could give valuable additional information about chronic wound microflora that is not apparent from cultural analysis alone.

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“…Untreated ulcers can lead to fever, serious soft tissue infection, sepsis, osteomyelitis and death. [8][9][10] In this setting, the paraplegic patient may neglect or not be able to effect the positioning required to prevent pressure necrosis/ischemia ulcer formation. Therefore, it is critical that the paraplegic patient be provided with a simple method of personal hygiene that will not foster pressure sore formation.…”

Section: Discussionmentioning

confidence: 99%

Continent urinary diversion and diverting colostomy in the therapy of non-healing pressure sores in paraplegic patients

et al. 1993

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Immobilization and subsequent sacral decubitus or pressure sore formation is a danger faced by the paraplegic. We report on 4 patients treated with non-heal ing pressure sores. Three male patients had decubiti eroding into the posterior urethra and bladder neck area. One female patient had bladder neck and urethral loss secondary to Foley catheter erosion and a sacral pressure sore. All 4 had non-healing decubiti secondary to urinary contamination and, in addition, gross fecal contamination in the male patients. All patients failed previous muscular flaps and urinary diversion per suprapubic tube.In the male patients, suprapubic continent urinary diversion included bladder neck mobilization, closure of the distal urethra by oversewing and patching with bovine dura, and augmentation of the bladder with a Miami pouch. Fecal diversion was provided with a sigmoid colostomy. In the female patient, continent diversion was performed by forming a Miami pouch. Total diversion allowed healing of the pressure sores and provided a simpler method of personal hygiene. Details of the diversion and case studies will be presented.

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Sepsis associated with decubitus ulcers

Cited by 169 publications

References 8 publications

Pressure ulcers presentations and management at Kenyatta National Hospital and Spinal Injury Hospital

Pressure ulcers presentations and management at Kenyatta National Hospital and Spinal Injury Hospital

Use of 16S Ribosomal DNA PCR and Denaturing Gradient Gel Electrophoresis for Analysis of the Microfloras of Healing and Nonhealing Chronic Venous Leg Ulcers

Continent urinary diversion and diverting colostomy in the therapy of non-healing pressure sores in paraplegic patients

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