1/10. Algosteril calcium alginate dressing for moderate/high exudate.Algosteril is a new alginate dressing manufactured by Les Laboratoires BROTHIER and distributed by Beiersdorf Medical. It is a natural, pure, non-woven dressing made from calcium alginate fibres. It complements other products in the Beiersdorf wound care family such as Cutinova, Cutifilm and Cutisorb. Algosteril rapidly absorbs and retains wound fluid to form an integral gellified structure, thereby maintaining an ideal moist wound healing environment. It traps and immobilizes pathogenic bacteria in the network of gellified fibres, stimulates macrophage activity and activates platelets, resulting in haemostasis and accelerated wound healing.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
2/10. infection of the skin caused by corynebacterium ulcerans and mimicking classical cutaneous diphtheria.Extrapharyngeal infections caused by corynebacterium ulcerans have rarely been reported previously, and diphtheria toxin production has usually not been addressed. This case demonstrates that strains of C. ulcerans that produce diphtheria toxin can cause infections of the skin that completely mimic typical cutaneous diphtheria, thereby potentially providing a source of bacteria capable of causing life-threatening diseases in the patient's environment. Therefore, it is recommended to screen wound swabs for coryneform bacteria, identify all isolates, carefully assess possible toxin production, and send questionable strains to a specialist or a reference laboratory.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
3/10. Approach to skin ulcers in older patients.OBJECTIVE: To provide family physicians with an approach to managing skin ulcers in older patients. SOURCES OF INFORMATION: Clinical practice guidelines and best practice guidelines were summarized to describe an evidence-based approach. MAIN MESSAGE; Preventing ulcers is important in frail older patients. Using guidelines can help prevent ulcers in institutions. Clarifying the cause and contributing factors is the first step in management. pressure and venous ulcers are common in elderly people. Poor nutrition, edema, arterial insufficiency, and anemia often impair wound healing. Adequate debridement is important to decrease risk of infection and to promote healing. There are guidelines for cleaning ulcers. Choice of dressings depends on the circumstances of each wound, but dressings should provide a moist environment. Options for dressings are summarized. CONCLUSION: family physicians can manage skin ulcers effectively by applying basic principles and using readily available guidelines.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
4/10. Conflicts in the treatment of chronic ulcers in drug addicts--case series and discussion.Vascular access in intravenous drug abusers may become compromised by the repeated injection of toxic substances. In such circumstances abusers are driven by their addiction to seek alternative routes of drug delivery. We report a series of individuals with chronic ulcers, which were cultivated and maintained for the administration of heroin. We advise that practitioners should be wary of granulation tissue being promoted in this way and suggest that the patients' desire for wound healing may be overridden by their addiction and that successful treatment of these wounds is reliant upon cessation of drug abuse and patient compliance. In our experience this is most easily achieved in a multidisciplinary environment.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
5/10. mycobacterium haemophilum infection in immunocompromised patients: case report and review of the literature.mycobacterium haemophilum, previously characterized as an unusual pathogen, is found primarily in immunocompromised hosts. This organism has stringent growth characteristics and may not be isolated using routine techniques. M. haemophilum infects the skin and underlying tissues, a circumstance which reflects the organism's propensity for growth in a cooler environment. Infections have been reported in renal transplant recipients, patients with Hodgkin's disease, and, more recently, patients with AIDS. The organism has also been isolated from children with cervical lymphadenitis in the absence of apparent immunodeficiency. Response to therapy has not been uniform, and in some instances improvement in immune status has been associated with regression of lesions. With proliferation of transplantation surgery, chemotherapy, and AIDS, the number of infections due to M. haemophilum is likely to increase.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
6/10. Total contact povidone-iodine perfusion cast for the treatment of neuropathic ulcers.The total contact povidone-iodine perfusion cast is an effective, conservative treatment for the neuropathic ulcer. This is accomplished by redistribution of forces exerted on the foot, as well as the antiseptic environment established by the povidone-iodine. The case study presented demonstrates a cost-effective treatment for the diabetic neuropathic ulcer.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
7/10. Surgical management of doxorubicin (Adriamycin) extravasation.The advent of potent chemotherapeutic agents has been helpful in the medical management of a variety of malignancies. Unfortunately, the side effects and complications have been significant. Our recent experience with a patient who had the avoidable complication of extravasation with doxorubicin (Adriamycin) into the upper extremity is described. Frequently, the medical management of this problem has been observation alone followed by late surgical referral. This tissue fixation of the chemotherapeutic agent is such that it stays bound locally and causes an ever enlarging ulceration of tissue. This slough can occur not only in a circumferential fashion, but also in the superficial to deep manner, resulting in full-thickness lesions. Early surgical intervention is important to shorten the morbidity and to return the patients to their home environment.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
8/10. mycobacterium ulcerans infection (buruli ulcer): first reported patients in togo.mycobacterium ulcerans infection (buruli ulcer) is the third most common mycobacterial infection of immunocompetent humans, and is an emerging disease in West africa. We describe the first two reported patients with buruli ulcer in togo, establishing a geographical continuum of the disease in all countries bordering the Gulf of guinea. The aetiological agent was identified by molecular biological analysis of biopsy material. We speculate that changing environmental factors related to human habitation may influence rates of incidence of buruli ulcer.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
9/10. Shewanella alga bacteremia in two patients with lower leg ulcers.The first Danish cases of Shewanella alga bacteremia in two patients with chronic lower leg ulcers are reported. Both patients were admitted to the hospital during the same month of a very warm summer and had been exposed to the same marine environment, thereby suggesting the same source of infection. Both patients survived; however, one of them had extensive myonecrosis, while the other patient had an uncomplicated course. The strains were initially believed to be shewanella putrefaciens on the basis of key characteristics and results of the API 20NE identification system (bioMerieux, Marcy l'Etoile, france), but further genetic and physiological analyses identified them as Shewanella alga.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
10/10. case management in a wound care program.patients who need wound care can present a complex challenge in the current managed care environment. Managing health care benefits and financial and socioeconomic factors that impact wound healing are as crucial to wound healing as providing aggressive wound care. case management is used to describe the strategies involved in coordinating patient care to achieve optimal clinical and financial outcomes and ensure quality and continuity of care. In this article, the author illustrates how case management plays an integral part in a wound care program. The article features tips on how to effectively use limited financial resources that burden many patients who need wound care, includes ways to approach physicians when current wound care is not effective, and focuses on early discharge planning and a multidisciplinary team approach to ensure optimal clinical and financial outcomes. To help sharpen skills, included at the end of the article is a Case Study Challenge and tools to use in practice: case management Plans for Wound patients.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
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