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Medical Treatment And Conservative Measures

Decent Essays
Pressure injuries in healthy, uncompromised patients normally exhibit effective healing characteristics when pressure is effectively relieved from the affected areas.36However, in circumstances where medical treatment and conservative measures has been ineffective, surgical treatment is an alternative where necrotic tissue is excised along with any bony prominence and infected bursa.37,38Unfortunately, according to Brown et al36 an incidence of 13%-56% recurrence has been reported after a surgical repair of a pressure injury. Many factors are known to contribute to this recurrence rate. Below, I will discuss some of these factors and how programs can be implemented to improve on patient care outcomes.
According to Relander and Palmer39 the
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Rehabilitation preoperatively
According to Kirney et al43 in order to improve on patient outcomes in this particular population, a rehabilitation program should be initiated long before the surgery using an interdisciplinary team approach. As there are many physical and psychosocial factors that require attention when optimizing the healing proces,43 the patient would benefit from having a team (e.g. nurse and a social worker) visit the patients home and assess the patient as a whole, identifying areas of concern, and address and treat needs prior to surgery. A patient’s social situation needs to be carefully reviewed and referrals should be made to the appropriate disciplines. If a patient is a smoker for example, linking the patient to a smoking cessation program for 4-6 weeks before surgery is ideal. According to Jones44 a 6-week abstinence from smoking has shown improvements in a person’s immune system response. If patients struggle from other drug addictions and alcohol abuse, patients should be referred to the appropriate addictions services for counseling as alcohol and drugs can reduce the patient’s ability to obey treatment orders.36 An evaluation of various nutritional parameters (urine urea nitrogen, hemoglobin,
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