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Ostomy/Wound Management - ISSN: 0889-5899 - Volume 54 - Issue 6 - June 2008 | |
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| Holly Franzen-Korzendorfer, PT, PhD, FACCWS; Mary Blackinton, PT, MS, EdD; Shari Rone-Adams, PT, DBA; and Joseph McCulloch, PT, PhD, FAPTA, FACCWS
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Monochromatic infrared energy has been reported to restore protective sensation by increasing circulation. A controlled, double-blind, quasi-experimental, randomized clinical study was conducted to 1) examine the effects of monochromatic infrared energy treatments on tissue perfusion, 2) determine the effects of a published monochromatic infrared energy neuropathy protocol on sensation on the feet of patients with diabetes and a loss of protective sensation; 3) examine monochromatic infrared energy’s effect on pain; and 4) examine the relationship between transcutaneous oxygen levels and loss of protective sensation. The study was conducted at a wound and hyperbaric treatment center in Norwalk, Conn; 18 adults (12 men, six women; mean age 65 ±13 years, range 39 to 86 years) with diabetes and loss of protective sensation were recruited using convenience sampling methods. All patients served as their own control. Pre- and post treatment tests assessed sensation, pain, and transcutaneous
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Does Intestinal Resection Affect the Absorption of Essential Vitamins, Minerals, and Bile Salts?
An Overview of the Literature |
| Geraldine M. Lambert, RN, DBA, CWOCN
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As the number of persons living long lives following ostomy and bowel resection surgery increases, so do their questions about the effect of surgery on chronic conditions commonly associated with aging. The literature was reviewed to evaluate current evidence about the effect of bowel resection on the absorption of vitamins and minerals and related health concerns such as osteoporosis, gallstones, and renal calculi. Present knowledge about the process of vitamin and mineral absorption in the intestine and clinical study results suggest that chronic inflammation and corticosteroid use may adversely affect absorption. In general, a history of bowel resection does not appear to increase the risk of developing osteoporosis, gallstones, or renal calculi and the body can adjust to losing significant sections of intestine. Strategies to help prevent the majority of long-term complications should be encouraged, including monitoring hydration and transit time, consuming low-digestible carbohydr
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Total Contact Casting as Part of an Adaptive Care Approach:
A Case Study |
| Karen Farid, RN, MA, CWON, CNS/ET; Mark Farid, MA, CO, BCP; and Claire M. Andrews, PhD, CNM, FAAN |
Although total contact casting provides pressure relief and a moist wound-healing modality that allows patients to resume mobility while the wound is healing, it is not as widely used as it should be, in part because Board-certified pedorthists with relevant skills are scarce. As a result, clinicians may not appreciate the positive impact total contact casting has on the patient’s overall condition. This case study of a 75-year-old woman with a potentially life-threatening diabetic foot ulcer offers a comprehensive picture of pervasive physiological changes in a context of challenging comorbidities. This multifaceted case is presented against a backdrop of Sister Callista Roy’s nursing theory of adaptation and a total patient care approach to illustrate the cascading effects of diabetes on the patient’s well-being, as well as to show that total contact casting is not only an effective intervention in the management of the patient’s diabetic foot ulcer, but also a way to improve the pat
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| Michel Hermans, MD
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Pearls for Practice is made possible through the support of Ferris Mfg. Corp, Burr Ridge, IL (www.polymem.com). The opinions and statements of the clinicians providing Pearls for Practice are specific to the respective authors and are not necessarily those of Ferris Mfg. Corp., OWM, or HMP Communications. This article was not subject to the Ostomy Wound Management peer-review process.
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| Kristin Waldrop, PT, DPT; and Ann Serfass, PTA
The Center for Advanced Wound Care, St. Joseph Medical Center, Reading, Pa |
Most burns are thermal and can be treated on an outpatient basis with conventional care that includes daily dressing changes, debridement, and infection control. These treatments can exacerbate pain associated with burns. Noncontact, low-frequency, nonthermal ultrasound therapy is delivered via sterile saline mist and has been used to cleanse and debride a variety of acute and chronic wounds, including burns, with less associated pain. This case series study evaluated low-frequency, nonthermal ultrasound therapy as an adjunct to conventional burn care in six nonrandomly selected outpatients with partial- to full-thickness thermal burns. The effectiveness of low-frequency, nonthermal ultrasound was assessed through changes in wound bed composition, exudate characteristics, and pain. Patients rated pain using a 10-point numerical rating scale (0 = no pain; 10 = extreme pain). Noncontact ultrasound treatments of 3 to 20 minutes (depending on wound size) were administered up to five times
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