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Background: Pressure lesions are chronic wounds causing the development of infection and inflammation into deeper structures and finally necrosis. In Persian medicine, Alkanna orientalis (Boraginaceae) has been used for centuries as a naturally derived remedy for managing lesions. A cross-sectional pilot clinical trial was conducted to assess the wound healing effect of an ointment made of chloroform extract of roots of A. orientalis (CERAO). Methods: Sixty patients (36 men and 24 women) diagnosed with bedsore staging 1-2 entered the study for one year. They were divided into two groups of control and treatment with equal proportions. The control group received conventional treatment from the hospital, including irrigation serum, mupirocin, phenytoin ointments, and gauze dressing. After rinsing and cleansing with normal saline, in the intervention group, patients received a thin layer of CERAO once daily for four weeks. Clinical outcomes were measured at weeks 2 and 4. Results: Recovery assessment was carried out by measuring wound area, days of epithelia formation, and complete wound closure. The difference between the two groups was statistically significant (P-value

Background & Aim: Pressure ulcers are one of the indicators of the quality of nursing and health care. Nurses, as one of the main members of the health team, play an important role in the prevention of pressure ulcer in health care centers. Therefore, this study aimed to determine the knowledge, attitude, and practice of nurses in preventing pressure ulcer. Materials & Methods: This descriptive cross-sectional study was conducted in 2018. Through complete enumeration, all the employed intensive care unit nurses in the educational centers of Iran University of Medical Sciences were studied. Out of the 328 questionnaires, 308 questionnaires were completed by the participants. For data collection, Pieper Pressure Ulcer Knowledge Test (PPUKT) and Beeckman et al’s attitude toward pressure ulcer questionnaire were used. Data were analyzed by SPSS software version 16, using independent t-test, Chi-square, Fisher’s exact, and one-way ANOVA. Results: According to the results, the mean score of knowledge and attitude of nurses regarding the prevention of pressure ulcer were 63.10 ± 47.31, 39.39 ± 10.22, respectively. The knowledge and attitude of the majority of nurses, regarding the prevention of pressure ulcer was at an undesirable level. Different groups of gender, background of continuous education, work experience, and experience in ICU had a significant difference in knowledge score. There were significant differences between different groups of gender, working hours per week, work experience, and work experience in ICU in terms of attitude score. Conclusion: Considering the undesirable level of knowledge and attitude of nurses about the standards of prevention of pressure ulcers and the importance of improving the safety of patients admitted to the intensive care unit, it is suggested to develop appropriate educational planning to improve the knowledge and attitude of health care providers, especially nurses, in the area of prevention of pressure ulcer.

Background: Pressure ulcer continues to be a major health problem and prevention has been the main emphasis of patient care. Rigorous evaluation of patients in intensive care unit is necessary for early identification of those at risk of developing pressure ulcer. Multiple risk assessment scales are in practice for its prevention. This study aims to assess pressure ulcer risk of the patients admitted in intensive care unit using Braden Scale. Methods: A cross-sectional descriptive study was conducted among 272 patients admitted in intensive care unit of Nepal Medical College Teaching Hospital from August 2019 to January 2020. Consecutive sampling technique was used to collect data from the patients. Data was analyzed using chi-square test and multiple binary logistic regression in the statistical package for social sciences in version 16. Results: Among 272 patients, the mean Braden score of pressure ulcer risk was 18.23±3.51. Nearly half of the patients 127 (46.7%) had risk of developing pressure ulcer, while two of them eventually developed pressure ulcer. The mean age was 51.11±18.82 years. Majority of the patients 221 (81.2%) were admitted in intensive care unit with medical disorders. Risk of developing pressure ulcer was significantly associated with age, gender, fever, use of ventilator, pressure ulcer prevention device, total duration of the hospital stay and duration of Intensive Care Unit stay (p=

Background: Pressure ulcer continues to be a major health problem and prevention has been the main emphasis of patient care. Rigorous evaluation of patients in intensive care unit is necessary for early identification of those at risk of developing pressure ulcer. Multiple risk assessment scales are in practice for its prevention. This study aims to assess pressure ulcer risk of the patients admitted in intensive care unit using Braden Scale. Methods: A cross-sectional descriptive study was conducted among 272 patients admitted in intensive care unit of Nepal Medical College Teaching Hospital from August 2019 to January 2020. Consecutive sampling technique was used to collect data from the patients. Data was analyzed using chi-square test and multiple binary logistic regression in the statistical package for social sciences in version 16. Results: Among 272 patients, the mean Braden score of pressure ulcer risk was 18.23±3.51. Nearly half of the patients 127 (46.7%) had risk of developing pressure ulcer, while two of them eventually developed pressure ulcer. The mean age was 51.11±18.82 years. Majority of the patients 221 (81.2%) were admitted in intensive care unit with medical disorders. Risk of developing pressure ulcer was significantly associated with age, gender, fever, use of ventilator, pressure ulcer prevention device, total duration of the hospital stay and duration of Intensive Care Unit stay (p=

The subcutaneous or hypodermic tissue is the innermost layer of the skin, which is essential for adipose tissue. The dermal attachment to the epidermis is a basal layer composed of collagen. This basal layer performs four different functions and acts as a scaffold for soft tissue organization. It is citing for regeneration that has selective permeability for serum filtration. Also, it is a barrier between different cell types, and cite where the epithelium subcutaneous to the cells. Untreated, bedsores can lead to serious complications, one of which is cellulite, a potentially life-threatening bacterial infection. As the bedsore wound spreads to the joints and bones, it may cause bone and joint infections that can damage the cartilage, tissue, and reduce joint function. The bacteria can then enter the bloodstream through wounds, leading to shock and life-threatening conditions. Stage II wounds can heal in one to six weeks, but wounds that lead to stage three or four may last several months or may never heal, especially in children with health problems. The purpose of this study was to design bio-based wounds with gelatin, Gum Arabic, and polyurethane. The wounds were made with different bio composite specimens. The procedure is gelatin, and gum Arabic was combined with certain percentages. The temperature of mixing and solubilization was set at 50°C. After complete fabrication of the material and complete dissolution of the samples in the solvent without any agglomeration, the samples were placed in a low-temperature freezer at -70°C and were placed in a freeze dryer. After the drying process is completed and the pores are ready on the wound heal sample, in the next stages, several tests are carried out to check the suitability of the produced wounds. The SEM analysis was performed on bio-based wounds in which the results showed the suitability and porosity of these wound dress were suitable. The presence of proper porosity and moisture level for wound healing and non-acidity, as well as the use of bed wound healing, have been distinguished from other conventional wound healing products in the market and research domain.

Pressure ulcer in an otherwise sick patient is a matter of concern for the care givers as well as the medical personnel. A lot has been done to understand the disease process. So much so that USA and European countries have established advisory panels in their respective continents. Since the establishment of these organizations, the understanding of the pressure ulcer has improved significantly. The authors feel that the well documented and well publicized definition of pressure ulcer is somewhat lacking in the correct description of the disease process. Hence, a modified definition has been presented. This disease is here to stay. In the process of managing these ulcers the basic pathology needs to be understood well. Pressure ischemia is the main reason behind the occurrence of ulceration. Different extrinsic and intrinsic factors have been described in detail with review of literature. There are a large number of risk factors causing ulceration. The risk assessment scales have eluded the surgical literature and mostly remained in nursing books and websites. These scales have been reproduced for completion of the basics on decubitus ulcer. The classification of the pressure sores has been given in a comparative form to elucidate that most of the classifications are the same except for minor variations. The management of these ulcers is ever evolving but the age old saying of "prevention is better than cure" suits this condition the most.

Reduced blood flow due to obstruction is in most cases a primary factor in pressure ulcer formation and creation of bedsores. The aim of this study is to design and manufacture a care system for tissue under pressure, based on variations in blood flow at different depths of tissue. In the manufacture of the system two infrared light transmitters and receivers were located between 5 and 10 mm depth to measure the flow of blood at different in the under- pressure heel tissue. In addition, blood flow was evaluated in an unloaded and loaded condition, with 30 mmHg and 60.0 mmHg. A total of 15 people participated with a mean age of 50. Of these 15; 9 (60%) were men and 6 (40%) were women. Primary measurement results showed different individual differences in variation of blood flow in the tissue. To study signal amplitude changes significantly influenced by external pressure the PPG, P-value was measured. It was noted that there were significant changes in PPG signal amplitude during loading both pressures of 30 and 60 mmHg. Further development of this system would be possible with the use of a more flexible probe and by using a stronger optical receiver and transmitter to access more depth.

Pressure ulcer is a signifcant problem in elderly and critically ill patients, causing pain, decreasing quality of life and leading to prolonged hospital stay. Treatment of pressure ulcer to improve health status is a cost-effective approach. So, preventing the ulcers will be economical. Pressure ulcer is considered as a damage or necrosis of skin and its layers, which happens when there is a considerable pressure over the tissues. If the capillary arterie's pressure reaches 70 mmHg (2 times more than the normal pressure) pressure ulcer happens and depending on the depth of the ulcer, will be divided into 4 stages. The most important point for preventing the ulcers is reducing the pressure. Patients should be repositioned to relieve or minimize the tissue pressure. Considering the type of the ulcer, the necessary treatment (dressing, Antibiotic Therapy, debridement or surgery) should be performed.

Introduction: Bed sore is an important complication of operation. Long immobility, hypotension and hypothermia in perioperative period predispose patients to bed sore. The prevention of bed sore is a priority in caring for immobilized patients and different methods have been used for this purpose. Hydrocolloid dressing is one of these methods. Materials and Methods: This study is a quasi-experimental research. Subjects consisted of 60 patients aged 40-70 years who had eligibility criteria for this study. Subjects were selected with convenience sampling and randomly allocated to two 30-patient groups (experimental and control). In experimental group, hydrocolloid dressing was used before surgery. No procedure was performed for control group. After surgery sacral area was examined on three occasions to detect bed sore: immediately, 24 and 48 hours after surgery. The data were collected by demographic questionnaire and staging bed sore checklist and analyzed by SPSS statistic program and use of descriptive methods such as Chi square, Fisher exact test, t test, ANOVA and least significant difference (LSD). Results: Incidence of bed sore was 13.3% in experimental group and %36.7 in control group. Chi square test showed significant difference between incidence of bed sore in two groups (p=0.03). Incidence of bed sore in two groups had no relationship with respect to gender and number of grafts. There was a significant relationship between bed sore and age, body mass index and duration of hypothermia, immobility and cardiopulmonary bypass (p

Introduction: Bed sore is an important complication of operation. Long immobility, hypotension and hypothermia in perioperative period predispose patients to bed sore. The prevention of bed sore is a priority in caring for immobilized patients and different methods have been used for this purpose. Hydrocolloid dressing is one of these methods. Materials and Methods: This study is a quasi-experimental research. Subjects consisted of 60 patients aged 40-70 years who had eligibility criteria for this study. Subjects were selected with convenience sampling and randomly allocated to two 30-patient groups (experimental and control). In experimental group, hydrocolloid dressing was used before surgery. No procedure was performed for control group. After surgery sacral area was examined on three occasions to detect bed sore: immediately, 24 and 48 hours after surgery. The data were collected by demographic questionnaire and staging bed sore checklist and analyzed by SPSS statistic program and use of descriptive methods such as Chi square, Fisher exact test, t test, ANOVA and least significant difference (LSD). Results: Incidence of bed sore was 13.3% in experimental group and %36.7 in control group. Chi square test showed significant difference between incidence of bed sore in two groups (p=0.03). Incidence of bed sore in two groups had no relationship with respect to gender and number of grafts. There was a significant relationship between bed sore and age, body mass index and duration of hypothermia, immobility and cardiopulmonary bypass (p