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Comparative analysis of pressure ulcer development in stroke patients within and outside healthcare facilities: A systematic review and meta‐analysis

Abstract

The risk of pressure ulcers in stroke patients is a significant concern, impacting their recovery and quality of life. This systematic review and meta-analysis investigate the prevalence and risk factors of pressure ulcers in stroke patients, comparing those in healthcare facilities with those in home-based or non-clinical environments. The study aims to elucidate how different care settings affect the development of pressure ulcers, serving as a crucial indicator of patient care quality and management across diverse healthcare contexts. Following PRISMA guidelines, a comprehensive search was conducted across PubMed, Embase, Web of Science and the Cochrane Library. Inclusion criteria encompassed studies on stroke patients in various settings, reporting on the incidence or prevalence of pressure ulcers. Exclusion criteria included non-stroke patients, non-original research and studies with incomplete data. The Newcastle–Ottawa scale was used for quality assessment, and statistical analyses involved both fixed-effect and random-effects models, depending on the heterogeneity observed. A total of 1542 articles were initially identified, with 11 studies meeting the inclusion criteria. The studies exhibited significant heterogeneity, necessitating the use of a random-effects model. The pooled prevalence of pressure injuries was 9.53% in patients without family medical services and 2.64% in patients with medical services. Sensitivity analysis confirmed the stability of these results, and no significant publication bias was detected through funnel plot analysis and Egger's linear regression test. The meta-analysis underscores the heightened risk of pressure injuries in stroke patients, especially post-discharge. It calls for concerted efforts among healthcare providers, policymakers and caregivers to implement targeted strategies tailored to the specific needs of different care environments. Future research should focus on developing and evaluating interventions to effectively integrate into routine care and reduce the incidence of pressure injuries in stroke patients.

Comparative study on wound healing and infection between open and minimally invasive surgical methods in pediatric otolaryngology surgery

Abstract

Pediatric otolaryngology surgeries are crucial interventions requiring careful consideration of surgical methods to optimize outcomes. The choice between open and minimally invasive surgical approaches in this context warrants thorough investigation. While both methods aim to address ear, nose, and throat conditions in children, a comparative study assessing their impact on crucial factors such as intraoperative parameters, wound healing, complications, and postoperative pain is essential. This study aims to compare the effects of open and minimally invasive surgical methods on wound healing and infection in pediatric otolaryngology surgery, and provide a scientific basis for the selection of surgical methods. Two groups of patients were selected, with 90 people in each group. One group received open surgery and the other received minimally invasive surgery. Recording the intraoperative time, anesthesia time, and intraoperative blood loss; the number of days required for wound healing; the occurrence of wound-related complications; the comparison of pain on postoperative Days 1, 3, and 7; and the factors influencing postoperative wound healing were analyzed. In the minimally invasive surgery group, the intraoperative time was shorter, the anesthesia time was relatively reduced, and the amount of bleeding was significantly reduced. Wounds also take fewer days to heal and have lower rates of wound-related complications. When comparing the pain on 1, 3, and 7 days after surgery, the minimally invasive surgery group had relatively mild pain. Analysis of postoperative wound healing factors showed that minimally invasive surgical methods have a positive impact on healing. In pediatric otolaryngology surgery, minimally invasive surgery performs better than open surgery in terms of intraoperative operation time, anesthesia time, blood loss, wound healing time, complication rate, and postoperative pain. Therefore, minimally invasive surgery may be a safer and more effective surgical method.

Effects of continuing nursing intervention on high‐risk patients with diabetic foot ulcers: A meta‐analysis

Por: Zhao Xu · Hui Wu · Jing Shi

Abstract

A comprehensive meta-analysis was conducted to evaluate the impact of continuous nursing interventions on patients with high-risk diabetic foot (DF). We systematically searched electronic databases including PubMed, Embase, Google Scholar, Cochrane Library, China National Knowledge Infrastructure and Wanfang for randomized controlled trials (RCTs), from database inception to October 2023, pertaining to continuous nursing interventions in high-risk DF patients. Independent literature screening, data extraction and quality assessment were performed by two researchers. Data analysis was executed using Stata 17.0 software. Overall, 18 RCTs involving 1450 high-risk DF patients were included. The analysis revealed that continuous nursing interventions significantly reduced levels of fasting blood glucose (standardized mean difference [SMD] = −1.02, 95% confidence interval [CI]: −1.29 to −0.76, p < 0.001), 2-h postprandial blood glucose (SMD = −1.76, 95%CI: −2.23 to −1.29, p < 0.001) and glycated haemoglobin levels (SMD = −1.05, 95%CI: −1.40 to −0.70, p < 0.001) in high-risk DF patients. Furthermore, there was a significant reduction in the incidence of DF (odds ratio [OR] = 0.22, 95%CI: 0.14–0.33, p < 0.001). This study demonstrates that continuous nursing interventions are effective in controlling glycaemic indices (fasting blood glucose, 2-h postprandial blood glucose and glycated haemoglobin) and reducing the incidence of DF in high-risk patients. These interventions contribute to stabilizing the patients' condition and optimizing their prognosis.

Patient‐reported outcomes and their predictors 2 years after burn injury: A cross‐sectional study

Abstract

This study aimed to describe patient-reported outcomes 2 years after burn injury and to comprehensively elucidate predictors that may influence these outcomes. This cross-sectional, prospective study included 352 patients who were admitted to the Department of Burn Surgery at a tertiary teaching hospital between January 2017 and December 2020. We collected demographic and disease-related data and instructed participants to complete the Readiness for Hospital Discharge Scale (RHDS) and the Burn Specific Health Scale-Brief (BSHS-B) questionnaire. The overall score of patient-reported outcomes 2 years after burn injury was 126.55 ± 33.32 points, and the dimensions with the lowest scores were “hand function” (13.96 ± 5.75), “heat sensitivity” (14.84 ± 4.90), “treatment regimens” (13.41 ± 6.77) and “work” (11.30 ± 4.97). Multiple linear regression analysis revealed that less postburn pruritus, better readiness for hospital discharge, less total body surface area (TBSA), better social participation, white-collar jobs, older age, better sleep quality and burns not caused by electricity were associated with better outcomes. Patients experienced poor patient-reported outcomes 2 years after burn injury. Integrated rehabilitative care is necessary to address patients' unique needs and improve long-term patient-reported outcomes.

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