[PDF] Adjunctive Hyperbaric Oxygen Therapy With Standard Wound Care In Adult Diabetic Patients With Slow Healing Non Healing Ulcers eBook

Author : Jennifer Long
Publisher :
Page : 0 pages
File Size : 46,16 MB
Release : 2014
Category : Evidence-based nursing
ISBN :

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Identifying relevant, current, evidence-based practice requires a commitment in nursing practice that is essential in the continued care of all individuals in order to improve patient outcomes and quality of life. Methodologies and theory-based approaches provide a basis of understanding about the symptoms, prevention, onset, or slowing of healing in individuals with chronic illnesses. One such chronic illness this project aims to identify is chronic slow healing/nonhealing ulcers in adult diabetic patients. Despite standardized wound care, healing for this population of patients may take months, years, or no healing at all; also, the treatment of chronic diabetic ulcers puts a great strain on the individual and the health care system in whole. Numerous quality research studies have reported that adjunctive hyperbaric oxygen therapy (HBOT) has shown to be effective and beneficial in healing diabetic ulcers when used with standardized wound care. Nursing education and understanding the standards of nursing practice may promote the use of adjunctive hyperbaric oxygen therapy (HBOT) with standardized wound care in order for patients to receive the best possible health outcomes. Utilizing evidence-based research identifies the targeted audience of adult diabetic patients with chronic ulcers; provides a problem statement to the current issues regarding patient's healing and quality of life; describes a well-developed implementation plan that incorporates theory; describes an evaluation plan; an evaluation plan; and a dissemination plan for including HBOT into practice. Current review of evidence is included as well as an essential assessment tool that may educate potential project participants as well as a tool for evaluating project outcomes.

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Page : 0 pages
File Size : 39,38 MB
Release : 2007
Category : Diabetes
ISBN : 9781897257388

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In the US, the prevalence of DFUs in adults with DM is reported to range from 12% to 15%.2,3 Factors in their occurrence include mechanical changes in the conformation of the bony architecture of the foot, peripheral neuropathy, and atherosclerotic peripheral arterial disease, all of which occur with higher frequency and intensity among those with diabetes. [...] Major LEAs are amputations of the leg above or below the knee, whereas minor LEAs involve amputation of the toes or the forefoot.2A study of diabetes-related LEAs in Ontario from 1987 to 1988 found a crude rate of 40 LEAs per 10,000 patients with DM annually.4 There was a wide range among regions in the province (i.e., 30 to 60 per 100,000 annually).4 Major LEAs accounted for 45% of the total.4 LE [...] The standard of care for treating DFU includes the maintenance of optimal blood glucose control; use of débridement, antibacterials, and dressings; administration of antibiotics to control infection; and pressure relief in the areas of the foot that are most subject to weight bearing. [...] The increased pressure, which is associated with the inspiration of high levels of oxygen, increases the level of oxygen dissolved in the blood plasma. [...] In the case of DFU, HBOT treatments would have to result in a reduction in hospital stay of at least 29% in the full capacity scenario, or 62% in the status quo scenario, to yield a favourable hospital cost per benefit ratio.8 5.2 Cost Effectiveness Analysis 5.2.1 Methods A decision model was developed to determine the cost effectiveness of adjunctive HBOT for the treatment of DFU.

Author : Health Quality Ontario
Publisher :
Page : 0 pages
File Size : 12,12 MB
Release : 2017
Category : Diabetics
ISBN : 9781460690475

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"About 15% to 25% of people with diabetes will develop a foot ulcer. These wounds are often resistant to healing; therefore, people with diabetes experience lower limb amputation at about 20 times the rate of people without diabetes. If an ulcer does not heal with standard wound care, other therapeutic interventions are offered, one of which is hyperbaric oxygen therapy (HBOT). However, the effectiveness of this therapy is not clearly known. The objectives of this health technology assessment were to assess the safety, clinical effectiveness, and cost-effectiveness of standard wound care plus HBOT versus standard wound care alone for the treatment of diabetic foot ulcers. We also investigated the preferences and perspectives of people with diabetic foot ulcers through lived experience."--Background.

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Page : 0 pages
File Size : 22,11 MB
Release : 2005
Category :
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According to recent data, the prevalence of DM increased from 4.72% of the population aged 20 years and over in 1995, to 6.19% of the population aged 20 years and over in 1999, or about 680,900 people in 1999. [...] The Medical Advisory Secretariat also evaluated the studies that the Cochrane Collaboration used in their analysis, and agreed with their evaluation that the quality of the evidence was low for major and minor. [...] The quality of the evidence assessing the effectiveness of HBOT as an adjunct to standard therapy for people with non-healing diabetic foot ulcers is low, and the results are inconsistent. [...] The extended review aimed to elucidate the best evidence on the impact of HBOT to manage diabetic, venous, arterial, and pressure ulcers, because the available evidence was "sparse and difficult to interpret." This systematic review followed the Cochrane method to search and assess the literature. [...] According to this rubric, the overall certainty of the outcomes gleaned from the HBOT literature is low to moderate for the outcome of wound healing, and low for the outcomes of major and minor amputation.

Author : Dr. Harry T. Whelan
Publisher : Best Publishing
Page : 1112 pages
File Size : 50,26 MB
Release : 2017-06-01
Category : Medical
ISBN : 1930536100

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A textbook may sometimes gain the unusual trait of longevity beyond all other books - it can be revised and remain a primary source of information for generations of students. Hyperbaric Medicine Practice seems destined to become such a book. This 4th edition, edited by Harry T. Whelan, pays tribute to its original author, Dr. Kindwall, who died in 2012. It also adds new information of interest to all in the field of diving and clinical hyperbaric medicine. Most chapters have been written or revised by new authors, but many have returned to update their chapters. New chapters include indications for hyperbaric oxygen treatment subjects recently approved for treatment such as idiopathic sudden sensorineural hearing loss and central retinal vein occlusion. There are also chapters on submarine rescue and problems that pertain to technical and rebreather diving. This book will be an important addition to the library of physicians in clinical hyperbaric medicine and those involved with divers—recreational, commercial, and military—as well as other professionals who care for them. - comments by Henry J.C. Schwartz, MD, FACP New Information and Updates in the Fourth Edition Indications for the Use of HBO2 - Completely re-written chapters on basis for HBO2 therapy of Radiation Necrosis and Burns - New clinical trial data for traumatic brain injuries - Tabulation of almost all published cases of hyperbaric oxygen used for refractory osteomyelitis and the new CPT codes needed for reimbursements - Updates on the multiplace hyperbaric chamber with monitoring and provisions for critical care and carbon monoxide emergency - A new complete description of the multiplace hyperbaric chamber as a medical device - Improved illustrations and better clarification for the use of hyperbaric oxygen for crush injuries - Totally new chapter on the role of hyperbaric oxygen for fracture management - Complications and Contraindications for the Use of HBO2 - Completely re-written chapter on the contraindications and relative risks, and the management recommendations - Completely re-written chapter on complications and the management recommendations - Updated details on use of medications and indications for myringotomy The Science of HBO2 - Additional basic science and clinical data regarding HBO2 management of infectious diseases - Completely re-written chapter on basis for HBO2 therapy of Infectious Diseases - Updates on mechanism of action of HBO2 and preconditioning - Added human and animal literature section utilizing hyperbaric oxygen for brown recluse spider bite - Re-written evidence-based recommendations for use of hyperbaric oxygen for brown recluse spider bite - New innovative research developed in Brazil when the first lines of hyperbaric medicine therapy history in South America were written. - Introduces challenging questions to readers including: Should we try HBO2 for Hansen’s disease in present day? Is there any better way to increase oxygen toxicity against Mycobacterium leprae than methylene blue? - All new hyperbaric oxygen mechanism chapter complimented by exceptionally well-illustrated figures - New approach to appreciating the mechanisms of hyperbaric oxygen with primary effects that occur immediately and secondary effects that are long standing and generally require repetitive treatments - In-depth discussion about the physiological, cellular and molecular response to exogenous ketone supplementation and ketogenic diet - New section on pharmacokinetic disposition of drugs in HBO2 New section on antibiotic interactions Updated literature on pharmacodynamics interactions Fully updated discussion on the use of hyperbaric oxygen therapy in pediatrics including risks and benefits, practical considerations, indications and controversies and oxygen administration schedules Discussion of latest information on pediatric disease indications for hyperbaric oxygen therapy and current controversies Updated recommendations for pediatric psychological preparation and sedation

Author : Health Quality Ontario
Publisher :
Page : 142 pages
File Size : 20,32 MB
Release : 2017
Category : Diabetics
ISBN : 9781460690475

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"About 15% to 25% of people with diabetes will develop a foot ulcer. These wounds are often resistant to healing; therefore, people with diabetes experience lower limb amputation at about 20 times the rate of people without diabetes. If an ulcer does not heal with standard wound care, other therapeutic interventions are offered, one of which is hyperbaric oxygen therapy (HBOT). However, the effectiveness of this therapy is not clearly known. The objectives of this health technology assessment were to assess the safety, clinical effectiveness, and cost-effectiveness of standard wound care plus HBOT versus standard wound care alone for the treatment of diabetic foot ulcers. We also investigated the preferences and perspectives of people with diabetic foot ulcers through lived experience."--Background.

Author : Clifford P. Shearman
Publisher : Springer
Page : 227 pages
File Size : 30,14 MB
Release : 2015-02-04
Category : Medical
ISBN : 1447145259

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​Public and political concern about the increasing prevalence of diabetes has prompted major concern about treatment of patients with the condition. Foot complications are some of the commonest causes of hospitalisation of people with diabetes and if not treated well often lead to amputation. There is evidence that 85% of these amputations can be prevented by better understanding of the problem and by multi-disciplinary teams working more effectively together. This has been recognised and NICE have recently published guidelines on diabetic foot complications as have Diabetes UK and NHS Diabetes. These have been successful in raising awareness of the problem but the local multi-disciplinary teams need clear practical advice on how to manage the foot in diabetes and deliver high quality care. With the current interest in improving outcomes for patients with foot complications this is an ideal time to make a practical evidence-based handbook available. This book will provide clear practical guidelines on how to manage all aspects of the foot in diabetes as well as an in-depth analysis of the most recent evidence. The book will be based on care pathways with algorithms for each section so it would be of practical value in any clinic in primary or secondary care. It will appeal to a wide range of health care professionals treating people with diabetes: vascular surgeons and trainees, orthopaedic surgeons, diabetes specialist nurses, podiatrists and tissue viability nurses.​

Author :
Publisher :
Page : 0 pages
File Size : 13,27 MB
Release : 2017
Category :
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The objectives of this health technology assessment were to assess the safety, clinical effectiveness, and cost-effectiveness of standard wound care plus HBOT versus standard wound care alone for the treatment of diabetic foot ulcers. [...] Methods We performed a review of the clinical and economic literature for the effectiveness and cost- effectiveness of hyperbaric oxygen therapy, as well as the budget impact of HBOT from the perspective of the Ministry of Health and Long-Term Care. [...] Clinical Need and Target Population Standard wound care for patients with diabetic foot ulcers consists of four phases: 1. Assessing the wound, including examining the size and looking for signs of infection and ischemia, most often using the Wagner Ulcer Classification System,9 which categorizes ulcers based on wound depth and the presence of infection (Table A1) 2. Planning the best course of tr [...] May 2017 Context Hyperbaric oxygen therapy is currently publicly funded by the Ministry of Health and Long-Term Care for 14 indications, including the "enhancement of healing in selected problem wounds."22 There are an estimated 47 HBOT units in Canada, of which 12 are located in Ontario.20 Given the uncertainty of the available evidence, the present review was undertaken in response to a request [...] May 2017 CLINICAL EVIDENCE REVIEW Objectives The objectives of this study were to assess the safety and effectiveness of standard wound care plus HBOT compared with standard wound care alone for the treatment of diabetic foot ulcers.