A Study on Pressure Ulcer: Influencing Factors and Diagnostic Techniques

The application effect of autologous platelet-rich plasma combined with negative pressure sealing drainage technology in pressure ulcer wound repair

This study aimed to evaluate the efficacy of combining autologous platelet-rich plasma (PRP) with negative pressure wound therapy (NPWT) for the repair of pressure ulcers. We included 90 patients with pressure ulcers from General Technology Gemstone Flower Healthcare Jilin City Hospital of Chemical Industry between January 2021 and December 2023. Patients were randomly assigned to either a control group or an observation group, with 45 patients in each. The control group received NPWT alone, while the observation group received a combination of PRP and NPWT. Outcomes were compared between the groups, including clinical efficacy, wound recovery time (infection control time, wound healing time, hospital stay), levels of inflammatory markers (C-reactive protein, erythrocyte sedimentation rate, white blood cell count), pain scores (numerical rating scale), Pressure Ulcer Scale for Healing scores, and incidence of complications. The observation group demonstrated a total effective rate of 95.56% (43/45), significantly higher than the control group's 80.00% (35/45) (P < .05). Additionally, the observation group had significantly shorter infection control times, wound healing times, and hospital stays (P < .05). Two weeks post-surgery, the observation group had significantly lower levels of C-reactive protein, erythrocyte sedimentation rate, and white blood cell count, as well as reduced numerical rating scale and Pressure Ulcer Scale for Healing scores (P < .05). The incidence of complications was 6.67% (3/45) in the observation group compared to 33.33% (15/45) in the control group, with a significant difference (P < .05). Combining autologous PRP with NPWT significantly improves clinical outcomes, reduces inflammatory responses, decreases pain, accelerates wound healing, and lowers complication rates in patients with pressure ulcers.

Pressure and Skin: A Review of Disease Entities Driven or Influenced by Mechanical Pressure

Skin perceives and reacts to external mechanical forces to create resistance against the external environment. Excessive or inappropriate stimuli of pressure may lead to cellular alterations of the skin and the development of both benign and malignant skin disorders. We conducted a comprehensive literature review to delve into the pressure-induced and aggravated skin disorders and their underlying pressure-related mechanisms. Dysregulated mechanical responses of the skin give rise to local inflammation, ischemia, necrosis, proliferation, hyperkeratosis, impaired regeneration, atrophy, or other injurious reactions, resulting in various disease entities. The use of personal devices, activities, occupations, weight bearing, and even unintentional object contact and postures are potential scenarios that account for the development of pressure-related skin disorders. The spectrum of these skin disorders may involve the epidermis (keratinocytes and melanocytes), hair follicles, eccrine glands, nail apparatuses, dermis (fibroblasts, mast cells, and vasculature), subcutis, and fascia. Clarifying the clinical context of each patient and recognizing how pressure at the cellular and tissue levels leads to skin lesions can enhance our comprehension of pressure-related skin disorders to attain better management.

Investigation of factors associated with pressure ulcer in patients receiving home care services via path analysis

BACKGROUND

Recent trends indicate a rise in the number of elderly and bedridden patients enrolled in home care programs, leading to an increased occurrence of complications such as pressure ulcers within the home health care setting.

OBJECTIVE

The primary objective of this research was to ascertain the prevalence of pressure ulcers and identify the associated factors in adults who were recipients of home health care services.

METHOD

This study, adopting a cross-sectional design, encompassed a sample of 566 patients who sought services from the Home Health Care Unit in a specific province in Turkey. The timeframe for data collection spanned from August to November 2022, during which two primary instruments were employed: the "Demographic Characteristics Form" and two specific scales - the "Braden Pressure Ulcer Risk Assessment Scale" and the "ITAKI Falls Risk Scale."

FINDINGS

In this study, the average age of patients receiving home health care services was identified as 75.9 years, with a standard deviation of 15.1 years. Furthermore, 73.7 % of these patients were classified as being at risk for developing pressure ulcers. The study identified a direct correlation between the risk of BRADEN pressure ulcers and the escalation in scores across several parameters. These parameters included "Addiction Status," delineated as a spectrum from addicted to non-addicted, the "Number of Medical Diagnoses," quantified on a scale, the "State of Consciousness," categorized from clear to confused, and the scores derived from the "ITAKI" scale.

CONCLUSION

The findings of this study highlight the significance of pressure ulcers as a critical health issue among patients receiving home care services. It underscores the necessity for home care nurses to be acutely aware of the risk factors associated with pressure ulcers among high-risk patients.

Broadcast speech recognition and control system based on Internet of Things sensors for smart cities

With the wide popularization of Internet of Things (IoT) technology, the design and implementation of intelligent speech equipment have attracted more and more researchers’ attention. Speech recognition is one of the core technologies to control intelligent mechanical equipment. An industrial IoT sensor-based broadcast speech recognition and control system is presented to address the issue of integrating a broadcast speech recognition and control system with an IoT sensor for smart cities. In this work, a design approach for creating an intelligent voice control system for the Robot operating system (ROS) is provided. The speech recognition control program for the ROS is created using the Baidu intelligent voice software development kit, and the experiment is run on a particular robot platform. ROS makes use of communication modules to implement network connections between various system modules, mostly via topic-based asynchronous data transmission. A point-to-point network structure serves as the communication channel for the many operations that make up the ROS. The hardware component is mostly made up of the main controller’s motor driving module, a power module, a WiFi module, a Bluetooth module, a laser ranging module, etc. According to the experimental findings, the control system can identify the gathered sound signals, translate them into control instructions, and then direct the robot platform to carry out the necessary actions in accordance with the control instructions. Over 95% of speech is recognized. The control system has a high recognition rate and is simple to use, which is what most industrial controls require. It has significant implications for the advancement of control technology and may significantly increase production and life efficiency.

The Relationship between Nutritional Risk and the Most Common Chronic Diseases in Hospitalized Geriatric Population from Central Poland

The aim of this study was to assess the relationship between Nutrition Risk Screening 2002 (NRS-2002) and the prevalence of concomitant chronic diseases among hospitalized older adults. This study included 2122 consecutively hospitalized older participants with an average age of 82 years. The criteria to participate were the ability to communicate and give consent. In multivariate design, the prevalence of nutritional risk with at least 3 points in the NRS-2002 score was associated with the presence of stroke, atrial fibrillation, dementia and pressure ulcers. Patients with arterial hypertension, lipid disorders, osteoarthritis and urine incontinence had a significantly lower (better) NRS-2002 score. The explanation of the inverse relationship between some disorders and nutritional risk may be their occurrence in relatively earlier age and the relationship with body mass index. In conclusion, the study revealed which medical conditions coexist with the increased nutritional risk in a “real-world” hospitalized geriatric population. The hospital admission of an older subject with stroke, atrial fibrillation, dementia or pressure ulcers should primarily draw attention to the nutritional risk of the patient.

Prediction of internal changes in the sacral region on immobility using bio-mechanical and bio-thermal modelling

Pressure injury usually develop in the bony prominence of immobile bedridden subjects. Predicting pressure injuries based on the subjects’ physiological information will reduce the burden of the caretakers in adjusting the frequency of repositioning such subjects. Visual assessment, diagnostic, and prognostic approaches only provide pressure injury information after onset. Therefore, the objective of this unique modeling technique is to predict the internal alterations that take place in human tissues before the onset of pressure injuries. In this approach the bio-mechanical and bio-thermal properties was integrated to predict the internal changes of skin, fat, and muscle layers when subjects were self-loaded continuously for one hour in the sacrum region. A change in temperature of all the layers, as well as the distribution of Von-Mises stress in these layers, was observed. The inflammation caused by the changes in the temperature and the stress was measured from the simulation model. Ultrasound measurements was also taken for the same subjects in the supine position in the sacral region, before and after one hour by applying a self-load. An identical change in the thickness of the above-mentioned layers due to thermal expansion was noticed. Hence this computational model is hypothesized to give identical thermal expansion in comparison with the ultrasound measurements. There was an agreement between the thermal expansion using the simulation technique and the ultrasound technique which was assessed through Bland-Altman analysis, with a 96% confidence interval.