Gurjot S. Walia

Efficacy of Monitoring Devices in Support of Prevention of Pressure Injuries: Systematic Review and Meta-analysis.

GENERAL PURPOSE:To present a systematic review of the literature assessing the efficacy of monitoring devices for reducing the risk of developing pressure injuries. TARGET AUDIENCE:This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES:After participating in this educational activity, the participant should be better able to:1. Explain the methodology of the literature review and its results.2. Discuss the scope of the problem and the implications of the research. ABSTRACTOBJECTIVE: To assess the efficacy of monitoring devices for reducing the risk of developing pressure injuries (PIs).DATA SOURCES: The authors systematically reviewed the literature by searching PubMed/MEDLINE and CINAHL databases through January 2016.STUDY SELECTION: Articles included clinical trials and cohort studies that tested monitoring devices, evaluating PI risk factors on patients in acute and skilled nursing settings. The articles were scored using the Methodological Index for Non-randomized Studies.DATA EXTRACTION: Using a standardized extraction form, the authors extracted patient inclusion/exclusion criteria, care setting, key baseline, description of monitoring device and methodology, number of patients included in each group, description of any standard of care, follow-up period, and outcomes.DATA SYNTHESIS: Of the identified 1866 publications, 9 met the inclusion criteria. The high-quality studies averaged Methodological Index for Non-randomized Studies scores of 19.4 for clinical trials and 12.2 for observational studies. These studies evaluated monitoring devices that measured interface pressure, subdermal tissue stress, motion, and moisture. Most studies found a statistically significant decrease in PIs; 2 studies were eligible for meta-analysis, demonstrating that use of monitoring devices was associated with an 88% reduction in the risk of developing PIs (Mantel-Haenszel risk ratio, 0.12; 95% confidence interval, 0.04–0.41; I2 = 0%).CONCLUSIONS: Pressure injury monitoring devices are associated with a strong reduction in the risk of developing PIs. These devices provide clinicians and patients with critical information to implement prevention guidelines. Randomized controlled trials would help assess which technologies are most effective at reducing the risk of developing PIs.

Abstract P34: Variation in Transfusion Practice and Associated Postoperative Complications in Abdominally-Based Autologous Breast Reconstruction Surgery

RESULTS: Ten patients with lymphedema of the arm were enrolled for volume measurement. Arm volumes ranged from 1517 to 4050 cc. The Vectra 3D provided precise volume measurements (average standard deviation +/0.8%). Measurements of the forearm and upper arm correlated with circumference measurements (R = 0.991) and were in good agreement, with the mean difference between measurement techniques being 2.8 ± 2.0%. Three dimensional measurements of hand, forearm, and upper arm also correlated with water measurements (R = 0.994) and had a mean difference between measurement techniques of 2.2 ± 1.8%.

Abstract P28: Nanofiber-Hydrogel Composite with Human Adipose-Derived Stem Cells to Enable Soft Tissue Regeneration

PSRC Abstract Supplement P oter P rofs transection without repair. First, we evaluated the extensor digitorum longus (EDL) muscles of 15 adult wildtype C57BL/6 mice (n=3 per time point) at days 1, 3, 5, 7, and 14 after sciatic nerve injury. The uninjured EDL muscles served as the experimental controls. These muscles were harvested for immunostaining with CD68 (monocytes/ macrophages) and DAPI (nuclear) staining. Next, using the same injury and mouse model, flow cytometry was utilized to evaluate total cells present in EDL muscle after sciatic nerve injury. Animals were sacrificed at days 1 and 5 after nerve injury, and all muscles of the hindlimb innervated by the sciatic nerve were harvested from the right injured and left uninjured legs. Cells were analyzed following muscle digestion.