Journal of ET nursing : official publication, International Association for Enterostomal Therapy最新文献

Thousands of ostomies are performed on children every year to treat a variety of acquired conditions and congenital anomalies. The parents of children with ostomies are faced with the challenge of successfully living with and managing their child's ostomy. These families need practical information and support, both from the professional community and from parents who have shared the responsibility of a child with an ostomy. A parental support network has been developed throughout the country to address some of the needs of these families. This article provides current information about the status of these networks: what they have to offer and how they can be accessed. These groups, which continue to evolve, demonstrate a trend within this unique population. The parents of a child with an ostomy no longer need to feel alone in their experience.

Pressure ulcers are a major health problem for the elderly population in the United States. Billion of health care dollars are spent for hospitalization, air support therapy, wound care products, and nursing care. In addition, the cost in human suffering is priceless. Many patients with pressure ulcers have several chronic diseases that make wound healing difficult. Nurses must begin to examine the ethical principles that guide their care of these patients. This article focuses on some ethical issues related to the care of patients with pressure ulcers and the difficulties encountered with pressure ulcer care. Careful analysis of the goals of pressure ulcer treatment may help nurses develop ethical guidelines to direct them in the care of these patients.

Fibronectin, a fibrillar glycoprotein, is the major adhesive protein deposited at the wound interface during acute wound healing. Its abilities to interact with both cells and matrix are responsible for its description and characterization as a multifunctional adhesive glycoprotein. Fibronectin functions to promote cell adhesion, cell shape and spreading, organization of the cytoskeleton, hemostasis and thrombosis, cell migration, and phagocytosis. Both in vitro and in vivo studies indicate that fibronectin interacts with cells important to wound healing, including platelets, neutrophils, monocytes, fibroblasts, endothelial cells, and epidermal cells. It promotes adhesion between cells and between cell and matrix, cell spreading, migration, chemotaxis, phagocytosis, and matrix and basement membrane organization. Fibronectin is consequently active during each stage of wound healing. Its importance in acute wound healing is now widely recognized. More recently, investigators have begun to study fibronectin's role in chronic wounds. This article briefly reviews fibronectin, outlines its role in wound healing, and discusses current research on fibronectin in chronic wounds.

Pressure ulcers in hospitalized patients represent a significant challenge to the health professionals who care for these patients. This challenge extends to the health care system as a whole because of the staggering costs associated with pressure ulcer resolution. Although the relative benefits of various treatment methods have long been debated, intervention before ulcer formation clearly stands as the most efficacious approach to this problem. The Braden Scale for Predicting Pressure Sore Risk, a recently developed paper tool, was evaluated in our acute care medical unit for its ability to predict pressure ulcer occurrence. The sensitivity of the Braden Scale in this evaluation was much lower than that reported in other published studies. The Braden Scale was less effective than the nurse judgment prediction method, the current prevailing prediction method at this institution. The gravity of these results, however, is unclear because of the questionable incidence of ulcers in this study, which may be artificially high due to permissive criteria used in the identification of stage 1 ulcers. We determined that the lack of unequivocally defined criteria for the identification of stage 1 ulcers may contribute to variance between studies. We also found that intervention measures were used only 27% of the time after the identification of patients at risk.