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“It is impossible to achieve independence with self-care when you are an acute spinal cord injured patient with a Stage IV sacral decubitus ulcer. These patients need to be fixed and should never be referred to nursing homes where their risk of sepsis and death become increasingly foreseeable,” states Greg Vigna, MD, JD. Dr. Anthony [...]
“Dr. Herbert Conway, plastic surgery, wrote about his experience with 1,000 cases of sacral, ischial, and trochanteric decubitus ulcer providing care for paralyzed Veterans at the Veterans Hospital, Bronx, New York. Flap closure provided superior outcomes when compared with conservative management,” states Greg Vigna, MD, JD, national decubitus ulcer attorney. What did Dr. Herbert Conway [...]
Patients with deep Stage 3 and Stage 4 who are not provided flap closure have a 17% risk of death at one year, and there is a 44% risk of readmission. Long-term acute care hospitals (LTACHs) have a niche role in the health care system. They specialize in caring for patients who are ventilator-dependent, [...]
Maggot therapy has never shown prevent osteomyelitis and death. LTACs may provide level of care for hospital or nursing home acquired decubitus ulcer patients. “Flap closure is rarely a readily available option in these complex patients due to their malnutrition, immobility, inability to offload, and other factors, such as immunosuppression,” states Caitlin Trottier, MD, [...]
Medical device-related pressure ulcers create localized injury to the skin or underlying tissue as a result of sustained pressure from a device. “Medical device-related pressure ulcers (MDR PrUs) hospital acquired pressure ulcers (HAPUs) often mirror the shape and location of a medical device. A unique aspect of MDR PrUs is a rigid plastic material [...]
In our study, patients with Medicare or Medicaid were significantly more likely to develop a pressure ulcer than patients with private insurance… In our study, patients with Medicare or Medicaid were significantly more likely to develop a pressure ulcer than patients with private insurance… Our results indicate that Black and Hispanic patients had significantly [...]
Reviewing cases where infectious disease specialists are not treating obvious symptoms of soft tissue infections from hospital or nursing home acquired bedsores If the wound will not be closed, we find no clear evidence supporting a role for antibiotic therapy” … Dr. Darren Wong, USC, Division of Infectious Disease in Clinical Infectious Disease, 2019:68. [...]
Heel pressure ulcers' healing challenges and prognostic factors In a heel ulcer population, having a severe rather than a superficial ulcer… is associated with half the chance of healing over time… The presence of peripheral artery disease also significantly reduces the chance of healing over time” … Dr. Elizabeth McGinnis, Leeds Teaching Hospitals NHS [...]
Optimal repositioning frequencies from human studies for decubitus ulcer prevention. Greg Vigna, MD, JD, national decubitus ulcer attorney explains, “The principles of decubitus ulcer prevention were described by Dr. Michael Kosiak in 1961 and his opinions have stood the test of time.” What did Dr. Kosiak say? “Since it is impossible to completely eliminate all [...]
Evaluating hospital-acquired and nursing home-acquired decubitus ulcers and the care offered at LTACs “The outcomes of conservative wound care for deep Stage 3 or Stage 4 pressure ulcers ischial decubitus ulcers are poor. There is little justification for admission to a Long-term Acute Care Hospitalization at a facility that doesn’t offer myocutaneous flaps” … Greg [...]