Conectar
Pilonidal sinus disease (PSD) is associated with substantial morbidity because of wound complications and recurrence after surgery. Adjunct laser hair removal (LHR) has been incorporated into postoperative management in some settings, but real-world outcomes in cohorts treated uniformly with LHR remain incompletely described. This study aimed to characterize postoperative outcomes after PSD surgery in a large integrated healthcare system in which adjunctive LHR was standard practice and to compare outcomes by surgical approach. We performed a retrospective descriptive cohort study of patients aged 14–89 years who underwent operative treatment of PSD with adjunctive LHR at Kaiser Permanente Northern California between 2012 and 2024. Outcomes included repeat procedures, 30-day surgical site infection (SSI), and unplanned clinic visits. Outcomes were summarized as proportions overall and by surgical approach. Exploratory bivariable logistic regression examined associations between sex or body mass index (BMI) and outcomes. Multivariable modeling was not performed because of low event counts and sparse covariate distributions, which resulted in unstable models. Among 168 patients, the overall repeat procedure rate was 16.7%, the 30-day SSI rate was 14.4%, and 39.3% had at least one unplanned clinic visit. Patients treated with Bascom flap closure had fewer repeat procedures (10.4% vs. 20.8%) and fewer unplanned visits (33.8% vs. 43.6%) than those undergoing pilocystectomy, with similar SSI rates (14.9% vs. 14.0%). In exploratory analyses, sex and BMI were not significantly associated with outcomes in either surgical group. In this real-world cohort managed uniformly with adjunctive LHR, postoperative outcomes appeared to vary more by surgical approach than by sex or BMI. These findings are descriptive and do not estimate the independent effect of LHR. Controlled comparative studies are needed to determine the contribution of LHR to PSD outcomes.
The ‘Wound Hygiene Italia’ project was designed to provide expert-driven recommendations for the assessment, management and monitoring of venous leg ulcers, tailored to diverse settings of care (hospital, ambulatory and home care). The recommendations, developed by a multidisciplinary panel, emphasise the implementation of the Wound Hygiene strategy, a systematic approach targeting biofilm as a primary barrier to wound healing. Wound management is structured around four steps: cleansing, debridement, edge refashioning and dressing selection adapted to the wound bed characteristics, care setting and clinical capabilities, embedded in a holistic approach through comprehensive patient assessment and monitoring of overall well-being. The findings highlight the necessity of interdisciplinary collaboration, standardised tools and continuous patient monitoring, as assessed by objective metrics, such as wound size measurements and photographic documentation. Effective communication with patients and caregivers is also essential to ensure treatment adherence and foster trust in the care process. This framework integrates evidence-based practices to optimise outcomes and patient quality of life. By addressing both clinical and psychosocial factors, the recommendations promote a holistic, patient-centred approach that underscores the importance of education, structured follow-ups and tailored interventions.
Chronic wounds present a significant challenge to society and have a negative impact on the quality of life and daily activities of patients. This review aimed to identify the cost-effectiveness of the currently used care alternatives for the treatment of chronic wounds. This study serves to identify cost-effectiveness boundaries and provide a basis for determining the cost-effectiveness of the proposed care alternatives. A systematic literature search was conducted in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles published on Web of Science and PubMed from June 2013 to June 2023 were included. A comparative analysis was performed using the data adjusted for inflation and transformed for the same time horizon. The median time to heal was approximately 2.5 months in the first quartile of studies ending at 1.3 months and the third quartile ending at 3.7 months. The average cost of complete chronic wound healing for all care alternatives in the study sample was $6435, with a median cost of $5814. This systematic review covers a diverse range of treatment alternatives, their health effects and costs and highlights the complex landscape of cost-effectiveness in the treatment of chronic wounds.
Trial Registration: PROSPERO database under registration number: CRD42023434074
Pressure injuries present significant challenges in clinical care, leading to severe complications such as infection, pain and delayed wound healing. They are a common chronic wound that contribute to increased morbidity, prolonged hospital stays and substantial healthcare costs. Despite national efforts to enhance chronic wound management, development of optimal treatment strategies remains a priority. The Pressure Injury Treatment Advisory (PITA) Quick Guide was developed to provide an evidence-based guide to support clinicians in pressure injury management. A survey was conducted to evaluate clinician perspectives on the usability and practicality of the Guide in acute care, residential aged care and community settings. A post-test survey was conducted on a convenience sample of healthcare professionals from three healthcare settings across metropolitan, regional and rural Australia. The survey included 5-point Likert-scale items assessing ease of use, effectiveness and integration with workflows. Three hundred and two responses were received (66.7% response rate). Clinicians expressed overwhelmingly positive perceptions, with over 95% agreeing or strongly agreeing on the guide's utility and effectiveness. No respondents strongly disagreed with any item. Residential aged care and rural clinicians rated the tool slightly higher than acute care and medical clinicians. The PITA Quick Guide was well-received across all settings, demonstrating strong potential to enhance evidence-based pressure injury management.
FreshRSS 