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Heel Pressure Injuries: Consensus-Based Recommendations for Assessment and Management
Significance: A systematic approach to develop experts-based recommendations could have a favorable impact on clinical problems characterized by scarce and low-quality evidence as heel pressure ulcers. Recent Advances: A systematic approach was used to conduce a formal consensus initiative. A multid...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Mary Ann Liebert, Inc., publishers
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7155923/ https://www.ncbi.nlm.nih.gov/pubmed/32286202 http://dx.doi.org/10.1089/wound.2019.1042 |
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author | Rivolo, Massimo Dionisi, Sara Olivari, Diletta Ciprandi, Guido Crucianelli, Serena Marcadelli, Silvia Zortea, Rosa Rita Bellini, Fabio Martinato, Matteo Gabrielli, Armando Pomponio, Giovanni |
author_facet | Rivolo, Massimo Dionisi, Sara Olivari, Diletta Ciprandi, Guido Crucianelli, Serena Marcadelli, Silvia Zortea, Rosa Rita Bellini, Fabio Martinato, Matteo Gabrielli, Armando Pomponio, Giovanni |
author_sort | Rivolo, Massimo |
collection | PubMed |
description | Significance: A systematic approach to develop experts-based recommendations could have a favorable impact on clinical problems characterized by scarce and low-quality evidence as heel pressure ulcers. Recent Advances: A systematic approach was used to conduce a formal consensus initiative. A multidisciplinary panel of experts identified relevant clinical questions, performed a systematic search of the literature, and created a list of statements. GRADE Working Group guidelines were followed. An independent international jury reviewed and voted recommendations for clinical practice. Consent was developed according to Delphi rules and GRADE method was used to attribute grade of strength. Critical Issues: The extensive search of the literature retrieved 42 pertinent articles (26 clinical studies, 7 systematic reviews or meta-analysis, 5 other reviews, 2 consensus-based articles, and 2 in vitro studies). Thirty-five recommendations and statements were created. Only 1 of 35, concerning ankle–brachial pressure index reliability in diabetic patients, was rejected by the panel. No sufficient agreement was achieved on toe brachial index test to rule out the orphan heel syndrome, removing dry eschar in adult patients without vascular impairment, and using an antimicrobial dressing in children with infected heel pressure injuries. Eleven recommendations were approved with a weak grade of strength. Experts strongly endorsed 20 recommendations. Offloading, stages I and II pressure injuries, and referral criteria were areas characterized by higher level of agreement. Future Directions: We believe that the results of our effort could improve practice, especially in areas where clear and shared opinions emerged. Barriers and limits that could hinder implementation are also discussed in the article. |
format | Online Article Text |
id | pubmed-7155923 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Mary Ann Liebert, Inc., publishers |
record_format | MEDLINE/PubMed |
spelling | pubmed-71559232020-04-14 Heel Pressure Injuries: Consensus-Based Recommendations for Assessment and Management Rivolo, Massimo Dionisi, Sara Olivari, Diletta Ciprandi, Guido Crucianelli, Serena Marcadelli, Silvia Zortea, Rosa Rita Bellini, Fabio Martinato, Matteo Gabrielli, Armando Pomponio, Giovanni Adv Wound Care (New Rochelle) Comprehensive Invited Review Significance: A systematic approach to develop experts-based recommendations could have a favorable impact on clinical problems characterized by scarce and low-quality evidence as heel pressure ulcers. Recent Advances: A systematic approach was used to conduce a formal consensus initiative. A multidisciplinary panel of experts identified relevant clinical questions, performed a systematic search of the literature, and created a list of statements. GRADE Working Group guidelines were followed. An independent international jury reviewed and voted recommendations for clinical practice. Consent was developed according to Delphi rules and GRADE method was used to attribute grade of strength. Critical Issues: The extensive search of the literature retrieved 42 pertinent articles (26 clinical studies, 7 systematic reviews or meta-analysis, 5 other reviews, 2 consensus-based articles, and 2 in vitro studies). Thirty-five recommendations and statements were created. Only 1 of 35, concerning ankle–brachial pressure index reliability in diabetic patients, was rejected by the panel. No sufficient agreement was achieved on toe brachial index test to rule out the orphan heel syndrome, removing dry eschar in adult patients without vascular impairment, and using an antimicrobial dressing in children with infected heel pressure injuries. Eleven recommendations were approved with a weak grade of strength. Experts strongly endorsed 20 recommendations. Offloading, stages I and II pressure injuries, and referral criteria were areas characterized by higher level of agreement. Future Directions: We believe that the results of our effort could improve practice, especially in areas where clear and shared opinions emerged. Barriers and limits that could hinder implementation are also discussed in the article. Mary Ann Liebert, Inc., publishers 2020-06-01 2020-04-08 /pmc/articles/PMC7155923/ /pubmed/32286202 http://dx.doi.org/10.1089/wound.2019.1042 Text en © Massimo Rivolo, et al. 2019; Published by Mary Ann Liebert, Inc. This Open Access article is distributed under the terms of the Creative Commons Attribution Noncommercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and the source are cited. |
spellingShingle | Comprehensive Invited Review Rivolo, Massimo Dionisi, Sara Olivari, Diletta Ciprandi, Guido Crucianelli, Serena Marcadelli, Silvia Zortea, Rosa Rita Bellini, Fabio Martinato, Matteo Gabrielli, Armando Pomponio, Giovanni Heel Pressure Injuries: Consensus-Based Recommendations for Assessment and Management |
title | Heel Pressure Injuries: Consensus-Based Recommendations for Assessment and Management |
title_full | Heel Pressure Injuries: Consensus-Based Recommendations for Assessment and Management |
title_fullStr | Heel Pressure Injuries: Consensus-Based Recommendations for Assessment and Management |
title_full_unstemmed | Heel Pressure Injuries: Consensus-Based Recommendations for Assessment and Management |
title_short | Heel Pressure Injuries: Consensus-Based Recommendations for Assessment and Management |
title_sort | heel pressure injuries: consensus-based recommendations for assessment and management |
topic | Comprehensive Invited Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7155923/ https://www.ncbi.nlm.nih.gov/pubmed/32286202 http://dx.doi.org/10.1089/wound.2019.1042 |
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