The authors also explore risk stratification as it relates to history and clinical presentation with subsequent focus on contingencies to mitigate the adverse effects of vasoconstriction on peripheral tissues.

Fasciotomy with resection of nonviable muscle is often necessary when there is a delay in compartment syndrome (CS) diagnosis after revascularization. The reported rate of major amputation following missed CS or delayed fasciotomy ranges from 12% to 35%. Herein, the authors present a series of critically ill patients who experienced delayed CS diagnosis and required complete resection of the anterior and/or lateral compartments but still achieved limb salvage and function.

A retrospective chart review identified five patients from April 2018 to April 2019 within a single institution who met the inclusion criteria. Patient charts were reviewed for demographic data, risk factors, time to diagnosis following revascularization, muscle compartments resected, operative and wound care details, and functional outcome at follow-up.

All of the patients developed CS of the lower extremity following revascularization secondary to acute limb ischemia and required two-incision, four-compartment fasciotomies. Further, they all required serial operative debridements to achieve limb salvage; however, there were no major amputations, and all of the patients were walking at follow-up.

Delay in CS diagnosis can have devastating consequences, resulting in major amputation. In cases where myonecrosis is isolated to two or fewer compartments, complete compartment muscle resection can be safely performed, and limb preservation and function can be maintained with aggressive wound management and physical therapy.

Delay in CS diagnosis can have devastating consequences, resulting in major amputation. In cases where myonecrosis is isolated to two or fewer compartments, complete compartment muscle resection can be safely performed, and limb preservation and function can be maintained with aggressive wound management and physical therapy.

To assess the effectiveness of a dimethicone- and zinc-based barrier cream compared with hyperoxygenated fatty acids in preventing pressure injuries (PIs) in patients at high or very high risk.

Researchers conducted a retrospective noninferiority study in an inpatient acute care hospital in Spain that included hospitalized patients in nonsurgical departments with impaired mobility.

The study authors reviewed 522 patients in a control group (hyperoxygenated fatty acids) and an experimental group (barrier cream) over a period of 7 days. The incidence of PI was 31% in the control group and 31.1% in the experimental group. The hazard ratio for developing PI was 0.84 (confidence interval, 0.61-1.17; P = .32) in the experimental group compared with the control group, meeting the criteria for noninferiority. The Kaplan-Meier estimator indicated no statistically significant difference between groups (log-rank = 0.654).

Dimethicone- and zinc-based barrier cream was not inferior to hyperoxygenated fatty acids in preventing PIs in hospitalized patients at high or very high risk of developing them during their hospital stay.

Dimethicone- and zinc-based barrier cream was not inferior to hyperoxygenated fatty acids in preventing PIs in hospitalized patients at high or very high risk of developing them during their hospital stay.

To date, no reports have been published on active Leptospermum manuka honey (ALH) feasibility as a postoperative topical wound supplement in neurosurgical patients. The objective of the study is to present the authors’ initial experience with using ALH in postoperative neurosurgical patients.

A single-surgeon retrospective case series review of cranial and spinal operations between 2018 and 2020 was performed in patients with nonhealing wounds or wounds deemed “at risk” as defined by grade 1 Sandy surgical wound dehiscence grading classification. An ALH gel or ointment was applied to these incisions once a day for 2 to 4 weeks. Patients were followed up in the clinic every 2 weeks until incisions had healed.

Twenty-five postoperative patients (12 cranial, 13 spinal) were identified to be at high risk of operative debridement. All 25 patients were prescribed a topical application of ALH, which was easily adopted without patient-related adverse events. Seven (four cranial, three spinal) patients required operative debridement and treatment with long-term antibiotic therapy.

In this small case series of neurosurgical patients who were at risk of poor wound healing, the application of medical-grade ALH was well tolerated without patient-reported adverse events. The ALH may have prevented the need for operative debridement in the majority of patients. Tefinostat HDAC inhibitor Further prospective studies are necessary to establish its efficacy in wound healing in the neurosurgical population.

In this small case series of neurosurgical patients who were at risk of poor wound healing, the application of medical-grade ALH was well tolerated without patient-reported adverse events. The ALH may have prevented the need for operative debridement in the majority of patients. Further prospective studies are necessary to establish its efficacy in wound healing in the neurosurgical population.

To present a comprehensive review of patient-centered outcomes of topical or systemic interventions applied to those with shingles or postherpetic neuralgia to inform clinical practice and identify related research needs.

This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

After participating in this educational activity, the participant will be able to1. Explain the importance of early diagnosis and treatment of herpes zoster (HZ).2. Identify interventions that have resulted in documented improvement of validated patient-centered outcomes in patients with HZ or postherpetic neuralgia.3. Recognize the average per patient medical costs of HZ in the US.

After participating in this educational activity, the participant will be able to1. Explain the importance of early diagnosis and treatment of herpes zoster (HZ).2. Identify interventions that have resulted in documented improvement of validated patient-centered outcomes in patients with HZ or postherpetic neuralgia.