PubMed Health⌕ Search

Biomedical subjects

J E Barr

Publications and source records attributed to J E Barr.

11 recordsLinked to original sources
PubMed1996

Wound care clinical pathway: a conceptual model.

A clinical pathway is a written sequence of clinical processes or events that guides a patient with a defined problem toward an expected outcome. Clinical pathways are tools to assist with the cost-effective management of clinical outcomes related to specific problems or disease processes. The primary obstacles to developing clinical pathways for wound care are the chronic natures of some wounds and the many variables that can delay healing. The pathway introduced in this article was modeled upon the three phases of tissue repair: inflammatory, proliferative, and maturation. This physiology-based model allows clinicians to identify and monitor outcomes based on observable and measurable clinical parameters. The pathway design, which also includes educational and behavioral outcomes, allows the clinician to individualize the expected timeframe for outcome achievement based on individual patient criteria and expert judgement. Integral to the pathway are the "4P's" which help standardize the clinical processes by wound type: Protocols, Policies, Procedures, and Patient education tools. Four categories into which variances are categorized based on the cause of the deviation from the norm are patient, process/system, practitioner, and planning/discharge. Additional research is warranted to support the value of this clinical pathway in the clinical arena.

Cost-Benefit Analysis↗
PubMed1995

Assessing clinical efficacy of a hydrocolloid/alginate dressing on full-thickness pressure ulcers.

An absorbent hydrocolloid/alginate spiral dressing and a hydrocolloid secondary dressing were used in the management of 30 patients with 30 exuding State III and IV pressure ulcers. After a mean treatment time of 12.9 days (SD 6.5), all wounds had a significant increase in the amount of granulation tissue/epithelium and a decrease in the amount of devitalized tissue (p < 0.05). Wounds that underwent wide surgical debridement prior to the study were covered with 15 percent fibrin slough at study entry versus 39 percent for non-debrided wounds (p < 0.05). The dressing combination facilitated wound contraction and removal of fibrin slough in ulcers that were surgically debrided prior to the study. Ulcers which had not been surgically debrided expanded as autolytic debridement reduced the amount of fibrin slough/necrotic tissue present at the wound bed (Mean: 17.6 percent, p < 0.05). The absorbent spiral dressing helped manage exudate, was easy to use and comfortable for the patients. The average time between dressing changes in these exuding wounds was 1.56 days (SD = 0.95). Use of air-fluidized bed or mattress was found to significantly reduce wear time of the dressing (p < 0.01). Further studies are needed to confirm short-term, and evaluate long-term effects of this dressing combination on healing and debridement.

Adult↗
PubMed1995

Principles of wound cleansing.

Cleansing the wound of necrotic tissue, excess wound exudate, dressing residue and metabolic wastes from the wound surface is essential for optimum healing. Wound cleansing involves using an appropriate solution and an adequate mechanical force. Every effort should be made to use biocompatible cleansing solution with the minimal mechanical force. The objective is to adequately cleanse the wound while preventing any unnecessary chemical or mechanical trauma to the wound surface. By utilizing the Clinical Model for Wound Cleansing, the clinician can implement an effective wound cleansing protocol. Further research is needed to show the efficacy of wound cleansing procedures and to demonstrate the correlation between adequate wound cleansing and wound healing outcomes.

Detergents↗
PubMed1979

Techniques for the chronic cannulation of the jugular vein in mice.

The use of chronic intravenous cannulae implanted in the jugular vein of mice utilizing techniques previously developed for larger rodents is discussed. Two cannula designs and a chronic infusion chamber are illustrated. Cannula insertion depths for mice of three strains and various body weights, and estimates of operative mortality and cannula durability are given.

Animals↗
PubMed1979

Electrophysiological responses to ethanol, pentobarbital, and nicotine in mice genetically selected for differential sensitivity to ethanol.

Cortical electroencephalographic (EEG) changes induced by ethanol (4.3 and 1.4 g/kg, ip), pentobarbital (50 and 16 mg/kg), and nicotine (1.0 g/kg) were examined in long-sleep (LS) and short-sleep (SS) mice that were genetically selected for differential sleep times induced by a hypnotic dosage of ethanol. Ethanol (4.3 g/kg) caused EEG changes that paralleled the behavioral differences, whereas no differences between selected lines were observed following the activating dose (1.4 g/kg). Data support the notion that the known difference in ethanol sleep times is due not to greater SS sensitivity to ethanol activation but rather to greater LS sensitivity to ethanol hypnosis. No differences between selected lines were observed following 50 mg/kg pentobarbital, which again parallels previous behavioral data. The SS mice were more responsive to pentobarbital activation (16 mg/kg). Nicotine more severely reduced EEG power and heart rate in LS mice; a continuous iv infusion of nicotine elicited a distinct pattern of behavioral stereotypy for each selected line, with more profound motor and reflex depression in LS mice. The lines do not differ in rate of nicotine metabolism, hence they must differ in central nervous system sensitivity to nicotine. Thus, lines of mice selectively bred for differential sensitivity to ethanol also display marked differences in electrophysiological and behavioral responses to nicotine.

Animals↗
PubMedDate not supplied

Multi-center evaluation of a new wound dressing.

Ninety-two wounds were evaluated for at least three dressing changes each. The vast majority of the wounds were lightly exuding Stage II pressure ulcers and skin tears. This evaluation confirmed the hypothesis that the protective, conformable, and elastic properties of Flexzan, combined with its limited absorption capacity, high moisture vapor permeability and easy to use adhesive system, provided a dressing well suited to the management of the non- to lightly exuding wounds included. In addition, it was found to be a "superior" secondary dressing for alginate dressings on highly exuding wounds.

Adult↗