Explore the vast range of titles available.

Treating cutaneous abscesses in children traditionally involves incision and drainage followed by moist dressing changes. This article addresses whether abscesses can safely heal with incision and drainage alone and daily warm water immersion. Sixteen children with cutaneous abscesses were treated without dressing changes. All were pain free at 24 hours. There was one abscess recurrence. In comparison, among 19 children with cutaneous abscesses who received postoperative dressing changes, seven (37%) had significant pain, six (32%) required IV pain medications, and 11 (58%) were hospitalized. We determined that cutaneous abscesses may be treated with incision and drainage alone, thus avoiding pain and hospitalization for the patient. AORN J 90 (October 2009) 569–574. © AORN, Inc, 2009.

Clinical reasoning has been defined as collecting clues, processing information, and coming to an understanding of a patient problem, then planning and implementing interventions, evaluating outcomes, and reflecting on and learning from the process. Clinicians with effective reasoning skills positively impact patient outcomes.

Despite the sophisticated pharmaceutical agents and technologies available today, many people, including older adults, continue to experience chronic pain. Inadequately treated chronic pain can seriously affect one’s quality of life. Health care providers are only beginning to understand the structural and functional changes that occur in older adults with chronic pain, but recent research suggests that nurses and other health professionals need to become aware of the unique needs of older adults who live with chronic pain. When health professionals lack specific knowledge of pain management in older adults, patients may suffer needlessly.

This article, the first of two parts, introduces the difficulties facing nurses working with injecting drug users with skin problems. Drug abuse is increasing globally, and has huge implications for healthcare practitioners. Increasing numbers of tissue viability nurses are also encountering drug injection-induced wounds in their practice, but there is a lack of evidence for management of chronic skin problems in this patient group. Together with rising numbers of injecting drug users, there are increased health implications such as bacteraemia, septicaemia, amputation and skin breakdown. Abscesses and chronic wounds as well as prolonged leg ulceration are common. Drug users may demonstrate chaotic lifestyles which may inhibit access to usual healthcare provision. Issues relating to healing of these wounds are explored. The second part, which will appear in the next Tissue Viability Supplement, will describe the development of a specialist wound care clinic for homeless drug users.

The selection of wound management products by nurses can be an area of confusion. Healthcare professionals involved with tissue viability issues have to make choices from a wide range of commercially available products to suit wound conditions. This article recounts the challenges facing a specialist nurse and his selection of a range of Smith & Nephew Healthcare products, when he was asked for expert advice to promote granulation in a massive wound following debridement for extensive abscess formation in the lower abdominal, perineum and ischial areas.

This is the first of a series of three articles which won the Alison Bell Writer's Award this year. Jill Biggins won first prize for this article which looks at a way of improving the patient's experience of day surgery. The Writer's Award is sponsored by NATN and Regent Medical.

Introduction Spinal epidural abscess (SEA) is a rare and life-threatening infection with increasing incidence over the past two decades. Delays in diagnosis can cause significant morbidity and mortality among patients. Objective The objective of this study was to describe trends in time-to-imaging and intervention, risk factors, and outcomes among patients presenting to the emergency department with SEA at a single academic medical center in Portland, Oregon. Methods This retrospective cohort study analyzed data from patients with new SEA diagnosis at a single hospital from October 1, 2015 to April 1, 2018. We describe averages to time-to-imaging and interventions, and frequencies of risk factors and outcomes among patients presenting to the emergency department with SEA. Results Of the 34 patients included, 7 (20%) died or were discharged with plegia during the study period. Those who died or were discharged with plegia ( n  = 7) had shorter mean time-to-imaging order (20.8 h versus 29.2 h). Patients with a history of intravenous drug use had a longer mean time-to-imaging order (30.2 h versus 23.7 h) as compared to those without intravenous drug use. Patients who died or acquired plegia had longer times from imaging completed to final imaging read (20.9 h versus 7.1 h), but shorter times from final imaging read to surgical intervention among patients who received surgery (4.9 h versus 46.2 h). Further, only three (42.9%) of the seven patients who died or acquired plegia presented with the three-symptom classic triad of fever, neurologic symptoms, and neck or back pain. Conclusions SEA is a potentially deadly infection that requires prompt identification and treatment. This research provides baseline data for potential quality improvement work at the study site. Future research should evaluate multi-center approaches for identifying and intervening to treat SEA, particularly among patients with intravenous drug use.

Brain abscess (BA) is a severe neurological emergency, which remains a challenge for physicians despite medical advancements. The purpose of this study is to describe the epidemiology of BA in Taiwan and to investigate potential factors affecting the survival of patients with BA. By using the Taiwan National Health Insurance Research Database, we identified hospitalized patients with a discharge diagnosis of pyogenic BA (324.X) between 2000 and 2013. The incidence and in-hospital mortality of BA were calculated based on both age and sex. A total of 6027 BA cases were identified. The overall incidence of BA was 1.88 (95% CI: 1.83-1.93) per 100,000 person-years and increased with age, from 0.58 per 100,000 person-years in individuals aged 0-14 years to 4.67 per 100,000 person-years in those over 60 years of age. The male-to-female incidence ratio was 2.37 (95% CI: 2.24-2.50), with a mountain-shaped distribution across ages peaking at 40-44 years. The in-hospital mortality also increased with age, from 4.22% (95% CI: 2.54-6.97) at 0-14 years to 17.34% (95% CI: 15.79-19.02) in individuals over 60 years of age, without a gender difference (11.9% for males, 12.5% for females). Age, stroke, septicemia, pneumonia, meningitis, and hepatitis were associated with increased risk of in-hospital mortality. There was a male predominance for BA, and both the incidence and in-hospital mortality rates increased with age. Infection-related disease such as septicemia, pneumonia and meningitis were important factors associated with in-hospital mortality. In addition to the original treatment of BA, we suggest paying close attention to potential infections to improve the outcome of BA patients.

To investigate the effect of a clinical nursing pathway and visual health education on patients with perianal abscesses was the objective of this study. Eighty patients with perianal abscesses undergoing in-patient surgical treatment (blinded for review) between December 2019 and November 2020 were divided randomly and evenly into a control group and an experimental group. The control group received routine nursing care, and the experimental group received visual health education nursing care. Digital pain scores, patient satisfaction scores, nursing quality scores, and scores measuring knowledge of perianal abscess disease for the two groups before and after nursing care were compared and analyzed. The experimental group had visual analog scale (VAS) scores significantly lower than those of the control group ( < 0.05). For total nursing satisfaction, the experimental group demonstrated a higher satisfaction rate ( < 0.05). Clinical nursing quality scores were significantly higher in the experimental group than those in the control group ( < 0.05). The perianal abscess disease-related knowledge scores after intervention were significantly higher in the experimental group than those in the control group ( < 0.01). Visual health education nursing can help patients better understand and deal with perianal abscess disease.