Background and Objectives: This study aimed to assess the level of selected biochemical parameters in venous blood and their potential effects on the development of pressure ulcers in patients treated in intensive care settings. Materials and Methods: Fifty patients hospitalised in an intensive care unit (ICU) were enrolled for the study. The methods used included controlled observation, literature review and medical record analysis. The observation protocol applied in the study consisted of two parts comprising the basic information, sociodemographic data, results of laboratory tests (CRP, PCT, albumin, protein and haemoglobin concentrations) as well as the Braden Scale for Predicting Pressure Ulcer Risk. Results: The subjects presented moderate to high risk of pressure ulcers, reflected by the mean score of 8.18 ± 1.3 points, with minimum and maximum scores of 6 and 12 points, respectively. Normal albumin level was identified in only five subjects (10.0%) while 45 subjects (90.0%) were found with results below the norm. A statistical relationship was observed between such variables as albumin concentration (p < 0.01) and total protein level (p = 0.007). The findings show a strong correlation between the score in the Braden Scale and the level of albumins (R = 0.55). Conclusions: In our study, lower concentrations of albumins and total proteins correspond to a greater risk of pressure ulcers.

Despite numerous studies and recommendations, the acceptance of treatments involving medicinal maggots in many clinics has been slow. Several factors may account for this, including the gender of nurses administering the treatment, their level of work experience, and their perceived level of personal stress. The aim of the study was to assess the impact of selected variables (gender, work experience, stress level) on the readiness of nurses to administer maggot debridement therapy (MDT), which is a form of biodebridement. The study population was a cohort of 290 wound care nurses providing specialist care for patients with chronic wounds. It was assumed that the identified variables may determine the implementation of larval therapy in everyday professional practice. A subsample of 35 men and 35 women was further analyzed to determine if gender, work experience, and/or personal stress levels were correlated with attitudes towards the utilization of maggots in biodebridement. Assessment tools included the Perceived Stress Scale (PSS-10) and the MDT 10 Perception Assessment Questionnaire, a protocol by which the subject ranked six wound photographs in order of repulsiveness and responded to questions regarding demographic variables, which include education and work experience. The visual perception of pictures of a wound with larvae is indirectly an indicator of the attitude towards larval therapy. Selection of the photograph with maggots on the wound as the most repulsive image was associated with a personal appraisal of not being ready to implement maggot therapy (chi-square = 8.430, p = 0.015). Low work experience (chi-square = 14.039, df = 4, p = 0.007), and low readiness for MDT (chi-square = 8.430, df = 2, p = 0.015) were also associated with unpreparedness to administer maggot therapy. Neither gender nor perceived stress level were exclusively associated with disgust for maggots or lack of readiness to implement MDT. Low professional experience and a deficit of knowledge in maggot therapy may negatively affect the readiness of nurses to administer biodebridement. Gender and personal stress levels do not affect nurses’ readiness to utilize larval therapy.

Background/Objectives: Pain management during minor surgical procedures in wound care across various etiologies is often underestimated in daily clinical practice. Pharmacotherapy remains the most effective and efficient method for pain reduction. However, growing concerns regarding the side effects of traditional analgesics and distressing psychosomatic experiences highlight the need for innovative non-pharmacological pain management strategies. The use of virtual reality (VR) has been suggested as a potential method to alleviate pain during medical procedures. The aim of this study was to assess the feasibility of virtual reality as a non-pharmacological approach to pain reduction during the debridement and dressing of hard-to-heal vascular wounds. Methods: This prospective observational study included a cohort of 100 patients who were consulted and treated at a specialized wound care clinic in the Podkarpacie region, Poland. Participant selection was based on predefined inclusion criteria. Patients were assigned to two groups: Group A, in which VR goggles were used, and Group B, in which standard care without VR was provided. All wounds were pre-treated with Lignocaine 2% gel for approximately 3–5 min before tissue debridement. Pain intensity was measured before the procedure, during the procedure, and 10 min after completion. A structured research questionnaire was used for data collection, consisting of two parts: sociodemographic data, functional assessment, wound characteristics, clinical scales, and the Numeric Rating Scale (NRS) for pain assessment before, during, and after the procedure. Results: A total of 100 participants voluntarily took part in the study, of whom 49.0% (n = 49) were male and 51.0% (n = 51) were female. The age of participants ranged from 43 to 89 years, with a mean age of 68.02 ± 10.0 years. A statistically significant difference in pain perception was observed between the pre-procedure and intra-procedure phases of wound debridement. The average pain increase in the Group with VR was lower than in the Group without VR (p = 0.006, effect size = 0.32). Conclusion: Pain occurrence and intensity during wound debridement are common challenges in clinical practice. The visual perception of a bleeding and treated wound may contribute to the psychogenic pain component. Virtual reality may serve as a simple adjunctive method to medical procedures by diverting attention away from surgical interventions. Further research, including psychological aspects of non-pharmacological pain management, is necessary in the context of wound care prevention and treatment.

Introduction: The key objectives of palliative care include relief from suffering, improvement of the quality of life, dignified dying conditions and acceptance of impending death. The higher risk of developing pressure ulcers in palliative care patients is connected with the likelihood of the occurrence of undesirable symptoms, limited self-care and the destruction of the skin and subcutaneous tissues in each area exposed to pressure. In patients over 65 years of age, pressure ulcers on the heel, coexisting with limb ischemia, may increase the risk of premature death. Aim of the study: The objective of the study was to identify the directions of intervention performed in the management of pressure ulcers on the heel in accordance with the guidelines of the Polish Wound Management Association (Polskie Towarzystwo Leczenia Ran (PTLR), the Europe Pressure Ulcer Advisory Panel (EPUAP), the National Pressure Injury Advisory Panel (NPIAP), as well as own experience. Material and methods: Analysis of literature based on the guidelines of PTLR, EPUAP and NPIAP. Conclusions: Holistic and interdisciplinary care for the patients at the end of their lives is an integral part of palliative care. Secondary prevention and wound management aiming at minimising negative symptoms play an important role in the therapeutic process. Wound management taking into account clinical practice gives wide opportunities in the scope of methods and measures to minimise exudate caused by local infection.

Introduction. Endotracheal intubation (ETI) may be a procedure necessary to perform by a nurse in the event of sudden cardiac arrest (SCA). Its correct execution improves the course and organization of a rescue operation and contributes to increased self-confidence in stressful situations. Aim. Assessment of the effectiveness of endotracheal intubation among system nurses under simulated conditions. Material and methods. A pilot study of prospective observational simulation study using advanced evaluation tools for intubation phantom (BT-CSIE, Q’ty model) with a tablet (PC-1EA), IntuBrite laryngoscope with curved handle. The results were analyzed with Statistica PL 12.0 and Microsoft Office Excel 2016, using the Student’s t and chi-square tests. Results. Nurses with specialization intubated twice faster (30.4 s) than nurses during specialization (68.8 s) or without specialization (67.5 s). The shortest time of inserting an endotracheal tube demonstrated subjects with over 10 years of work experience (37.0 s). The mean pressure on the incisors during the procedure was 10.9 N. Ventilation with an average tidal volume of 543 cm³ (p=0.024) was in line with the recommendations of the European Rescue Council (ERC). Conclusions. Work seniority and specialization significantly affected the effectiveness of the intubation procedure in time, while maintaining the recommended frequency and volume of mechanical ventilations.

Background/Objectives: Pressure injuries on the heels of critically ill patients occurring during hospitalization are a global problem. Risk factors include comorbidities, distal perfusion disorders, multiple organ failure, pharmacotherapy, and immobilization associated with mechanical ventilation. These factors affect microperfusion quality in the heels. The presence of friction, shear, and compressive forces contributes directly to local tissue hypoxia and secondary tissue destruction in the heels. This study aimed to assess the impact of risk factors on the development of pressure injuries on the heels of patients in intensive care. Methods: A prospective observational study using controlled observation and assessment was conducted on 120 patients treated in the Department of Anesthesiology and Intensive Care. The initial risk assessment for pressure injuries was conducted within 24 h of admission to the ward, with a follow-up assessment conducted between five and ten days after admission. Data were collected using a scientific research protocol consisting of three parts (A, B, and C). Part A contained sociodemographic data, selected biochemical results, an ankle-brachial index assessment, and a pressure injury risk assessment using the Braden scale within the first 24 h of admission. Parts B and C involved re-evaluating selected biochemical parameters and assessing areas particularly vulnerable to pressure injury development. Statistical analysis was performed using IBM SPSS Statistics v. 21. Results: It was shown that the high risk of pressure injuries in the heel area in critically ill patients is dependent on catecholamine infusion (p < 0.001, r = 0.45) and distal perfusion dysfunction, which is assessed using the ankle-brachial index (ABI-PAD) (p = 0.026, r = 0.23). The ABI (PAD) index is an important factor in the development of pressure ulcers associated with peripheral artery disease, which is associated with an approximately fivefold increase in the likelihood of heel pressure injuries compared to patients with normal ABI values (OR = 5.10, 95% CI: 1.56–16.65, p = 0.007). A correlation was demonstrated between CRP values (chi-square = 5.795, df = 1, p = 0.016) and creatinine levels (chi-square = 7.512, degrees of freedom = 2, p = 0.023, r = 0.25) and the occurrence of pressure ulcers in the heels of critically ill patients. It was shown that the strongest prognostic factor for the occurrence of heel pressure injury was a below-normal creatinine level (OR = 8.75, 95% CI: 1.20–64.13, p = 0.033). Conclusions: Distal perfusion disorders resulting from circulatory failure and low peripheral perfusion increase the risk of pressure ulcer development in critically ill patients. The use of catecholamines to stabilize the circulatory system increases the risk of pressure ulcers on the heels of critically ill patients. Specific pharmacotherapy and invasive medical procedures may contribute to the development of pressure ulcers regardless of the level of pressure ulcer prevention.