Evaluation of negative pressure vacuum-assisted system in acute and chronic wounds closure. Our experience

Negative-pressure therapy or vacuum-assisted closure (VAC) has been used in clinical applications since the 1940’s and has increased in popularity over the past decade. This dressing technique consists of an open cell foam dressing put into the wound cavity, a vacuum pump produces a negative pressure and an adhesive drape. A controlled sub atmospheric pressure from 75 to 150 mmHg is applied. The vacuum-assisted closure has been applied by many clinicians to chronic wounds in humans; however it cannot be used as a replacement for surgical debridement. The initial treatment for every contaminated wound should be the necrosectomy. The VAC therapy has a complementary function and the range of its indications includes pressure sores, stasis ulcers, chronic wounds such as diabetic foot ulcers, post traumatic and post operative wounds, infected wounds such as necrotizing fasciitis or sternal wounds, soft-tissue injuries, bone exposed injuries, abdominal open wounds and for securing a skin graft. We describe our experience with the VAC dressing used to manage acute and chronic wounds in a series of 135 patients, with excellent results together with satisfaction of the patients.

Evaluation of Urban Spaces from the Perspective of Universal Design Principles: The Case of Konya/Turkey

During the process of accessing services provided within urban interior and outer spaces the elderly and disabled individuals encounter with a myriad of problems due to the limitations posed by structured environments. This limitation hinders elderly and disabled individuals from mobility without assistance, which in turn negatively affects their full participation to urban and social life. Rearrangement of urban spaces to meet the needs of elderly and disabled individuals would correspondingly bolster life quality of the entire range of users. Within the scope of present research, as mandated by universal design principles to stick to plans and designs approaches inclusive for all users, it is aimed to conduct evaluations on the use of urban outer spaces situated within Konya City Center. In the hypothetical and theoretical part of this paper, the perception of disability throughout historical process has been examined from a sociological perspective. In addition, concept of universal design, its principles and gravity have also been elaborated. In the part dealing with the case study, outer spaces within Konya City Center have been analyzed with respect to universal design principles and a range of suggestions have been developed.

Acute Q Fever Presenting with Multi-Organ Failure: Re-Evaluation of the Initial Diagnosis

We present the case of a 48-year-old man admitted to the critical care unit with atrial fibrillation, and acute heart and kidney failure accompanied by coagulopathy and an abnormal liver test. Initially diagnosed as a non-ST elevation myocardial infarction, re-evaluation of the case led to the consideration of severe sepsis. Q fever and leptospirosis were the most probable causes and empiric treatment was initiated. A complete recovery was achieved following treatment.