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  At its March meeting, the American Board of Medical Specialties (ABMS) formally established a new subspecialty: Female Pelvic Medicine and Reconstructive Surgery.¹ The new subspecialty will be administered jointly by the American Board of Obstetrics and Gynecology (ABOG) and the American Board of Urology (ABU).

Abstract

  More than one million people develop pressure ulcers (PU) every year in the US — a major problem that leads to increased morbidity and mortality. A hospital-acquired PU (HAPU) is defined as any ulcer noted 24 or more hours after hospital admission. The purpose of this retrospective study was to compare the incidence of HAPUs between two 1-year periods of time (March 1, 2007 through March 17, 2008 and March 18, 2008 through March 31, 2009) at an acute care facility. Records from all admitted adult medical-surgical and critical care patients along with routinely submitted quality control reports on patients who acquired PUs during hospitalization were reviewed and abstracted. A locally developed PU risk assessment instrument (SST) was used during the first time period and the Braden Scale (BS) was used during the second time period. The overall PU incidence was 368 in 41,840 patient admissions (8.80 per 1,000); 9.49 in the SST and 8.08 in the BS patient sample (P = 0.125). No significant differences in patient age, race, and PU severity or location were observed. However, the incidence of more severe ulcers (Stage III and Stage IV) was lower in the BS group (0.5667 in the SST group compared to 0.2419 per 1,000 admissions in the BS group) even though median patient length of stay was longer (28 days and 34 days in the SST and BS groups, respectively), suggesting that use of a valid and reliable PU risk assessment instrument may reduce the incidence of severe PUs. Study design and sample size limit the ability to generalize the results of this study. Controlled clinical studies comparing the effect of different PU risk assessment instruments on PU incidence are needed.

Key Words: retrospective study, comparison, pressure ulcer, risk assessment, Braden Scale

Index: Ostomy Wound Management 2011;57(5):20–27

Potential Conflicts of Interest: none disclosed

Abstract

  Malignant neoplasms presenting on a stoma, as well as the development of colorectal adenocarcinoma after previous treatment for squamous cell carcinoma (SCC) of the anal canal, are rare. The unique case is presented of an 81-year-old woman with parastomal bleeding and ulceration found to have a primary colorectal adenocarcinoma arising de novo on a colostomy, formed after salvage abdominoperineal resection (APR) 3 years earlier for recurrent anal SCC. This is the first reported case of a colonic adenocarcinoma on a colostomy formed after an APR for anal SCC. Although stomal neoplasia is rare, the appearance of a friable bleeding lesion on the stoma should be investigated to exclude metastatic cancer or a second primary malignancy.

Key Words: case study, stoma, colorectal adenocarcinoma, parastomal bleeding

Index: Ostomy Wound Management 2011;57(5):38–40

Potential Conflicts of Interest: none disclosed