Simple Nutritional and Inflammatory Markers Associated with Bed Sores in Elderly Stroke People

Background: Bed sores are major burden to hospital care and usually associated with worse prognosis and longer hospital stay. Aims: To evaluate whether simple biochemical inflammatory and nutritional markers would differ between those with bedsores and those without in elderly stroke patients and if there is a distinction between recent bed sore stroke patients and old bed sore stroke patients as regard these biomarkers. Methods: 80 Stroke elderly patients were enrolled and divided into four groups: patients with recent stroke who developed bedsores, patients with recent stroke who did not develop bedsores, patients with old stroke who developed bedsores and patients with old stroke who did not develop bedsores. Nutritional markers (albumin, total protein, magnesium, iron, total iron binding capacity (TIBC), hemoglobin and cholesterol) and inflammatory markers (total leucocyte count, neutrophil to lymphocyte ratio and ferritin) were compared between the four groups. Results: Concerning nutritional markers, albumin (P =< 0.001), Alb/Pr ratio (P =< 0.001), TIBC (P =< 0.001) and cholesterol (P = 0.005) are lower in the acute stroke with bed sore patients versus acute stroke without bed sore. Lower albumin (P =< 0.001) is only found in comparison between chronic stroke with bed sore patients and chronic without bed sore patients. There is a difference between acute stroke with bed sore and chronic stroke with bed sore concerning albumin (P =< 0.001), TIBC (P =< 0.001) and TG (p =< 0.001). Albumin is lower while TG and TIBC are higher in those with acute stroke with bed sores. Regarding inflammatory markers, high neutrophil and ferritin (p =< 0.001) were found in acute stroke with bed sore patients versus acute stroke without bed sore. No difference was found between chronic stroke with bed sore patients and chronic stroke without bed sore patients. Acute stroke with bed sore group has higher TLC, neutrophil, neut/lymph ratio and ferritin (p =< 0.001) than chronic stroke with bed sore group. Conclusions: Acute stroke patients with bed sores are the highest group as regard inflammatory markers due to acute stroke and bed sores together. The presence of bed sore itself causes or is caused by decrease in nutritional markers especially albumin in both, acute and chronic strokes. Other markers are more evident in acute stroke patients who develop bed sore like higher ferritin and neutrophils and lower TIBC, alb/prot ratio and cholesterol. TG differs only in relation to acute stroke but not bed sore. MG was not different between the four groups.

Determining the effect of Plantago major L. and Rosa damascene herbal ointment for bedsore healing

Background:Bedsores are damage or loss of skin integrity due to prolonged pressure which there are several ways to treat and prevent them.The aim of the study was to determine the effect of Plantago major L.and Rosa damascene herbal ointment for bedsore healing in hospitalized patients.Methods:This clinical trial study was accomplished with 100 patients divided into control(50 patients)and intervention(50 patients)groups.The control group had received routine treatment(dressing with Comfeel),but the intervention group only had received herbal ointment and then both groups were compared with each other through the pressure ulcer scale for healing(PUSH)tool.Results:The mean and standard deviation of recovery time in the Comfeel group was 27.40±12.467 and in the herbal ointment group was 21.57±12.695.In the pre-intervention evaluation,the mean and standard deviation of the PUSH score in the herbal ointment group was 10.44±0.323 while in the last evaluation in the same group it was 0.68±0.288 but in the Comfeel group,in the pre-intervention evaluation,the mean and standard deviation of the PUSH score was 10.68±0.317,while in the last evaluation it was 1.98±0.472.The highest frequency of bedsores in the study units was in the sacral region(49%)and the lowest frequency was in the sole of the foot with 1%.Conclusion:The results showed that Plantago major L.and Rosa damascene herbal ointment was effective in accelerating recovery time and wound healing.