A Comprehensive Review Of Hospital-Wide Early Mobility Protocols In Saudi Arabia: A Blueprint For Interdepartmental Collaboration To Reduce Patient Deconditioning
VOLUME 21, 2024
The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review
VOLUME 6, 2023
Abdullah Mohammed Aldossari, Bader Mohammed Abokayan, Nader Barki Alotaibi, Fisal Fayez Aladhyani, Sultan Awad Almutairi, Mohsin Safar Albakkar, Ahmad Saud Almotiri, Fahd Saeed Abdullah Alshahrani, Sultan Mohammed Abuqayyan
Abstract
Early mobility (EM) guidelines on a hospital-wide scale are essential in avoiding patient deconditioning, which is typified by muscle atrophy, worsening of functional ability, and extended hospitalization because of immobility. EM has been implemented in intensive care units (ICUs) in Saudi Arabia, with the benefits of this intervention being a decrease in delirium, a reduction in the duration of mechanical ventilation, and better functional outcomes (Alshahrani et al., 2022; Alqahtani et al., 2021). It is a review of evidence regarding EM prevalence, which indicates that in the case of ICUs of mechanically ventilated patients, the absence of protocols (55%), insufficient training (64% untrained staff), and resource constraints (Alshahrani et al., 2022; Al Harbi, 2024) lead to prevalence rates of about 47%. Hospital-wide expansion requires interdepartmental cooperation of nursing, physiotherapy, respiratory therapy, and other fields. The review suggests a multidisciplinary roadmap comprising of standardized protocols, training, and resource distribution to facilitate Vision 2030 healthcare goals with reduced instances of deconditioning complications and equity.
Keywords :
Early mobility protocols, patient deconditioning, interdepartmental collaboration, intensive care units, Saudi Arabia, multidisciplinary rehabilitation, ICU-acquired weakness, Vision 2030.
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.
Abstract
Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords :
Diabetic foot ulcer, angiosome, angioplasty