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I Sverige lider cirka 50 000, främst äldre personer av svårläkta bensår. Venös insufficiens är vanligaste sjukdom som orsakar svårläkta bensår. Behandlingen kan vara besvärlig och oftast påverkar patientens vardag. Syftet med studien var att beskriva patienters upplevelser av att leva med svårläkta bensår. En litteraturöversikt med kvalitativ ansats baserad på vetenskapliga artiklar genomfördes. Artiklarna söktes i databaser, analyserades och sammanställdes för att finna meningsbärande innehåll med utgångspunkten i patienters upplevelser. Resultatet visade att svårläkta bensår påverkade patienternas dagliga liv och välbefinnande på olika sätt och presenterades under fyra teman: Styrd av smärta, lukt och läckage i vardagen, Besvärlig behandling, Begränsningar som påverkar människans kroppsuppfattning, Betydelsen av vårdmötet. Patienterna hade negativa upplevelser av att leva med svårläkta bensår vilket orsakade mycket lidande och begränsade deras rörlighet och sociala liv. De upplevde dåligt självförtroende och en förlorad kontroll över sin egen kropp. Sjuksköterskor bör ha bättre förståelse för och ha kunskaper om hur det är att leva med svårläkta bensår för att ge en god patientcentrerad omvårdnad.

SYFTESyftet med studien var att beskriva sjuksköterskors erfarenheter av att behandla venösa bensår samt att beskriva undersökningsgruppen i de ingående artiklarna.BAKGRUNDBefolkningen ökar och människor lever längre vilket leder till att även bensår blir allt vanligare. Sjuksköterskor är omvårdnadsansvariga när det kommer till att behandla bensår och sjuksköterskors inställning och attityd till dessa patienter lägger grunden för hur behandlingen formas och utövas. En god omvårdnad ska skapas där sjuksköterskorska begränsa påfrestningarna och lidande för patienterna som uppstått på grund av deras bensår.METODFöreliggande studie är en beskrivande litteraturstudie som baseras på nio vetenskapliga artiklar med både kvantitativ och kvalitativ ansats. Databaserna Cinahl, Scopus och PubMed har systematiskt använts med sökningar mellan 2000 -2015.RESULTATSjuksköterskors erfarenheter av att behandla venösa bensår kunde delas in i tre övergripande teman. Dessa resulterade i de övergripande rubrikerna sjuksköterskorserfarenheter av patienters följsamhet, sjuksköterskors erfarenhet av upplevd kunskap och samarbete samt sjuksköterskors erfarenhet av känslor relaterat till behandling. Sjuksköterskor beskrev att behandla bensår kunde leda till en rad olika känslor och det fanns mycket som påverkade behandlingen, som patienters motvillighet och följsamhet, sjuksköterskors egen kunskap samt samarbetet med andra professioner.SLUTSATSSjuksköterskor visade brister i sitt ansvar vid behandling av bensår då de inte följer professionens etiska kod. Många sjuksköterskor erfor en otillräcklig kunskap inom bensårsbehandling och en motvillighet att ta sig an patienter med bensår, då de inte såg det som givande.

Song Jing-mei. / Thesis submitted in: December 1998. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1999. / Includes bibliographical references (leaves 141-156). / Abstract also in Chinese. / Title page --- p.i / Acknowledgments --- p.ii / Table of contents --- p.iii / Abbreviations --- p.viii / Abstract --- p.x / 摘要 --- p.xii / Chapter Chapter1 --- Introduction --- p.1 / Chapter Chapter2 --- Evaluation of Antiulcer Effect Exhibited by Hippophae rhamnoides Using Different Ulcer Models / Chapter 2.1 --- Introduction --- p.20 / Chapter 2.1.1 --- Ethanol-induced gastric lesions --- p.24 / Chapter 2.1.2 --- NSAID-induced gastric lesions --- p.24 / Chapter 2.1.3 --- Stress-induced gastric lesions --- p.25 / Chapter 2.1.4 --- Pylorus ligation-induced gastric lesions --- p.25 / Chapter 2.1.5 --- Acetic acid-induced chronic gastric ulcer --- p.26 / Chapter 2.1.6 --- Necrotizing agent-induced lesion model --- p.27 / Chapter 2.2 --- Materials and Methods / Chapter 2.2.1 --- Plant materials --- p.28 / Chapter 2.2.2 --- Identification of the plant --- p.28 / Chapter 2.2.3 --- Preparation of crude extract for animal studies --- p.28 / Chapter 2.2.4 --- Experimental animals --- p.31 / Chapter 2.2.5 --- Ethanol-induced gastric mucosal lesions --- p.31 / Chapter 2.2.6 --- Acidified aspirin-induced gastric lesions --- p.32 / Chapter 2.2.7 --- Water immersion plus restraint-induced stress lesion model --- p.32 / Chapter 2.2.8 --- Pylorus ligation-induced gastric lesions --- p.32 / Chapter 2.2.9 --- Acetic acid-induced chronic gastric ulcer --- p.34 / Chapter 2.2.10 --- Necrotizing agent-induced gastric lesions --- p.34 / Chapter 2.2.11 --- Test of acute toxicity of Hippophae --- p.35 / Chapter 2.2.12 --- Statistical analysis --- p.35 / Chapter 2.3 --- Results / Chapter 2.3.1 --- Effect of Hr extract on ethanol-induced gastric lesions --- p.36 / Chapter 2.3.2 --- Effect of Hr extract on aspirin-induced gastric damage --- p.39 / Chapter 2.3.3 --- Effect of Hr extract on stress-induced gastric lesions --- p.40 / Chapter 2.3.4 --- Effect of Hr extract on pylorus ligation-induced gastric injury --- p.43 / Chapter 2.3.5 --- Effect of Hr extract on acetic acid-induced chronic ulcer --- p.48 / Chapter 2.3.6 --- Effect of Hr extract on necrotizing agent-induced gastric damage --- p.54 / Chapter 2.3.7 --- Test of acute toxicity of Hr --- p.55 / Chapter 2.4 --- Discussion / Chapter 2.4.1 --- Cytoprotective effect of Hr against ethanol-induced lesions --- p.56 / Chapter 2.4.2 --- Preventive effect of Hr on NSAIDs-induced gastric lesions --- p.57 / Chapter 2.4.3 --- Inhibitory effect of Hr on stress-induced lesions --- p.58 / Chapter 2.4.4 --- Inhibitory effect of Hr extract on pylorus ligation-induced gastric lesions --- p.59 / Chapter 2.4.5 --- Healing effect of Hr extract on acetic acid-induced gastric ulcer --- p.60 / Chapter 2.4.6 --- Protective effect of Hr extract on necrotizing agent-induced gastric damage --- p.61 / Chapter 2.4.7 --- Summary --- p.61 / Chapter Chapter3 --- Study on Cytoprotective Effect of Hippophae rhamnoides on Ethanol-induced Gastric Damage / Chapter 3.1 --- Introduction --- p.63 / Chapter 3.2 --- Materials and Methods --- p.65 / Chapter 3.2.1 --- Chemicals and Instruments --- p.65 / Chapter 3.2.2 --- Test on effect of different concentrations of ethanol on gastric mucosa --- p.67 / Chapter 3.2.3 --- Examination of the gastric protective effect of Hr extract by different routes of administration --- p.68 / Chapter 3.2.4 --- Study on relationship between gastric protective effect of Hr extract and endogenous PGs --- p.68 / Chapter 3.2.5 --- Measurement of gastric mucosal blood flow (GMBF) --- p.69 / Chapter 3.2.6 --- Measurement of gastric secretion and acidity in gastric juice --- p.70 / Chapter 3.2.7 --- Measurement of gastric gastric emptying rate --- p.70 / Chapter 3.2.8 --- Measurement of pepsin content in gastric juice --- p.71 / Chapter 3.2.9 --- Measurement of protein content in gastric juice --- p.73 / Chapter 3.2.10 --- Measurement of mucus content on gastric wall --- p.75 / Chapter 3.2.11 --- Measurement of GSH content in gastric mucosa --- p.77 / Chapter 3.2.12 --- Measurement of PGE2 content in gastric mucosa --- p.79 / Chapter 3.2.13 --- Determination of protein content in gastric mucosa --- p.81 / Chapter 3.3 --- Results / Chapter 3.3.1 --- Test on gastric lesions induced by different concentrations of ethanol --- p.83 / Chapter 3.3.2 --- Effect of Hr extract on ethanol-induced gastric damage by different routes of administration --- p.83 / Chapter 3.3.3 --- Effect of Hr extract on GMBF and output of gastric acid --- p.85 / Chapter 3.3.4 --- Effect of Hr extract on gastric emptying rate --- p.87 / Chapter 3.3.5 --- Effect of Hr extract on gastric mucus --- p.88 / Chapter 3.3.6 --- Effect of Hr extract on gastric GSH content --- p.89 / Chapter 3.3.7 --- Influence of Hr extract on endogenous prostanglandin-E2 --- p.90 / Chapter 3.3.8 --- Antagonistic effect of indomethacin on the gastric protection of Hr extract --- p.91 / Chapter 3.4 --- Discussion / Chapter 3.4.1 --- Formation of gastric lesions induced by ethanol at different concentrations --- p.92 / Chapter 3.4.2 --- Different routes of administration --- p.92 / Chapter 3.4.3 --- "Role of GMBF, gastric acidity and acid output in the formation of gastric lesions" --- p.93 / Chapter 3.4.4 --- Effect of Hr extract on gastric motility --- p.95 / Chapter 3.4.5 --- Effect of Hr extract on gastric mucus --- p.96 / Chapter 3.4.6 --- Effect of Hr extract on gastric GSH content --- p.96 / Chapter 3.4.7 --- Effect of Hr extract on endogenous prostaglandins --- p.98 / Chapter 3.4.8 --- Summary --- p.99 / Chapter Chapter 4 --- Study on plant constituents of Hippophae rhamnoides / Chapter 4.1 --- Introduction --- p.100 / Chapter 4.2 --- Materials and Methods --- p.100 / Chapter 4.2.1 --- Plant Materials --- p.100 / Chapter 4.2.2 --- Plant Extraction --- p.101 / Chapter 4.2.3 --- Fractionation of hexane-extract by column chromatography --- p.103 / Chapter 4.2.4 --- Phytochemical identification and analyses of vitamin content in Hr extract --- p.104 / Chapter 4.2.4.1 --- Identification of vitamin A and vitamin C in the Hr extract by TLC --- p.104 / Chapter 4.2.4.2 --- Identification of α-tocopherol and γ-tocopherol by HPLC --- p.105 / Chapter 4.2.4.3 --- Analyses of the content of α-tocopherol in the Hr extract --- p.108 / Chapter 4.2.4.4 --- Identification and analysis of fatty acid in the Hr fractions --- p.111 / Chapter 4.2.4.4.1 --- Esterification of fatty acids --- p.111 / Chapter 4.2.4.4.2 --- Isolation and identification of FAME by GC-MS --- p.111 / Chapter 4.2.4.5 --- Quantitative analysis of composition and relative content of fatty acid in the Hr fractions --- p.112 / Chapter 4.3 --- Results / Chapter 4.3.1 --- Phytochemical analysis and identification --- p.114 / Chapter 4.3.1.1 --- Identification of vitamin A --- p.114 / Chapter 4.3.1.2 --- Identification of vitamin C --- p.115 / Chapter 4.3.1.3 --- Identification of α-tocopherol and γ-tocopherol --- p.116 / Chapter 4.3.1.4 --- Quantitative analysis of α-tocopherol content in the Hr extract --- p.117 / Chapter 4.3.1.5 --- Identification of fatty acid composition --- p.117 / Chapter 4.3.1.6 --- Analysis of relative content of fatty acids in the Hr extract --- p.122 / Chapter 4.3.1.7 --- Study on phytosterols of Hr --- p.124 / Chapter 4.3.2 --- Examination of antiulcer effect of Hr fractions against ethanol-induced gastric lesions --- p.124 / Chapter 4.3.2.1 --- Effect of different extracts of Hr seed on ethanol-induced gastric lesions --- p.125 / Chapter 4.3.2.2 --- Effect of fractions of hexane-extract of Hr on gastric lesions induced by ethanol --- p.126 / Chapter 4.3.2.3 --- Effect of Hr components on gastric lesions induced by different ulcer models --- p.127 / Chapter 4.3.2.3.1 --- Effect of Hr components on ethanol-induced lesions --- p.127 / Chapter 4.3.2.3.2 --- Effect of Hr components against stress-induced gastric lesions --- p.128 / Chapter 4.3.2.3.3 --- Effect of β-sitosterol against gastric lesions induced by pylorus ligation --- p.129 / Chapter 4.4 --- Discussion / Chapter 4.4.1 --- Role of fatty acids in the stomach protection --- p.130 / Chapter 4.4.2 --- Role of vitamins in the gastric protection --- p.133 / Chapter 4.4.3 --- Role of plant terpenoids in the stomach --- p.134 / Chapter 4.4.4 --- Summary --- p.135 / Chapter Chapter 5 --- General discussion --- p.136 / References --- p.141

A live animal model of major haemorrhage using an implanted short gastric artery was devised to test the efficacy and safety of these endo-suture devices in vivo. Pulsatile arterial bleeding was successfully reproduced in eight pigs' stomachs through incision of the pre-buried vessels. Endoscopic suturing controlled the bleeding in all animals without obvious complications. The mean operating time with the Eagle Claw V was statistically shorter than that with the Eagle Claw II machine (3.6 verse 13.8 minutes, p<0.001). / A vessel-perfusion-manometry system was first established incorporating porcine stomach and splenic artery with the Erlangen model. / From these investigations, it is concluded that (1) Both the vessel-perfusion-manometry system and the animal arterial haemorrhage model are reliable, reproducible and realistic methods suitable for endoscopic experiment in the laboratory settings. (2) Either three-throw knot tied endoscopically or intracorporeal endo-loop ligation can secure vessels as large as 2mm in diameter enduring flow pressure greater than 200 mmHg. (3) It is possible to control massive arterial bleeding in stomach with endoscopic suturing using the novel apparatus with a curved needle. (4) The Eagle Claw V represents significant improvement over previous version, and is associated with ease of operation and higher security, which brings the technique closer to clinical applications. (Abstract shortened by UMI.) / Peptic ulcer remains the most common cause of upper gastrointestinal haemorrhage. Existing endoscopic haemostatic modalities cannot securely control massive ulcer bleeding from large eroded vessels. A well-designed endoscopic suturing device has the possibility to plicate large artery. In addition, it may provide enormous potential in other forms of endo-surgery. A novel suturing device using a curved needle, the Eagle Claw, was developed. The aims of this thesis were to evaluate the efficacy and safety of the Eagle Claw II and V in arresting artificial gastric bleeding from large vessel in a laboratory setting. These devices were tested both in vitro on the bench and in vivo in live animal models. / Hu Bing. / "August 2005." / Adviser: Ng Ekw. / Source: Dissertation Abstracts International, Volume: 67-07, Section: B, page: 3694. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (p. 136-160). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract in English and Chinese. / School code: 1307.

by Lau Wan Yee, Joseph. / Thesis (M.D.)--Chinese University of Hong Kong, 1995. / Includes bibliographical references (leaves 145-189). / Title Page --- p.1 / Dedication --- p.2 / Table of Contents --- p.3 / Hypotheses --- p.7 / Precis to the thesis --- p.8 / List of Publications of my research work used in this thesis --- p.19 / List of Figures --- p.25 / List of Tables --- p.26 / Acknowledgments --- p.27 / Statement of Originality --- p.28 / Chapter PART I --- HISTORICAL REVIEW --- p.30 / Chapter Chapter 1 --- History of Endoscopic and Laparoscopic Surgery --- p.31 / Chapter 1.1 --- History of Endoscopic Surgery --- p.31 / Chapter 1.2 --- History of Documentation of Endoscopic and Laparoscopic Surgery --- p.38 / Chapter 1.3 --- History of Laparoscopic Surgery --- p.39 / Chapter 1.4 --- The future of Endoscopic and Laparoscopic Surgery --- p.52 / Chapter Chapter 2 --- History of Perforated Peptic Ulcer --- p.53 / Chapter PART II --- SIZE OF THE PROBLEM --- p.57 / Chapter Chapter 1 --- Incidence of Feptic Ulcer in Different Parts of The World --- p.58 / Chapter Chapter 2 --- Incidence of Peptic Ulcer in Hong Kong 1970 -1993 --- p.60 / Chapter Chapter 3 --- Incidence of Perforated Peptic Ulcer --- p.70 / Chapter 3.1 --- Incidence of Perforated Peptic Ulcer in Different Parts of The World --- p.70 / Chapter 3.2 --- Incidence of Perforated Peptic Ulcer in Hong Kong --- p.71 / Chapter 3.3 --- "Incidence of Perforated Peptic Ulcer in Prince of Wales Hospital, Hong Kong" --- p.71 / Chapter PART III --- CURRENT TREATMENT OF PERFORATED PEPTIC ULCER --- p.74 / Chapter Chapter 1 --- Recent Developments in Treatment of Uncomplicated Peptic Ulcer --- p.75 / Chapter Chapter 2 --- My Contributions to the Medical Treatment of Uncomplicated Peptic Ulcer --- p.78 / Chapter Chapter 3 --- Review on Current Treatment of Perforated Peptic Ulcer --- p.79 / Chapter 3.1 --- Introduction --- p.79 / Chapter 3.2 --- Currently Available Treatment Options --- p.80 / Chapter 3.2.1 --- Perforated Duodenal Ulcer --- p.81 / Chapter [A] --- Nonoperative Treatment --- p.81 / Chapter [B] --- Laparotomy and patch repair --- p.83 / Chapter [C] --- Definitive Ulcer Surgery --- p.84 / Chapter [D] --- Laparoscopic Treatment --- p.87 / Chapter 3.2.2 --- Perforated Gastric Ulcer --- p.89 / Chapter PART IV --- DEVELOPMENT OF LAPAROSCOPIC REPAIR OF PERFORATED PEPTIC ULCER IN OUR CENTRE --- p.91 / Chapter Chapter 1 --- Development of the Technique of Laparoscopic Suture Repair of Perforated Peptic Ulcer --- p.92 / Chapter 1.1 --- Surgical Technique --- p.93 / Chapter 1.2 --- Initial Results of Laparoscopic Suture Repair --- p.95 / Chapter Chapter 2 --- Development of the Technique of Laparoscopic Sutureless Repair of Perforated Peptic Ulcer --- p.98 / Chapter 2.1 --- Animal Studies --- p.98 / Chapter [A] --- Pilot Animal Study --- p.99 / Chapter [B] --- Mortality Rate on Different Methods of Repair of the Perforations --- p.100 / Chapter [C] --- Strength of the Repair Site by Studying the Bursting Pressure --- p.103 / Chapter [D] --- Detailed Histological Study --- p.108 / Chapter 2.2 --- Clinical Studies --- p.111 / Chapter [A] --- Surgical technique of Laparoscopic Sutureless Repair --- p.113 / Chapter [B] --- Initial Results of Laparoscopic Sutureless Repair --- p.114 / Chapter PART V --- TESTING THE HYPOTHESES OF THIS THESIS --- p.117 / Chapter Chapter 1 --- A Non-randomised Clinical Study --- p.119 / Chapter Chapter 2 --- A Randomised Clinical Study --- p.126 / Chapter PART VI --- CONCLUSIONS --- p.140 / Chapter PART VII --- THE FUTURE OF LAPAROSCOPIC REPAIR OF PERFORATED PEPTIC ULCER --- p.142 / Chapter PART VIII --- REFERENCES --- p.145 / References to the Precis --- p.146 / References to Part I Chapter 1 --- p.147 / References to Part I Chapter2 --- p.157 / References to Part II --- p.162 / References to Part III --- p.168 / References to Part IV --- p.183 / References to Part V --- p.186 / References to Part VII --- p.189 / APPENDIX I BRIEF SUMMARY OF MY CONTRIBUTIONS TO THE MEDICAL TREATMENT OF UNCOMPLICATED PEPTIC ULCER --- p.190

Bakgrund: En kombination av olika riskfaktorer och ett yttre tryck bidrar till att patienter drabbas av trycksår. Sjuksköterskor i samarbete med undersköterskor ansvarar för att förhindra risken för trycksår hos patienter. Tidigare studie påvisar att femton procent av inneliggande patienter på sjukhus drabbas av trycksår. Syfte: Syftet med studien är att belysa varför patienter får trycksår trots att sjuksköterskan i samarbete med undersköterskan bör ha kunskaper för att förebygga vårdrelaterade trycksår. Metod: Författarna använder sig av metoden allmän litteraturöversikt. Tolv artiklar med både kvalitativ och kvantitativ ansats ligger till grund för resultatet. Resultat: Resultatet påvisar tre huvudteman som påverkar det förebyggande arbetet av vårdrelaterade trycksår. Dessa teman är kunskaper angående trycksårsprevention, hinder i trycksårspreventionen och personalrelaterade faktorer. Diskussion: De huvudteman och subteman som framkommer i resultatet är bidragande faktorer till att patienter i dag utvecklar vårdrelaterade trycksår. Faktorerna bidrar även till ett ökat vårdlidande för patienten. Ett lidande som kan undvikas om ett gott förebyggande arbete utförs. / Background: A combination of risk factors and external pressure might cause a patient suffering from pressure ulcer. Health-care professionals who work close to patients are responsible for preventing the risk of pressure ulcer. A study found that fifteen percent of hospitalized patients suffer from pressure ulcer. Aim: The aim of this study is to highlight why patients have pressure ulcers even though the nurse in collaboration with the assistant nurse should have the knowledge to prevent health care associated pressure ulcer. Method: This study is a literature review. Twelve articles, of both quantitative and qualitative approach, was found and included in the results. Results: The result shows three main themes that seems to influence the pressure ulcer prevention. These themes are knowledge in pressure ulcer prevention, barriers in pressure ulcer prevention and personnel-related factors. Discussion: The main themes and subthemes that emerged from the results are contributing factors to patients today are developing healthcare associated pressure ulcers. These factors also contribute to an increased care associated suffering for the patient. A suffering that can be avoided if a good preventive work are performed.

Diss. (sammanfattning) Stockholm : Karol. inst., 2006. / Härtill 4 uppsatser.

Thesis (Ph.D. in Nursing) -- University of Colorado Denver, 2007. / Typescript. Includes bibliographical references (leaves 195-207). Free to UCD affiliates. Online version available via ProQuest Digital Dissertations;