Joseph P Corallo

University of Miami Miller School of Medicine, Miami, Florida, United States

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Publications (5)4.41 Total impact

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    ABSTRACT: The purpose of this study was to compare retention cuff pressures of 3 indwelling stool management systems while subjects assumed different body positions and while cuffs were inflated to different volumes. Retention cuff pressure study of 3 indwelling stool management systems was a randomized, crossover, open-label pilot study of 10 healthy adult volunteers in 3 body positions (supine, right side, and left side), 3 head-of-bed elevations (20°, 30°, and 40°), and 3 cuff overfill volumes (5, 10, and 15 mL). The devices were DigniCare Stool Management System (device A; Bard Medical Division, C. R. Bard, Inc, Covington, Georgia), Flexi-Seal Fecal Management System (device B; ConvaTec, a division of E. R. Squibb & Sons, LLC, Princeton, New Jersey), and ActiFlo Indwelling Bowel Catheter System (device C; Hollister, Inc, Libertyville, Illinois). We assessed cuff pressure by manometry and rectal mucosa by digital examination and small-diameter, flexible endoscopy. Cuffs were appropriately seated in the rectal vault for all 3 devices in all body positions and overfill volumes. Rectal mucosal abnormalities were observed in 4 of 10 subjects (40%) after removal of device A, 1 of 5 (20%) after removal of device B, and 3 of 5 (60%) after removal of device C. Retention cuff pressure was at least 2-fold lower for device A than for device B or C in all body positions, head-of-bed elevations, and device overfill volumes. For example, mean pressure while subjects were on their left sides was 25.0 mm Hg for device A, 79.2 mm Hg for device B, and 67.2 mm Hg for device C. Corresponding pressures at 15 mL of overfill were 52.5, 102.0, and 94.0 mm Hg. Subject comfort scores were comparable for all 3 devices. All devices appeared to seat well within the rectal vault, but device A was associated with cuff pressure measurements that were consistently lower than those of devices B and C. More studies are needed to elucidate the clinical relevance of these findings and whether they translate to differences in patient safety or comfort.
    Journal of wound, ostomy, and continence nursing: official publication of The Wound, Ostomy and Continence Nurses Society / WOCN 08/2011; 38(5):569-73. DOI:10.1097/WON.0b013e31822ad43c · 1.18 Impact Factor
  • Louis R Pizano · Joseph P Corallo · Jennifer Davies
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    ABSTRACT: There are an estimated 1.2 million burn injuries per year in the United States, one third of which occur in children. Most of these injuries will be treated nonoperatively, frequently in an outpatient setting. This article aims to provide the practitioner with a understanding of the pathophysiology of burn injuries, a guide to the initial assessment of the patient, and management recommendations for nonoperative treatment of the burned pediatric patient.
    The Journal of craniofacial surgery 07/2008; 19(4):877-81. DOI:10.1097/SCS.0b013e318175b5ee · 0.68 Impact Factor
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    ABSTRACT: Burn injuries continue to be a significant cause of pediatric morbidity in the United States, with approximately 20,000 admissions per year to centers specializing in the treatment of burn injuries. In this article, we aim to provide the practitioner with a guideline to the unique challenges, advances and current expectations, and treatment in this patient population.
    The Journal of craniofacial surgery 07/2008; 19(4):929-32. DOI:10.1097/SCS.0b013e318175f3cd · 0.68 Impact Factor
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    ABSTRACT: Staged excision and grafting remains the mainstay of the surgical treatment of large burn injuries since Jackson and colleagues demonstrated a decreased mortality with excisions of 20% or less in 1960 [1]. The major factors limiting these excisions are blood loss and hypothermia. Despite these known limitations, little progress had been made in combating the hypothermia that comes with a large excision. The current re-warming strategies include: increasing ambient room temperature, infusing warm intravenous fluids, and using hot air technologies such as the Bair Hugger (TM), but no single solution or combination of solutions has proven adequate (2). Recently at our institution, a new intravascular warming catheter was used to perform a large burn excision with excellent results.
    Burns 06/2008; 34(3):418-20. DOI:10.1016/j.burns.2007.08.012 · 1.88 Impact Factor
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    ABSTRACT: Background: Fecal incontinence and diarrhea are common in critically ill patients and, if unmanaged, may lead to incontinence-associated dermatitis. Management of these patients can be labor intensive and complex. Several stool management systems (SMS) designed to divert and contain semi-liquid/liquid feces are now available and their clinical use is increasing. SMS utilize a retention cuff designed to maintain placement in the rectal vault; however, tissue damage has been reported. Methods: This study was designed to measure retention cuff pressure of three commercially available SMS. Ten healthy subjects were enrolled; all subjects received Device A and were randomized to receive either Device B or Device C. Pressure measurements were taken with the subject in various positions (e.g., side, supine, elevated head-of-bed). Endoscopic examination was also performed before, during, and after SMS placement to assess rectal vault tissue and cuff seating. Results: Overall, mean cuff pressure for Device A was 31 mm/Hg (16-48 mm/Hg), for Device B was 81 mm/Hg (60-106 mm/Hg), and for Device C was 73 mm/Hg (58-88 mm/Hg). These differences were statistically significant (p<0.05). Cuff pressures were lowest when the subjects were on their side; pressure increased when the subjects were in a supine position and when the head-of-bed was elevated. There were no endoscopically detectable differences in cuff seating between the three SMS; however, function was not assessed in this study. Conclusions: SMS examined in our study utilize different retention cuff designs. While all appear to seat well within the rectal vault, there were significant differences in pressure measurements. Low cuff pressure devices may transmit less pressure to the rectal mucosa; however, the clinical relevance of these cuff pressure differences is not yet known.
    42th Annual Conference of the Wound, Ostomy and Continence Society 2010;