Application of Self-Adhesive Soft Silicone Common Foam Dressing in Reducing Intraoperative Pressure Ulcers in Elderly ICU Patients

Pressure ulcer (PU), also called pressure injury, is localized damage to the skin and underlying soft tissues, usually over bony prominences, as a result of sustained mechanical loads applied to the tissues. However, in many situations, complete off-loading of sacral PUs is not possible. Minimising the exposure of wounds and their surroundings to elevated mechanical loads is crucial for healing. We for the first time reported the application of Meipicang in the prevention and treatment of intraoperative pressure ulcers in elderly ICU patients with severe illness. We found that the pressure ulcer risk score ( 20.15 ± 2.17 ) in the dressing group after intervention was higher than that ( 17.42 ± 3.62 ) in the regular group. The incidence of pressure sores in the dressing group was 3.77% lower than the 18.88% in the regular group. The psychological concern score ( 31.41 ± 3.15 ) of the dressing group was higher than that ( 26.92 ± 3.43 ) of the regular group. The trust score ( 29.57 ± 2.61 ) of the dressing group was higher than the score ( 24.28 ± 2.29 ) of the regular group. The score of physiological problems in the dressing group ( 34.69 ± 3.82 ) is higher than that in the regular group ( 29.88 ± 3.54 ). The skin complication rate of the dressing group was 5.56% lower than that of the regular group (22.64%). The comfort score (92.46 ± 4.15) of the dressing group was higher than that ( 80.59 ± 5.43 ) of the regular group. The nursing satisfaction score ( 94.53 ± 3.72 ) of the dressing group was higher than that ( 81.79 ± 4.61 ) of the regular group. To conclude, in this study, we found that the Meipicang dressing can reduce the incidence of pressure ulcers in ICU patients with severe ICU and improve the comfort and nursing satisfaction of elderly ICU patients with severe ICU, which is worthy of promotion.

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Pressure ulcers: the core, care and cure approach

British Journal of Community Nursing ◽

10.12968/bjcn.2019.24.sup12.s38 ◽

2019 ◽

Vol 24 (Sup12) ◽

pp. S38-S42 ◽

Cited By ~ 2

Author(s):

Adi Subrata Sumarno

Keyword(s):

Pressure Ulcer ◽

Health Problem ◽

Pressure Ulcers ◽

Three Dimensions ◽

Comprehensive Care ◽

Nursing Theory ◽

Injury Management ◽

The Core ◽

Pressure Injury ◽

Significant Health

Pressure ulcer/injury remains a significant health problem in the community, requiring comprehensive care. Nurses are involved in the management and prevention of pressure injury. However, to date, studies focusing on applying nursing theory to pressure ulcer care have been limited. In the present study, the three dimensions of Lydia Hall's 1964 theory—core, care and cure—are extensively discussed and linked with the practice of pressure injury management. It is hoped that this review will help community nurses understand the application of this nursing theory to the prevention and management of pressure injury.

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Teste de conhecimento sobre lesão por pressão

Revista de Enfermagem UFPE on line ◽

10.5205/1981-8963-v12i6a234578p1738-1750-2018 ◽

2018 ◽

Vol 12 (6) ◽

pp. 1738

Author(s):

Adriana Montenegro de Albuquerque ◽

Josilene De Melo Buriti Vasconcelos ◽

Ana Paula Marques Andrade de Souza ◽

Tereza Raquel Costa de Lima Chaves ◽

Isabelle Katherinne Fernandes Costa ◽

...

Keyword(s):

Pressure Ulcer ◽

Health Professionals ◽

Pressure Ulcers ◽

Test Method ◽

Knowledge Test ◽

Level Of Evidence ◽

Hospital Units ◽

Knowledge Deficit ◽

Pressure Injury ◽

Terapia Intensiva

RESUMOObjetivo: analisar a produção científica referente à utilização do Teste de Conhecimento sobre Úlcera por Pressão. Método: revisão integrativa, realizada entre os meses de março e julho de 2017, norteada pela questão << Quais as produções científicas sobre úlcera por pressão que utilizaram o Teste de Conhecimento? >> Realizou-se busca nas bases de dados SCOPUS, CINAHL, MEDLINE, BDENF e LILACS, no período de 1995 a 2017, com descritores “nursing”, “prevention pressure ulcers” e “knowledge”, utilizando o boleano “and”. Foram incluídos artigos originais nos idiomas português e inglês, publicados na íntegra e disponíveis eletronicamente. Resultados: foram identificadas 22 publicações, 12 nacionais e 10 internacionais, a maioria produzida em 2015 (27,3%), predomínio no nível de evidência VI, aplicando o teste, realizado, prioritariamente, em terapia intensiva e setores críticos, nos hospitais universitários e privados, contemplando profissionais de enfermagem e de outras áreas da saúde. Conclusão: é indiscutível o deficit de conhecimento por parte dos profissionais de saúde, em unidades críticas hospitalares sobre avaliação, estadiamento e prevenção da lesão por pressão utilizando o instrumento. Descritores: Conhecimento; Úlcera por Pressão; Enfermagem; Prevenção; Educação Continuada; Cuidados Críticos. ABSTRACT Objective: to analyze the scientific production regarding the use of the Pressure Ulcer Knowledge Test. Method: this is an integrative review, conducted between March and July 2017, guided by the question << What are the scientific productions about pressure ulcer used by the Knowledge Test? >> There was a search in the databases SCOPUS, CINAHL, MEDLINE, BDENF, and LILACS, from 1995 to 2017, with descriptors “nursing”, “prevention pressure ulcers” and “knowledge”, using the Boolean “and”. Original articles have been included in Portuguese and English, published in full and electronically available. Results: there were 22 publications, 12 national and 10 international identified, most of them produced in 2015 (27.3%), predominantly in the level of evidence VI, applying the test, carried out primarily in intensive care and critical sectors, in university and private hospitals, including nurses and other health professionals. Conclusion: the knowledge deficit by health professionals in critical hospital units on evaluation, staging, and prevention of pressure injury using the instrument is indisputable. Descriptors: Knowledge; Pressure Ulcer; Nursing; Prevention; Continuing Education; Critical Care.RESUMEN Objetivo: analizar la producción científica referente a la utilización del Test de Conocimiento sobre Úlcera por Presión. Método: revisión integradora, realizada entre los meses de marzo y julio de 2017, guiada por la pregunta << Cuáles son las producciones científicas sobre úlcera por presión que utilizaron el Test de Conocimiento? >> Se realizo un búsqueda en las bases de datos SCOPUS, CINAHL, MEDLINE, BDENF y LILACS, en el período de 1995 a 2017, con descriptores “nursing”, “prevention pressure ulcers” y “knowledge”, utilizando el boleano “and”. Fueron incluidos artículos originales en los idiomas portugués e inglés, publicados en su íntegra y disponibles electrónicamente. Resultados: fueron identificadas 22 publicaciones, 12 nacionales y 10 internacionales, la mayoría producida en 2015 (27,3%), predominio em el nivel de evidencia VI, aplicando el test, realizado, prioritariamente, en terapia intensiva y sectores críticos, en los hospitales universitarios y privados, contemplando profesionales de enfermería y de otras áreas de la salud. Conclusión: es indiscutible el deficit de conocimiento por parte de los profesionales de salud, en unidades críticas hospitalares sobre evaluación, fases y prevención de la lesión por presión utilizando el instrumento. Descriptores: Conocimiento; Úlcera por Presión; Enfermería; Prevención; Educación Continua; Cuidados Críticos.

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Managing the Prevention of Skin Breakdown

Adult Nursing Practice ◽

10.1093/oso/9780199697410.003.0038 ◽

2012 ◽

Author(s):

Andrea Nelson

Keyword(s):

Cardiovascular Disease ◽

Pressure Ulcer ◽

Pressure Ulcers ◽

Foot Ulcers ◽

Severe Illness ◽

Advisory Panel ◽

Nursing Management ◽

Nursing Role ◽

Skin Breakdown

This chapter addresses the fundamental role of nurses in the prevention of skin breakdown. Every nurse should possess the knowledge and skills to identify people at risk of skin breakdown, to select and implement strategies to maintain skin integrity, and to review the effectiveness of these to inform any necessary changes in care. Skin breakdown is associated with long-term conditions such as diabetes, cardiovascular disease, and spinal cord injury, and with acute illnesses that cause mobility restriction such as surgery and severe illness. Diabetes is associated with foot ulcers, cardiovascular disease with leg ulcers, and acute or long-term mobility restriction is associated with pressure ulcers. This chapter focuses on these three categories of skin breakdown and illuminates the key responsibilities carried by nurses in each of these areas. The first section of this chapter provides detailed guidance on the nursing management of pressure ulcer prevention. This is followed by a subsidiary section on the prevention of diabetic foot ulcers. The final section provides a short overview of the nursing role in preventing or managing venous ulceration. Pressure ulcers, which are also called pressure sores, bed sores, and decubitus ulcers, have been defined as:…localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear. (European Pressure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel, 2010)…Pressure ulcers may present as persistent redness (where the skin is damaged, but not yet broken), blisters, shallow sores, or necrotic wounds extending to the muscle and bone. An ‘avoidable pressure ulcer’ is one that developed and the provider of care did not do one of the following:…● evaluate the person’s clinical condition and pressure ulcer risk factors; ● plan and implement interventions consistent with the person’s needs and goals, and recognize standards of practice; ● monitor and evaluate the impact of the interventions; or ● revise the interventions as appropriate….

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Hospital acquired pressure injury prediction in surgical critical care patients

BMC Medical Informatics and Decision Making ◽

10.1186/s12911-020-01371-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jenny Alderden ◽

Kathryn P. Drake ◽

Andrew Wilson ◽

Jonathan Dimas ◽

Mollie R. Cummins ◽

...

Keyword(s):

Risk Assessment ◽

Model Performance ◽

Routine Care ◽

Predictor Variables ◽

Classification Algorithms ◽

Data Set ◽

Icu Patients ◽

Pressure Injury ◽

Surgical Icu ◽

Hospital Acquired

Abstract Background Hospital-acquired pressure injuries (HAPrIs) are areas of damage to the skin occurring among 5–10% of surgical intensive care unit (ICU) patients. HAPrIs are mostly preventable; however, prevention may require measures not feasible for every patient because of the cost or intensity of nursing care. Therefore, recommended standards of practice include HAPrI risk assessment at routine intervals. However, no HAPrI risk-prediction tools demonstrate adequate predictive validity in the ICU population. The purpose of the current study was to develop and compare models predicting HAPrIs among surgical ICU patients using electronic health record (EHR) data. Methods In this retrospective cohort study, we obtained data for patients admitted to the surgical ICU or cardiovascular surgical ICU between 2014 and 2018 via query of our institution's EHR. We developed predictive models utilizing three sets of variables: (1) variables obtained during routine care + the Braden Scale (a pressure-injury risk-assessment scale); (2) routine care only; and (3) a parsimonious set of five routine-care variables chosen based on availability from an EHR and data warehouse perspective. Aiming to select the best model for predicting HAPrIs, we split each data set into standard 80:20 train:test sets and applied five classification algorithms. We performed this process on each of the three data sets, evaluating model performance based on continuous performance on the receiver operating characteristic curve and the F1 score. Results Among 5,101 patients included in analysis, 333 (6.5%) developed a HAPrI. F1 scores of the five classification algorithms proved to be a valuable evaluation metric for model performance considering the class imbalance. Models developed with the parsimonious data set had comparable F1 scores to those developed with the larger set of predictor variables. Conclusions Results from this study show the feasibility of using EHR data for accurately predicting HAPrIs and that good performance can be found with a small group of easily accessible predictor variables. Future study is needed to test the models in an external sample.

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From the Cochrane Library: Foam surfaces for preventing pressure ulcers (Preprint)

10.2196/preprints.34112 ◽

2021 ◽

Author(s):

Yvonne Nong ◽

Torunn Sivesind ◽

Robert P. Dellavalle

Keyword(s):

Systematic Review ◽

Pressure Ulcer ◽

Pressure Ulcers ◽

Cochrane Library ◽

Cochrane Systematic Review ◽

Pressure Ulcer Prevention ◽

The Cochrane Library ◽

Ulcer Prevention

UNSTRUCTURED This article summarizes an important Cochrane systematic review on the evidence of foam surfaces for pressure ulcer prevention.

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Assessing Pressure Injury Knowledge Using the Pieper-Zulkowski Pressure Ulcer Knowledge Test

Advances in Skin & Wound Care ◽

10.1097/01.asw.0000540071.45158.29 ◽

2018 ◽

Vol 31 (9) ◽

pp. 406-412 ◽

Cited By ~ 6

Author(s):

Barbara Delmore ◽

Elizabeth A. Ayello ◽

Hiske Smart ◽

R. Gary Sibbald

Keyword(s):

Pressure Ulcer ◽

Knowledge Test ◽

Pressure Injury

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Prevention and treatment of pressure sore following spinal cord injury

Journal of Korean Medical Association ◽

10.5124/jkma.2020.63.10.623 ◽

2020 ◽

Vol 63 (10) ◽

pp. 623-632

Author(s):

Myeong Ok Kim

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Pressure Ulcer ◽

Wound Care ◽

Pressure Sore ◽

Therapeutic Interventions ◽

Advisory Panel ◽

Pressure Sores ◽

Cord Injury ◽

Pressure Injury

Pressure sores or pressure injury is a serious complication of a spinal cord injury (SCI), representing a challenging problem for patients, their caregivers, and their physicians. Persons with SCI are vulnerable to pressure sores throughout their life. Pressure sores can potentially interfere with the physical, psychosocial, and overall quality of life. Outcomes directly depend on education and prevention along with conservative and surgical management. Therefore, it is very important to understand everything about pressure sores following SCI. This review covers epidemiology, cost, pathophysiology, risk factors, staging, evaluation tools, prevention, education, conservative wound care methods, surgical treatment, and future trends in wound healing related to post-SCI pressure sores. A change in nomenclature was adopted by the National Pressure Ulcer Advisory Panel in 2016, replacing “pressure ulcer”with “pressure injury.” New concepts of pressure injury staging, such as suspected deep tissue injuries and unstageable pressure injuries, were also introduced. A systematic evidence-based review of the prevention of and therapeutic interventions for pressure sores was also discussed.

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Analysis of epidemiological characteristics and surgical treatment of patients with pressure ulcer

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh200319093p ◽

2021 ◽

pp. 93-93

Author(s):

Dragana Petrovic-Popovic ◽

Milan Stojicic ◽

Maja Nikolic-Zivanovic

Keyword(s):

Surgical Treatment ◽

Pressure Ulcer ◽

Traffic Accidents ◽

Pressure Ulcers ◽

Stage Iv ◽

Clinical Center ◽

Bony Prominence ◽

The University ◽

Epidemiological Characteristics ◽

Reconstructive Methods

Introduction/Objective. A pressure ulcer is a localized injury to the skin and/or underlying tissue, usually over a bony prominence. It appears as a result of pressure or combination of pressure and shear. Pressure ulcers can be identified within a wide variety of patient subpopulations and a major role in their treatment plays epidemiological and etiological aspects. Methods. A retrospective study of data analysis included 72 patients with pressure ulcers that were hospitalized and surgically treated during a five-year period at the Clinic for Burns, Plastic and Reconstructive Surgery of the University Clinical Center of Serbia in Belgrade. Main data features used in the analysis were: gender, age, principal diseases, comorbidities and biochemical indicators of malnutrition. The patients' data was obtained from the existing patients? records. Additionally, the study analyzed the method of treating pressure ulcers, types of reconstructive methods in surgical treatment, as well as the incidence rate of partial osteotomy. Results. A total of 72 patients with pressure ulcers were included into this study with 54.7 ? 16.1 mean age. Three times more patients injured in traffic accidents were male (75% vs. 25%), while the most of the patients with multiple sclerosis were female (85.7%). More than 95% of patients who had pressure ulcers of III or IV stage were treated surgically with a reconstructive method of transposition or rotation myocutaneous flap. The patient with pressure ulcer of stage IV was usually treated with partial osteotomy. Conclusion. A surgical reconstructive treatment with fasciocutaneous and myocutanaeous flaps represents a gold standard for treating patients with pressure ulcers. These procedures provide reconstruction with adequate flap coverage and obliteration of dead space with well-vascularized tissue but with necessity of further implementation of antidecubitus measures.

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Nursing Effects of Medical Treatment Combination on Patients at High Risk of Developing Pressure Ulcers at Rural Homes

Journal of Clinical and Nursing Research ◽

10.26689/jcnr.v4i3.1206 ◽

2020 ◽

Vol 4 (3) ◽

Author(s):

Hua Qin ◽

Xiuqiong Hu

Keyword(s):

High Risk ◽

Medical Treatment ◽

Pressure Ulcers ◽

Control Group ◽

Treatment Combination ◽

Nursing Satisfaction ◽

Second Stage ◽

The Third ◽

Patients Satisfaction ◽

Third Stage

Objective: To explore the nursing effects of medical treatment combination on patients at high risk of developing pressure ulcers at rural homes. Methods: From January 2018 to December 2018, 86 patients at high risk of developing pressure ulcers at rural homes who were in Wenjiang Hospital were randomly divided into a control group and an observed group. The control group received the routine publicity and education and visiting, while the observed group adopted the cooperative nursing model of medical treatment combination. Then compare the healing status and nursing satisfaction of the two groups. Results: Of the 43 patients with pressure ulcers in the observed group, 18 had been in the second stage of pressure ulcers and 16 had been healed; 14 had been in the third stage of pressure ulcers and 8 had been healed; 11 had been in the fourth stage of pressure ulcers and 5 had been healed. The nursing satisfaction of the patients in the observed group was 95.35%. Conclusion: Conducting medical treatment combination on patients at high risk of developing pressure ulcers at rural homes can effectively improve the patients’ and their families’ awareness of pressure ulcer nursing, standardize their nursing behaviour, help recover the patients themselves and promote the patients’ satisfaction.

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