Effectiveness of using hydrocolloid dressing combined with 3M Cavilon No-Sting Barrier Film to prevent facial pressure injury on medical staff in a COVID-19 designated hospital in China: a self-controlled study

IntroductionAlthough topical use of moisturisers is slightly effective for the prevention and avoiding the aggravation of hand–foot syndrome induced by multikinase inhibitors, there is still room for improvement. Hydrocolloid dressing is a type of wound dressing often used for wounds such as decubitus ulcers. The purpose of this study is to verify the usefulness of application of hydrocolloid dressings as prophylaxis against development of hand–foot syndrome induced by multikinase inhibitors by comparing the effects of this dressing and standard supportive care (moisturising care alone) within the same individuals.MethodsThis study is a phase 3 randomised, self-controlled study to compare prophylactic moisturising care with or without hydrocolloid dressing for hand–foot syndrome induced by multikinase inhibitors. Patients with radically unresectable advanced or recurrent colorectal carcinoma, gastrointestinal stromal tumour and hepatocellular carcinoma who scheduled to receive regorafenib or sorafenib therapy are eligible for enrolment.Supportive care for hand–foot syndrome will consist of basic moisturising care with or without hydrocolloid dressing. If hand–foot syndrome occurs, a steroid ointment will be applied two times per day at the affected sites. The primary endpoint is an incidence rate of grade 2 or more severe hand–foot syndrome (soles of the feet only) assessed by National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events V.4.0. Grading of hand–foot syndrome will be performed by central review using photographs taken weekly by blinded trained physicians. The ethical approval was obtained from National Cancer Center Hospital. The results of this study will be submitted for publication in international peer-reviewed journals and the key findings will be presented at international scientific conference.DiscussionIf the positive results are found in this study, it is shown that hydrocolloid dressing is effective not only as a symptom management but also as a prevention in hand–foot syndrome induced by multikinase.Trial statusThe enrolment was started in January 2019, and planned to closed in January 2021. As of February 2020, 26 patients enrolled in this study.Trial registration numberUMIN Clinical Trial Registry (UMIN000034853).Protocol versionV.1.4, 9 January 2020.

Download Full-text

APLICATIVO MÓVEL DE PROCESSAMENTO DE IMAGENS DIGITAIS PARA CLASSIFICAÇÃO AUTOMÁTICA DE TECIDOS DE LESÕES POR PRESSÃO

Enfermagem em Foco ◽

10.21675/2357-707x.2019.v10.n7.2489 ◽

2020 ◽

Vol 10 (7) ◽

Author(s):

Huara Paiva Castelo Branco ◽

Levy Aniceto Santana ◽

Rinaldo De Souza Neves ◽

Renato Da Veiga Guadagnin

Keyword(s):

Image Processing ◽

Pressure Ulcer ◽

Granulation Tissue ◽

Mobile Application ◽

Tissue Characterization ◽

Controlled Study ◽

Pressure Injury ◽

Automated Technique ◽

Complex Wounds

Objetivo: avaliar o desempenho de uma técnica automática para extração de características dos tipos de tecidos de lesões por pressão por processamento de imagens digitais, embutida em um aplicativo móvel (App) para smartphones. Metodologia: estudo transversal controlado, realizado em 20 imagens de lesões sacrais e trocantéricas. Aferiu-se a concordância na caracterização tecidual presente no leito das lesões entre o App e um comitê de juízes. Resultados: a precisão global do App na identificação de granulação, liquefação e coagulação foi de 75%. Constatou-se independência intraobservador nos desfechos das aferições realizadas pelo aplicativo. Conclusões: o App obteve desfechos promissores ao classificar os tipos de tecidos inviáveis e granulação, sendo necessário aprimoramento do desempenho em feridas complexas e de outras etiologias.Descritores: Lesão por Pressão, Fotografia, Smartphone.MOBILE IMAGING APP FOR AUTOMATIC CLASSIFICATION OF PRESSURE INJURY TISSUESObjective: to evaluate the performance of an automated technique for extraction of characteristics of the types of tissues from pressure lesions by digital image processing, inserted in a mobile application (App) for smartphones. Methodology: crosssectional, controlled study of 20 images of sacral and trochanteric lesions. The concordance in the tissue characterization present in the center of the lesions between the App and a committee of judges was checked. Results: the overall accuracy of the App in the identification of granulation, liquefaction and coagulation was 75%. Intraobserver independence was observed in the results of the measurements performed by the application. Conclusions: the App obtained promising outcomes classifying non-viable tissue types and granulation tissue, and an improvement of the app’s performance is necessary in complex wounds and other etiologies.Descriptores: Pressure Ulcer, Photography, Smartphone.APLICACIÓN MÓVIL DE PROCESAMIENTO DE IMÁGENES DIGITALES PARA LA CLASIFICACIÓN AUTOMÁTICA DE LOS TEJIDOS DE LESIÓN POR PRESIÓNObjetivo: evaluar el rendimiento de una técnica automática para extraer características de los tipos de tejido de las lesiones por presión mediante el procesamiento digital de imágenes, incorporado en una aplicación móvil para smartphone. Metodología: estudio transversal controlado hecho en 20 imágenes de lesiones trocantéricas y en la región sacro. Se verificó la concordancia en la caracterización de los tejidos presentes en el lecho de las lesiones entre la aplicación y un comité de jueces. Resultados: la precisión general de la aplicación en la identificación de tejidos presentes en el lecho de las LPP (lesiones por presión) fue de 75%. Se comprobó la independencia intraobservadora en los puntos finales de las mediciones realizadas por la aplicación. Conclusiones: la aplicación obtuvo resultados promisorios al evaluar los tipos de tejidos no viables y granulación y es necesario prefeccionar el desempeño en heridas complejas y de otras etiologías.Descriptores: Úlcera por Presión, Fotografía, Teléfono Inteligente.

Download Full-text

Investigating the Efficacy of Hydrocolloid Dressing for Preventing Nasotracheal Tube-Related Pressure Injury in the PICU

Pediatric Critical Care Medicine ◽

10.1097/pcc.0000000000002494 ◽

2020 ◽

Vol 21 (9) ◽

pp. e752-e758

Author(s):

Jie Chen ◽

Jinlu Chen ◽

Jine Yang ◽

Yanxuan Chen ◽

Yufeng Liang ◽

...

Keyword(s):

Hydrocolloid Dressing ◽

Pressure Injury ◽

Nasotracheal Tube

Download Full-text

Benefit of psychiatric evaluation on anxiety in patients with Charles Bonnet syndrome

BMJ Open Ophthalmology ◽

10.1136/bmjophth-2020-000463 ◽

2021 ◽

Vol 6 (1) ◽

pp. e000463

Author(s):

Birgit Doeller ◽

Martin Kratochwil ◽

Lena Sifari ◽

Nino Hirnschall ◽

Oliver Findl

Keyword(s):

Quality Of Life ◽

Medical Staff ◽

Vision Loss ◽

Age Related Macular Degeneration ◽

Controlled Study ◽

Psychiatric Evaluation ◽

Adequate Treatment ◽

Charles Bonnet Syndrome ◽

Severe Vision Loss

ObjectiveCharles Bonnet syndrome (CBS) is defined as an occurrence of visual hallucinations (VHs) in the absence of any psychiatric/neurological disorder. Significantly reduced vision due to age-related macular degeneration (AMD), cataract or glaucoma is the most common cause for CBS. Aim of this randomized controlled study was to assess whether additional treatment by a psychiatrist is beneficial for patients with CBS.Methods and AnalysisPatients with visual acuity of 0.5 LogMAR or worse in the better eye were screened. Instruments used were an interview asking about details of the VH, a mental test and a questionnaire on quality of life. Patients with CBS were randomised into two groups: in group 1, a patient-doctor consultation was performed by an ophthalmologist, and in group 2 a consultation and, if needed, additional medical assessment and treatment was given by a psychiatrist.Results4900 patients were screened. 390 patients met the inclusion criteria and among these a CBS prevalence of 34 patients (8.7%) was found. The female-to-male ratio was 4:1 and the average age was 79.3 ± 9.7 years. Four different types of VH were observed: 41% humans (n=14), 32% geometrical shapes/patterns (n=11), 15% plants (n=5) and 12% animals (n=4). The change in quality of life in patients with CBS was not significantly different in both groups (p=0.727, ophthalmologist: n=18, psychiatrist: n=16).ConclusionIt is essential for medical staff involved with patients suffering from severe vision loss to be aware of CBS. This will help to better identify and interpret symptoms and could also lead to a more adequate treatment for affected patients.DiscussionIt is essential for medical staff involved with patients suffering from severe vision loss to be aware of CBS. This will help to better identify and interpret symptoms and could also lead to a more adequate treatment for affected patients.

Download Full-text

Impact on quantitative fit test results after application of prophylactic hydrocolloid dressing under N95 respirators

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2021.293 ◽

2021 ◽

pp. 1-16

Author(s):

Irene Ng ◽

Benjamin Kave ◽

Fiona Begg ◽

Sarah Sage ◽

Reny Segal ◽

...

Keyword(s):

Healthcare Workers ◽

Respiratory Protection ◽

Test Results ◽

Pass Rates ◽

Hydrocolloid Dressing ◽

Fit Testing ◽

Pressure Injury ◽

N95 Respirators ◽

The Impact

Abstract Objective Discomfort and device-related pressure injury (DRPI) caused by N95 filtering facepiece respirators (FFRs) are common. The use of prophylactic hydrocolloid dressings is one of the strategies that may improve comfort and reduce DRPI. In this study, we investigated the impact of these dressings on N95 respirator fit. Methods We performed a repeat quantitative fit testing through the Respiratory Protection Program on 134 healthcare workers (HCWs), who applied hydrocolloid dressings on the bridge of their nose under the N95 FFRs that they passed the initial fit test but reported discomfort with. Results We found that the fit test pass rates, with the hydrocolloid dressings in place, for the semi-rigid cup style (3MTM 1860), the vertical flat-fold style (BYD), the duckbill style (BSN medical ProShield® and Halyard Fluidshield*), and the three-panel flat-fold style (3MTM Aura) N95 FFRs were 94% (108/115), 85% (44/52), 81% (87/108) and 100% (3/3) respectively. There was a statistically significant reduction in the overall fit factors for both the vertical flat-fold and duckbill type N95 respirators, after the application of hydrocolloid dressings. Conclusions Hydrocolloid dressings are likely to disturb the mask seal for non-rigid style N95 FFRs, in particular, the vertical flat-fold style and the duckbill style N95 FFRs. Given the risk of mask seal disturbance of N95 respirators as shown in this study, we advocate that any HCW requiring the use of prophylactic dressings should undergo repeat quantitative fit testing with the dressing in place prior to using the dressing and mask in combination.

Download Full-text

Association between N95 respirator wearing and device-related pressure injury in the fight against COVID-19: a multicentre cross-sectional survey in China

BMJ Open ◽

10.1136/bmjopen-2020-041880 ◽

2021 ◽

Vol 11 (2) ◽

pp. e041880

Author(s):

Qixia Jiang ◽

Yuxiu Liu ◽

Siping Song ◽

Wei Wei ◽

Yuxuan Bai

Keyword(s):

Medical Staff ◽

Cross Sectional Survey ◽

Nasal Bridge ◽

Cross Sectional ◽

Medical Institutions ◽

Epidemic Area ◽

Pressure Injury ◽

The Face ◽

N95 Respirators ◽

Very High

ObjectivesTo explore the association between N95 respirator wearing and device-related pressure injury (DRPI) and to provide a basis for protecting medical staff from skin injuries.DesignA cross-sectional, multicentre study.Setting and participantsMedical staff of 60 hospitals were selected from 145 designated medical institutions located in the epidemic area where the patients with COVID-19 were treated in China.ResultsIn total, 1761 respondents wore N95 respirators (use alone 20.8%; combination use 79.2%), and the prevalence of DRPI was 59.2% (95% CI 56.93 to 61.53). A daily wearing time of >4 hours (OR 1.62, 95% CI 1.11 to 2.35), wearing a N95 respirator in combination with goggles both with the presence of sweating (OR 13.40, 95% CI 7.34 to 23.16) and without the presence of sweating (OR 0.80, 95% CI 0.56 to 1.14) and wearing only a N95 respirator with the presence of sweating (OR 9.60, 95% CI 7.00 to 13.16) were associated with DRPI. A correspondence analysis indicated that if there was no sweating, regardless of whether the N95 respirator was worn by itself or in combination with goggles, single-site DRPI mainly occurred on the nose bridge, cheek and auricle. If there was sweating present, regardless of whether the N95 was worn by itself or in combination with goggles, multiple DRPI sites occurred more often on the face.ConclusionsThe prevalence of DRPI among medical staff caused by N95 respirators was very high, which was mainly associated with a longer daily wearing time and interaction with sweating. The nasal bridge, cheeks and auricles were the primary protection locations found.

Download Full-text

Silver Sulfadiazine–Impregnated Hydrocolloid Dressing Is Beneficial in Split-Thickness Skin-Graft Donor Wound Healing in a Small Randomized Controlled Study

The International Journal of Lower Extremity Wounds ◽

10.1177/1534734616670988 ◽

2016 ◽

Vol 15 (4) ◽

pp. 338-343 ◽

Cited By ~ 2

Author(s):

Sadanori Akita ◽

Hiroshi Yoshimoto ◽

Katsuya Tanaka ◽

Masao Oishi ◽

Chikako Senju ◽

...

Keyword(s):

Wound Healing ◽

Donor Site ◽

Corneal Thickness ◽

Silver Sulfadiazine ◽

Controlled Study ◽

Split Thickness Skin Graft ◽

Blue Color ◽

Color Analysis ◽

Intact Skin ◽

Hydrocolloid Dressing

Donor-site wound healing was tested with a silver sulfadiazine (SSD)-impregnated hydrocolloid dressing and hydrocolloid dressing applied manually by a physician on site. A total of 14 patients, 5 woman and 9 men (23-89 years old, average = 61.6 ± 18.70 years), were enrolled in this prospective controlled study. The degree of bleeding was significantly less with the SSD-impregnated than with the hydrocolloid dressing (P < .01). In the moisture meter analysis, the values of the effective contact coefficient and corneal thickness were significantly smaller with the SSD-impregnated dressing (P < .05). In the color analysis, the clarity was significantly lower with the hydrocolloid dressing after 3 months than that of intact neighboring skin (P < .01). Regarding red-green color, SSD-impregnated and hydrocolloid values were significantly greater than the intact skin value immediately after and at 3 months, and the hydrocolloid value was significantly greater than intact at 6 months (P < .01 immediately; P < .01 at 3 months and intact at 6 months) in redness. Regarding yellow-blue color, the hydrocolloid value was significantly lower than the intact skin value at 3 months (P < .05 and intact) in yellow. The extensibility was significantly lower with the hydrocolloid dressing than in intact skin immediately (P < .01), and viscoelasticity was significantly lower with the hydrocolloid dressing than in intact skin immediately and after 3 and 6 months (P < .01 immediately and at 6 months and P < .05 at 3 months). The SSD-impregnated hydrocolloid dressing led to superior wound healing, decreased the degree of bleeding, and demonstrated better corneal barrier function, clarity, color matching, and viscoelasticity in split-thickness donors.

Download Full-text

Application of a Simple Cold Stub to the Direct Observation of Frozen Hydrated Sand

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100071508 ◽

1973 ◽

Vol 31 ◽

pp. 212-213

Author(s):

John M. Wehrung ◽

Richard J. Harniman

Keyword(s):

United States ◽

Surface Water ◽

Direct Observation ◽

Controlled Study ◽

Clay Particles ◽

Organic Debris ◽

Rock Formations ◽

Water Tables ◽

Permeable Rock ◽

Natural Means

Water tables in aquifer regions of the southwest United States are dropping off at a rate which is greater than can be replaced by natural means. It is estimated that by 1985 wells will run dry in this region unless adequate artificial recharging can be accomplished. Recharging with surface water is limited by the plugging of permeable rock formations underground by clay particles and organic debris.A controlled study was initiated in which sand grains were used as the rock formation and water with known clay concentrations as the recharge media. The plugging mechanism was investigated by direct observation in the SEM of frozen hydrated sand samples from selected depths.

Download Full-text

Studies on Ultrastructure and Cytochemistry of Right Ventricular Endomyocardial Biopsy

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100158820 ◽

1990 ◽

Vol 48 (3) ◽

pp. 256-257

Author(s):

Xia Mingyu ◽

Ma Wengshu ◽

Wu Xiangh ◽

Chen Dong

Keyword(s):

Light Microscopy ◽

Right Ventricular ◽

Dilated Cardiomyopathy ◽

Endomyocardial Biopsy ◽

Heart Diseases ◽

Ultrastructural Localization ◽

Controlled Study ◽

Myocardial Biopsy ◽

Morphological Assessment ◽

Rheumatic Heart

This paper describes morphological and cytochemistry changes of endomyocardial biopsy in 94 patients. The samples of myoicardium were taken from 32 patients with dilated cardiomyopathy, and sdudied with light and electron microscop. The cytochemical studies in some of these patients were performed at histological and ultrastructure level. This paper also reported the result of myocardial biopsy in 33 patients with serious dysrythmia.The result of this controlled study indicates that morphological assessment in both cardiomyopathy and congenital or rheumatic heart diseases showed no special changes. In patients of dilated cardiomyopathy, the decreased activity of myosin ATPase was secondary to cardial failure. The change of succinate dehydrogenase (SDHase) was not significant with light microscopy. But ultrastructural localization of SDHase activity is valuable. Its activity was found to be localized in endomembrane and ridge of the mitochondria, the activity of this enzyme was decrease, normal, or increase. SDHase activity was more intense in cardial myocytes well-functioning, or ultrastructurally well preserved hearts.

Download Full-text