Infection prevention practices and the use of medical tapes

Utilization of 3-dimensional scanner technology to measure circumference and volume of limbs in patients bitten by venomous snakes

INTRODUCTION

The objective of this study was to compare limb circumference measurements between a three-dimensional scanner and a measuring tape.

METHODS

Patients older than 18 years, who were bitten by a green pit viper and visited the emergency department between 1 October and 20 December, 2019 were included. Two physicians measured the circumference of a bitten limb and a contralateral unaffected limb twice using both a measuring tape and a three-dimensional scanner. Each patient was measured at the first emergency department visit and again at 24 h, 48 h, and 72 h post-snakebite. There were three points of measurement on both limbs.

RESULTS

There were 408 anatomical locations from 17 patients for measurement. The three-dimensional scanner and the measuring tape demonstrated a very high correlation (r-squared >0.940, P value <0.001) in measuring limb circumferences. Bland Altman plots also demonstrated the two methods measured limb circumferences with similar results with mean differences <1 cm. Intraclass correlation coefficient between the two methods was greater than 0.8 in every site for the lower limbs, but for the upper limbs, most sites had a poor agreement (ranges: 0.073-0.633). For limb volume measurement, the three-dimensional scanner provided excellent and moderate inter and intrarater reliabilities for the lower and upper limbs, respectively.

DISCUSSION

The three-dimensional scanner could be reliably used to assess limb circumference with a strong correlation and with a relatively small error compared with the conventional method. Pictures from the scan can also be constructed to calculate limb volume that could have potential for other clinical purposes such as in evaluating antivenom response for limb swelling.

CONCLUSIONS

Circumferences from the three-dimensional scanner were comparable to those from the measuring tape, especially for the lower limbs, and the three-dimensional scanner demonstrated an added value for calculating limb volume.

The Science of Skin: Measuring Damage and Assessing Risk

Significance: Healthy skin provides a barrier to contaminants. Breaches in skin integrity are often encountered in the patient health care journey, owing to intrinsic health issues or to various procedures and medical devices used. The time has come to move clinical practice beyond mere awareness of medical adhesive-related skin injury and toward improved care and outcomes. Recent Advances: Methods developed in research settings allow quantitative assessments of skin damage based on the measurement of baseline skin properties. These properties become altered by stress and over time. Assessment methods typically used by the cosmetic industry to compare product performance could offer new possibilities to improve clinical practice by providing better information on the status of patient skin. This review summarizes available skin assessment methods as well as specific patient risks for skin damage. Critical Issues: Patients in health care settings may be at risk for skin damage owing to predisposing medical conditions, health status, medications taken, and procedures or devices used in their treatment. Skin injuries come as an additional burden to these medical circumstances and could be prevented. Technology should be leveraged to improve care, help maintain patient skin health, and better characterize functional wound closure. Future Directions: Skin testing methods developed to evaluate cosmetic products or assess damage caused by occupational exposure can provide detailed, quantitative information on the integrity of skin. Such methods have the potential to guide prevention and treatment efforts to improve the care of patients suffering from skin integrity issues while in the health care system.