1
|
Qi L, Zhao Q, Guo L, Zhao B, Zhang M. Prevention and care for moisture-associated skin damage: A scoping review. J Tissue Viability 2024; 33:362-375. [PMID: 38906753 DOI: 10.1016/j.jtv.2024.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 03/14/2024] [Accepted: 06/05/2024] [Indexed: 06/23/2024]
Abstract
OBJECTIVE Moisture-associated skin damage (MASD) is an inflammatory skin condition caused by long-term exposure to a moist environment, which can compromise the integrity of the barrier and increase pain. This scoping review aimed to systematically analyze the research status of prevention and care for MASD. METHODS We conducted a scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. PubMed, MEDLINE, Scopus, Web of Science, CINAHL, and the Cochrane Database of Systematic Reviews were searched for relevant articles until March 2023. RESULTS Based on eligibility criteria, 34 research studies and review articles were included. The prevalence of MASD varies greatly in different medical environments and patient groups. The high-risk factors included prolonged exposure to excessive water, chemical irritation such as urine or feces, mechanical factors such as friction or improper removal of medical adhesives and local bacterial colonization. Prevention measures mainly include avoiding skin exposure to moisture, skin cleansing, moisturizing and the treatment of secondary bacterial infection. CONCLUSION A variety of factors have an impact on MASD. Nurses should select suitable tools to screen high-risk patients and take targeted preventive measures according to the related types of skin injury to reduce the incidence of MASD.
Collapse
Affiliation(s)
- Lin Qi
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong Province, China; Qilu Hospital of Shandong University, Jinan, Shandong Province, China
| | - Qingsheng Zhao
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong Province, China; Qilu Hospital of Shandong University, Jinan, Shandong Province, China
| | - Lianrong Guo
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong Province, China; Qilu Hospital of Shandong University, Jinan, Shandong Province, China
| | - Bingnan Zhao
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong Province, China
| | - Min Zhang
- Qilu Hospital of Shandong University, Jinan, Shandong Province, China.
| |
Collapse
|
2
|
Flæten ØØ, Stafseth SK, Vinje H, Johansen E, Sunde K, Wøien H, Beeckman D, Petosic A. Incidence, characteristics, and associated factors of pressure injuries acquired in intensive care units over a 12-month period: A secondary analysis of a quality improvement project. Intensive Crit Care Nurs 2024; 81:103587. [PMID: 38029679 DOI: 10.1016/j.iccn.2023.103587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/18/2023] [Accepted: 11/08/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVES To determine the 12-month cumulative incidence, characteristics, and associated factors of pressure injuries acquired in Intensive Care Units. SETTING Four intensive care units in a Norwegian University Hospital. RESEARCH METHODOLOGY A prospective observational cohort study using data from daily skin inspections during a quality improvement project. We used descriptive statistics and logistic regression. Variables associated with the development of intensive care unit-acquired pressure injuries are presented with odds ratios (OR), and 95% confidence intervals. RESULTS The 12-month cumulative incidence of patients (N = 594) developing intensive care unit-acquired pressure injuries was 29 % (172/594) for all categories and 16 % (95/594) when excluding category I pressure injuries (no skin loss). Cumulative incidence for patients acquiring medical device-related pressure injuries was 15 % (91/594) and 11 % (64/594) for category II or worse. Compression stockings (n = 51) and nasogastric tubes (n = 22) were the most frequent documented medical devices related to pressure injuries. Development of pressure injuries category II or worse was significantly associated with vasoactive drug infusions (OR 11.84, 95 % CI [1.59; 88.13]) and longer intensive care unit length of stay (OR 1.06, 95 % CI [1.04; 1.08]). CONCLUSION The 12-month cumulative incidence of intensive care unit-acquired pressure injuries was relatively high when category I pressure injuries were included, but comparable to other studies when category I was excluded. Some medical device-related pressure injuries were surprisingly frequent, and these may be prevented. However, associated factors of developing pressure injuries were present and deemed non-modifiable. IMPLICATIONS FOR CLINICAL PRACTICE Awareness about pressure injury prevention is needed in the intensive care unit considering high incidences. Nurses can detect category I pressure injuries early, which may be reversed. Our findings show several factors that clinicians can control to reduce the risk of pressure injuries in the intensive care unit.
Collapse
Affiliation(s)
- Øystein Øygarden Flæten
- Department of Postoperative and Intensive Care Nursing, Division of Emergencies and Critical Care, Oslo University Hospital, Norway; Lovisenberg Diaconal University College, Oslo, Norway.
| | - Siv K Stafseth
- Lovisenberg Diaconal University College, Oslo, Norway; Centre for Patient Centered Heart and Lung Research, Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway
| | - Hilde Vinje
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - Edda Johansen
- University of South-Eastern Norway, Faculty of Health and Social Sciences, Borre, Norway; General Intensive Care, Vestre Viken Hospital Trust, Drammen, Norway
| | - Kjetil Sunde
- Department of Anesthesia and Intensive Care Medicine, Division of Emergencies and Critical Care, Oslo University Hospital, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Hilde Wøien
- Department of Postoperative and Intensive Care Nursing, Division of Emergencies and Critical Care, Oslo University Hospital, Norway; Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Dimitri Beeckman
- Ghent University, Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent, Belgium; Örebro University, Swedish Centre for Skin and Wound Research (SCENTR), School of Health Sciences, Örebro, Sweden; Odense University, Research Unit of Plastic Surgery, Department of Clinical Research, Faculty of Health Sciences, Odense, Denmark
| | - Antonija Petosic
- Department of Postoperative and Intensive Care Nursing, Division of Emergencies and Critical Care, Oslo University Hospital, Norway; The Norwegian Intensive Care Registry, Haukeland University Hospital, Helse Bergen, Bergen, Norway
| |
Collapse
|
3
|
Fan S, Jiang H, Shen J, Lin H, Yang L, Yu D, Chen L. Risk factors of incontinence-associated dermatitis in older adults: a protocol for systematic review and meta-analysis. BMJ Open 2023; 13:e078375. [PMID: 38135331 DOI: 10.1136/bmjopen-2023-078375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2023] Open
Abstract
INTRODUCTION Due to their ageing skin, older adults are more likely to develop incontinence-associated dermatitis (IAD). Although previous attempts to look at the risk factors for IAD in older adults were done, methodological barriers hindered an in-depth understanding. By investigating risk factors for IAD in the ageing population, the development of precise clinical interventions and guidance could be facilitated, which in turn would enhance patient care standards for incontinence management in this target group. To address this knowledge gap, this systematic review with meta-analysis aims to explore the major risk elements linked to IAD among older adults. METHODS AND ANALYSIS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols are adhered to in this systematic review and meta-analysis. To achieve its objectives, a comprehensive search strategy PubMed, Embase, Web of Science, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Medline, Chinese Scientific Journal Database (VIP database), WanFang Data Knowledge Service Platform, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, along with other relevant sources published until 18 July 2023 in both English and Chinese languages will be performed. The screening of articles, data abstraction and risk of bias evaluation will be done by two impartial reviewers. RevMan V.5.3 software will be used for data synthesis. The quality of the included study will be assessed using the Newcastle-Ottawa Quality Assessment tool and the Agency for Healthcare Research and Quality. The I 2 test will identify the heterogeneity. ETHICS AND DISSEMINATION There is no need for ethical approval. Individual patient information or the rights of participants will not be compromised by this protocol. The findings will either be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42023442585.
Collapse
Affiliation(s)
- Siyue Fan
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Hongzhan Jiang
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jiali Shen
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Huihui Lin
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Liping Yang
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Doudou Yu
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Lijuan Chen
- Department of General Surgery, Zhongshan Hospital Xiamen University, Xiamen, China
| |
Collapse
|
4
|
Yüceler Kaçmaz H, Kaplan Ö, Kaplan A, Şahin MG, Cetinkaya A, Avci A. Incontinence-Associated Dermatitis: Prevalence in Intensive Care Units and Knowledge, Attitudes, and Practices of Nurses. J Nurs Care Qual 2023; 38:354-360. [PMID: 36947830 DOI: 10.1097/ncq.0000000000000707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
BACKGROUND Incontinence-associated dermatitis (IAD) is a major concern among hospitals, especially in intensive care units (ICUs). PURPOSE To describe ICU nurses' knowledge, attitudes, and practices of IAD and to examine the relationships with IAD prevalence in the ICU setting. METHODS A descriptive correlational design was used including the Knowledge, Attitudes and Practices of Incontinence-Associated Dermatitis Questionnaire and 1-month IAD prevalence data. RESULTS The prevalence of IAD in ICUs was 6.89%. A positive correlation was found between IAD prevalence and nurses' IAD knowledge and attitudes. Nurses working in the ICU for more than 7 years, caring for patients at high risk for or having IAD, and thinking IAD-related nursing practices were sufficient had significantly higher IAD knowledge, attitudes, and practices. CONCLUSIONS Findings indicate that ICU nurses learned about IAD through clinical experience and have inadequate training on IAD. A standardized evidence-based care protocol for IAD should be developed.
Collapse
Affiliation(s)
- Hatice Yüceler Kaçmaz
- Department of Nursing, Health Science Faculty, Erciyes University, Kayseri, Turkey (Drs Yüceler Kaçmaz and Özlem Kaplan); First and Emergency Aid Program, İncesu Ayşe and Saffet Arslan Health Services Vocational School, University of Kayseri, Kayseri, Turkey (Dr Ali Kaplan); Department of Women's Health Nursing, Erciyes University, Kayseri, Turkey (Ms Şahin); Ministry of Health, Kayseri City Hospital, Kayseri, Turkey (Ms Şahin); and Departments of Internal Medicine (Mr Cetinkaya) and Dermatology (Mr Avci), Health Science University Kayseri City Hospital, Kayseri, Turkey
| | | | | | | | | | | |
Collapse
|
5
|
Guerrero JG, Mohammed H, Pingue-Raguini M, Cordero RP, Aljarrah I. A Multicenter Assessment of Nurses' Knowledge Regarding Pressure Ulcer Prevention in Intensive Care Units Utilizing the PUKAT 2.0. SAGE Open Nurs 2023; 9:23779608231177790. [PMID: 37273548 PMCID: PMC10233595 DOI: 10.1177/23779608231177790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/03/2023] [Accepted: 05/05/2023] [Indexed: 06/06/2023] Open
Abstract
Introduction Pressure ulcer (PU) care is pivotal in the practice of nurses working in intensive care units (ICUs). Therefore, nurses must possess adequate knowledge about the potential risks leading to the development of PUs, as well as managing complications that worsen patient conditions. Objective To evaluate the level of knowledge of ICU nurses concerning PU prevention in tertiary hospitals in Saudi Arabia. Methods In this cross-sectional study, the researchers recruited 320 ICU nurses from four tertiary hospitals using convenience sampling. Nurses' knowledge regarding PU prevention was assessed using the revised and updated version of the Pressure Ulcer Knowledge Assessment Tool (PUKAT) 2.0. Data were collected between May and June 2022. The CROSS checklist was observed for reporting. Results The mean scores of nurses' level of knowledge regarding PU prevention according to the themes of the revised and updated version of the PUKAT 2.0 were as follows-etiology: 62.81 ± 23.77; classification and observation: 50.86 ± 23.28; risk assessment: 31.19 ± 24.26; nutritious diet: 46.04 ± 25.96; prevention: 22.36 ± 12.41; and specific patient groups: 14.84 ± 22.88. Furthermore, the score for nurses' overall level of knowledge of PU prevention was 39.55 ± 8.84 out of 100, interpreted as low based on the 60% cutoff; the minimum knowledge score was 0. Notably, knowledge of PU etiology, classification, observation, and specific patient groups differed based on the hospital of affiliation. Interestingly, gender was the only demographic characteristic based on which nurses' knowledge regarding specific patient groups differed. Conclusion This study identified insufficient knowledge among ICU nurses regarding PU prevention, which can lead to complications among patients. Simulation scenarios related to PU prevention and management will be an effective way to help nurses gain appropriate knowledge that can be applied in clinical practice.
Collapse
Affiliation(s)
- Jefferson Garcia Guerrero
- Fakeeh College for Medical
Sciences, Abdul Wahab Naib Al Haram, Al-Hamra'a, Jeddah, Saudi
Arabia
- King Khalid University, College of
Nursing, Abha, Saudi Arabia
| | - Heba Mohammed
- Fakeeh College for Medical
Sciences, Abdul Wahab Naib Al Haram, Al-Hamra'a, Jeddah, Saudi
Arabia
- King Abdulaziz Hospital, Nursing
Department, Mecca, Saudi Arabia
| | - Minerva Pingue-Raguini
- Fakeeh College for Medical
Sciences, Abdul Wahab Naib Al Haram, Al-Hamra'a, Jeddah, Saudi
Arabia
| | | | - Imad Aljarrah
- Jadara University, College of Nursing,
Irbid, Jordan
| |
Collapse
|
6
|
Jiang H, Shen J, Lin H, Xu Q, Li Y, Chen L. Risk factors of incontinence-associated dermatitis among critically ill patients: A systematic review and meta-analysis. Front Med (Lausanne) 2023; 10:1146697. [PMID: 37113614 PMCID: PMC10126239 DOI: 10.3389/fmed.2023.1146697] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/27/2023] [Indexed: 04/29/2023] Open
Abstract
Objectives Incontinence-associated dermatitis (IAD) is increasingly found among critically ill patients, but the risk factors for IAD in these patients are currently unclear. The purpose of this meta-analysis was to identify the risk factors of IAD in critically ill patients. Methods Web of Science, PubMed, EMBASE, and Cochrane Library were systemically searched until July 2022. The studies were selected based on inclusion criteria, and data were independently extracted by two researchers. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the included studies. Odds ratios (ORs) and their associated 95% confidence intervals (CIs) were used to identify significant differences in the risk factors. The I 2 test was used to estimate the heterogeneity of studies, and Egger's test was used to assess the potential publication bias. Results A total of 7 studies enrolling 1,238 recipients were included in the meta-analysis. Age ≥ 60 (OR = 2.18, 95% CI: 1.38~3.42), female sex (OR = 1.76, 95% CI: 1.32~2.34), dialysis (OR = 2.67, 95% CI: 1.51~4.73), fever (OR = 1.55, 95% CI: 1.03~2.33), vasoactive agent (OR = 2.35, 95% CI: 1.45~3.80), PAT score ≥ 7 (OR = 5.23, 95% CI: 3.15~8.99), frequency of bowel movement > 3times/d (OR = 5.33, 95% CI: 3.19~8.93), and liquid stool (OR = 2.61, 95% CI: 1.56~4.38) were the risk factors of IAD among critically ill patients. Conclusions Many risk factors are related to IAD among critically ill patients. Nursing staff should pay more attention to evaluating the risk of IAD and enhance the care of high-risk groups.
Collapse
Affiliation(s)
- Hongzhan Jiang
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jiali Shen
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Huihui Lin
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Qiuqin Xu
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yuanchan Li
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Lijuan Chen
- Department of General Surgery, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen, China
- *Correspondence: Lijuan Chen
| |
Collapse
|
7
|
Johansen E, Bredesen IM, Jónasdóttir RJ, Lind R. ABCD before E-verything else-Intensive care nurses' knowledge and experience of pressure injury and moisture-associated skin damage. Int Wound J 2022; 20:285-295. [PMID: 35746849 PMCID: PMC9885462 DOI: 10.1111/iwj.13872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 06/02/2022] [Accepted: 06/06/2022] [Indexed: 02/03/2023] Open
Abstract
Patients in intensive care units are at high risk of developing pressure injuries and moisture-associated skin damages. Prevention and care rely much on intensive care nurses' competency and attitudes. This study explored intensive care nurses' experience, knowledge and bedside practice in prevention and care of pressure injuries and moisture-associated skin damages with a descriptive qualitative design. Six focus groups (n = 25) were carried out in three University hospitals, two in Norway and one inIceland. Interviews were guided by a questioning route, recorded and transcribed verbatim before an inductive content analysis. Three interconnected main categories related to nurses' experience, knowledge and bedside care were identified: (a) nursing; (b) context; and (c) patients. Intensive care nurses recognise patients' risk of developing pressure injuries, as well as their continuous need of personal hygiene because of leakage of body fluids. Nurses were therefore attentive to skin inspection and preventive care but felt insecure and in need of expert help in pressure injury wound care. It varied whether nurses had access to suitable beds and mattresses and experts in wound care. ABCD had to be before E-verything else, but the skin had higher priority in long-stay compared with short-stay patients.
Collapse
Affiliation(s)
- Edda Johansen
- Faculty of Health and Social SciencesUniversity of South‐Eastern NorwayBorreNorway
| | - Ida Marie Bredesen
- Faculty of Health and Social SciencesUniversity of South‐Eastern NorwayBorreNorway,Division of Orthopaedic SurgeryOslo University HospitalOsloNorway
| | | | - Ranveig Lind
- Department of Health and Care Sciences, Faculty of Health SciencesUiT The Arctic University of NorwayTromsøNorway,Intensive Care UnitUniversity Hospital of North NorwayTromsøNorway
| |
Collapse
|
8
|
Gray M, Bliss DZ, McNichol L. Moisture-Associated Skin Damage: Expanding and Updating Practice Based on the Newest ICD-10-CM Codes. J Wound Ostomy Continence Nurs 2022; 49:143-151. [PMID: 35255065 DOI: 10.1097/won.0000000000000865] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Moisture-associated skin damage (MASD) occurs when skin is repeatedly exposed to various sources of bodily secretions or effluents, often leading to irritant contact dermatitis with inflammation, with or without denudation of affected skin. In 2020, the Wound, Ostomy and Continence Nurses Society took an initiative that led to the addition of multiple International Classification for Diseases codes for irritant contract dermatitis caused by various forms of MASD for use in the United States (ICD-10-CM). In the last issue of the Journal of Wound, Ostomy and Continence Nursing, a clinical practice alert identifying the various new codes was published that summarized each of the new codes and provided highlights of the descriptions of each of the these codes. This is the first in a series of 2 articles providing a more detailed description of the newest irritant contact dermatitis codes linked to MASD. Specifically, this article reviews the clinical manifestations and assessment, pathophysiology, epidemiology, prevention, and management of irritant contact dermatitis due to saliva, respiratory secretions, and fecal or urinary incontinence.
Collapse
Affiliation(s)
- Mikel Gray
- Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, Department of Urology, University of Virginia, Charlottesville
- Donna Z. Bliss, PhD, RN, FGSA, FAAN, University of Minnesota School of Nursing, Minneapolis
- Laurie McNichol, MSN, RN, CNS, GNP, CWOCN, CWON-AP, FAAN, WOC Nurse, Cone Health, Greensboro, North Carolina
| | - Donna Z Bliss
- Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, Department of Urology, University of Virginia, Charlottesville
- Donna Z. Bliss, PhD, RN, FGSA, FAAN, University of Minnesota School of Nursing, Minneapolis
- Laurie McNichol, MSN, RN, CNS, GNP, CWOCN, CWON-AP, FAAN, WOC Nurse, Cone Health, Greensboro, North Carolina
| | - Laurie McNichol
- Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, Department of Urology, University of Virginia, Charlottesville
- Donna Z. Bliss, PhD, RN, FGSA, FAAN, University of Minnesota School of Nursing, Minneapolis
- Laurie McNichol, MSN, RN, CNS, GNP, CWOCN, CWON-AP, FAAN, WOC Nurse, Cone Health, Greensboro, North Carolina
| |
Collapse
|
9
|
Lu P, Liao Z, Zeng Q, Chen H, Huang W, Liu Z, Chen Y, Zhong J, Huang G. Customized Three-Dimensional-Printed Orthopedic Close Contact Casts for the Treatment of Stable Ankle Fractures: Finite Element Analysis and a Pilot Study. ACS OMEGA 2021; 6:3418-3426. [PMID: 33553960 PMCID: PMC7860236 DOI: 10.1021/acsomega.0c06031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 01/14/2021] [Indexed: 06/12/2023]
Abstract
Ankle fracture is one of the most common traumatic fractures among the elderly population. The majority of ankle fractures are stable types with the typically conservative strategy of close contact casting treatment. The continuous use of unventilated standard cast immobilization severely affects patient's satisfaction and compliance and markedly increases the rates of various complications. Three-dimensional (3D) printing for casts has advantages of lightweight, ventilated, proper-fit, and esthetic improvements. In this work, this novel 3D-printed cast has been applied to individuals with stable ankle fractures, and its effectiveness can be successfully validated with finite element analysis and a pilot study. A 30% reduction of the volume was chosen as the optimal result in topology optimization. Both 3D-printed casts and conventional casts showed significant ankle function improvement after immobilization for 6 weeks (p = 0.000). The 3D-printed casts were superior to the traditional casts in Olerud-Molander Ankle Scores (OMAS), with the mean difference of 8.3 ± 8.57 OMAS points (95% CI -10.8 to 27.5; p = 0.354) for 6 weeks, implying that the 3D-printed casts possibly maintain the equal clinical efficacy as the traditional casts. The statistically significant difference between groups from the 3D-printed cast and the traditional one observed in C-QUEST 2.0 was 11.3 ± 1.5 points (95% CI 8.0-14.6; p = 0.000), indicating that the 3D-printed cast possesses outperforming satisfaction and compliance and has great potential in practical applications. There were no severe complications in the 3D-printed casts, but more moderate complications were observed in the traditional casts.
Collapse
Affiliation(s)
- Pengcheng Lu
- Department
of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China
- Rehabilitation
Medical School, Southern Medical University, Guangzhou 510280, China
| | - Zhengwen Liao
- Department
of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China
- Rehabilitation
Medical School, Southern Medical University, Guangzhou 510280, China
| | - Qing Zeng
- Department
of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China
- Rehabilitation
Medical School, Southern Medical University, Guangzhou 510280, China
| | - Huan Chen
- Department
of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China
- Rehabilitation
Medical School, Southern Medical University, Guangzhou 510280, China
| | - Weichun Huang
- School
of Chemistry and Chemical Engineering, Nantong
University, Nantong 226019, China
| | - Zhen Liu
- Department
of Rehabilitation Medicine, The First People’s
Hospital of Foshan, Foshan 528000, China
| | - Yanjun Chen
- Guangdong
Medical Innovation Platform for Translation of 3D Printing Application,
Department of Medical Radiology, The Third
Affiliated Hospital of Southern Medical University, Guangzhou 510515, China
| | - Jing Zhong
- Guangdong
Engineering Research Center for Translation of Medical 3D Printing
Application, Guangdong Provincial Key Laboratory of Medical Biomechanics,
School of Basic Medical Sciences, Southern
Medical University, Guangzhou 510515, China
| | - Guozhi Huang
- Department
of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China
- Rehabilitation
Medical School, Southern Medical University, Guangzhou 510280, China
| |
Collapse
|
10
|
Labeau S, Blot S. Measuring point-prevalence: Walk in the park or bumpy road? Lessons learnt from the DecubICUs study. Intensive Crit Care Nurs 2021; 62:102933. [DOI: 10.1016/j.iccn.2020.102933] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
|
11
|
Llaurado-Serra M, Labeau S. Research on the prevention of pressure injuries in adult intensive care unit patients. Where are we today and where should we go? Intensive Crit Care Nurs 2020; 62:102959. [PMID: 33160802 DOI: 10.1016/j.iccn.2020.102959] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | - Sonia Labeau
- HOGENT University of Applied Sciences and Arts, School of Healthcare, Nursing Programme, Belgium
| |
Collapse
|
12
|
Coyer F. Moisture-associated skin damage: A timely report of an oft forgotten clinical problem. Intensive Crit Care Nurs 2020; 61:102944. [PMID: 33127215 DOI: 10.1016/j.iccn.2020.102944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 08/05/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Fiona Coyer
- Joint Appointment Intensive Care Services, Royal Brisbane and Women's Hospital and School of Nursing, Queensland University of Technology, Australia; Institute of Skin Integrity and Infection Prevention, University of Huddersfield, UK.
| |
Collapse
|
13
|
Johansen E, Petosic A. "Moisture-associated skin damage: A timely report of an oft forgotten clinical problem". Intensive Crit Care Nurs 2020; 61:102930. [PMID: 32900579 DOI: 10.1016/j.iccn.2020.102930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Edda Johansen
- University of South-Eastern Norway, Faculty of Health and Social Sciences, Norway.
| | - Antonija Petosic
- Professional development nurse/ PhD student, CCN, MS Oslo University Hospital, Division of Emergencies and Critical Care, Department of Postoperative and Intensive care University of Oslo, Faculty of Medicine, Institute of Health and Society, Norway
| |
Collapse
|