Estudio experimental para comprobar la efectividad de los ácidos grasos hiperoxigenados en la prevención de las úlceras por presión en pacientes ingresados

Retrospective Cohort Noninferiority Analysis of Barrier Cream in Preventing Pressure Injuries

OBJECTIVE

To assess the effectiveness of a dimethicone- and zinc-based barrier cream compared with hyperoxygenated fatty acids in preventing pressure injuries (PIs) in patients at high or very high risk.

METHODS

Researchers conducted a retrospective noninferiority study in an inpatient acute care hospital in Spain that included hospitalized patients in nonsurgical departments with impaired mobility.

RESULTS

The study authors reviewed 522 patients in a control group (hyperoxygenated fatty acids) and an experimental group (barrier cream) over a period of 7 days. The incidence of PI was 31% in the control group and 31.1% in the experimental group. The hazard ratio for developing PI was 0.84 (confidence interval, 0.61-1.17; P = .32) in the experimental group compared with the control group, meeting the criteria for noninferiority. The Kaplan-Meier estimator indicated no statistically significant difference between groups (log-rank = 0.654).

CONCLUSIONS

Dimethicone- and zinc-based barrier cream was not inferior to hyperoxygenated fatty acids in preventing PIs in hospitalized patients at high or very high risk of developing them during their hospital stay.

Effectiveness and safety of olive oil preparation for topical use in pressure ulcer prevention: Multicentre, controlled, randomised, and double-blinded clinical trial

This non-inferiority, multicentre, randomised, controlled, and double-blinded clinical trial compared the therapeutic effectiveness of the topical application of an olive oil solution with that of a hyperoxygenated fatty acid compound for the prevention of pressure ulcers in at-risk nursing home residents. The study population comprised 571 residents of 23 nursing homes with pressure ulcer risk, randomly assigned to a hyperoxygenated fatty acid group (n = 288) or olive oil solution group (n = 283). Both solutions were applied on at-risk skin areas every 12 hours for 30 days or until pressure ulcer onset. The main outcome variable was the pressure ulcer incidence. The absolute risk difference was estimated (with 95% CI) using Kaplan-Meier survival and Cox regression curves. The groups did not significantly differ in any study variable at baseline. The pressure ulcer incidence was 4.18% in the olive oil group vs 6.57% in the control group, with an incidence difference of -2.39% (95% CI = -6.40 to 1.56%), which is within the pre-established non-inferiority margin of ±7%, thus supporting the study hypothesis. We present the first evidence of the effectiveness and safety of the topical application of olive oil to prevent pressure ulcers in the institutionalised elderly.

Nursing records, prevention measures and incidence of pressure ulcers in an Intensive Care Unit

OBJECTIVES

The aim of this paper is to determine the incidence and most incident pressure ulcers (PU) category. Establish the main clinical characteristics of these PU. Determine whether there is adequate documentation of PU and of the measures used to prevent them.

METHOD

Observational descriptive and retrospective study during 2014 at Intensive Care Unit (ICU)-University Hospital of Araba. Study sample, all patients suffering from PU at the time of the study by accidental sampling. Computerised records regarding risk assessment, clinical assessment and pressure sore treatment, provided by the 'Metavision' computer programme and descriptive statistics using SPSS version 22.0. Approval from the Ethics Committee for Clinical Research of the University Hospital of Araba was obtained.

RESULTS

The incidence of patients suffering from PU during 2014 was 6.78%. The most common locations for PU were the sacral region and the heels: the most incident pressure ulcers category was grade II, followed by grade I. Out of the 98 PU treated in our patients, 43 occurred outside the ICU and 55 in the unit itself. The lack of records, in all the variables described about PU, was 19.10%.

CONCLUSIONS

The incidence of pressure ulcers was lower than in the current literature. The most frequent category, location and clinical characteristics are comparable to previous studies. There is a high rate of failing to record the characteristics of the PU declared. Good PU prevention measures and recording were carried out.

Uso de ácidos grasos en la prevención de úlceras por presión y de extremidad inferior

<p class="MsoNormal" style="text-align: justify; text-justify: inter-ideograph; line-height: normal;"><strong style="mso-bidi-font-weight: normal;"></strong><span style="font-size: 12.0pt;"><strong>Objetivo:</strong> Analizar la literatura científica acerca del uso y la efectividad de los ácidos grasos hiperoxigenados y las actuaciones de los profesionales de enfermería en la prevención y tratamiento de úlceras por presión y heridas crónicas.</span></p><p class="MsoNormal" style="text-align: justify; text-justify: inter-ideograph; line-height: normal;"><span style="font-size: 12.0pt;"><strong>Metodología:</strong> Se llevó a cabo una revisión bibliográfica de la literatura en las principales bases de datos de las ciencias de la salud y las ciencias sociales (MEDLINE-PUBMED, CINHAL, WEB of SCIENCE, LILACS, SOCIOLOGOCAL ABSTRACTS, CUIDEN, EMBASE, PSYCOINFO e ISI WEB of KNOWLEDGE). Se hizo una revisión analítica de los artículos seleccionados utilizando un protocolo para extraer los datos.</span></p><p class="MsoNormal" style="text-align: justify; text-justify: inter-ideograph; line-height: normal;"><span style="font-size: 12.0pt;"><strong>Resultados:</strong> Del total de artículos encontrados, 14 reportaron los resultados de ensayos clínicos o estudios cualitativos. Los autores señalaron los beneficios de la utilización de los ácidos grasos hiperoxigenados en la prevención y tratamiento de las úlceras por presión y heridas crónicas.</span></p><p class="MsoNormal" style="text-align: justify; text-justify: inter-ideograph; line-height: normal;"><span style="font-size: 12.0pt;"><strong>Conclusiones:</strong> En los estudios analizados se identificaron principalmente asuntos sobre la prevención, el tratamiento y el cuidado de enfermería en personas con úlceras crónicas y agudas. Como estrategia<br />de intervención, se reportó la efectividad de los ácidos grasos hiperoxigenados, lo que permite sugerir el uso protocolizado en el ámbito institucional, bajo la consideración de un plan de cuidados estructurado con la metodología científica del Proceso de Atención de Enfermería.</span></p>

IPARZINE-SKR study: randomized, double-blind clinical trial of a new topical product versus placebo to prevent pressure ulcers

This study compared the efficacy of a new topical agent (IPARZINE-4A-SKR) on preventing category I pressure ulcers (PUs) over a 2-week period, compared with a placebo. A double-blind, randomised, multi-centre, placebo-controlled clinical trial in two parallel groups was conducted. The primary objective was to compare PU incidence between groups. Hospital and socio-sanitary centre patients (n = 194) at risk of developing a PU (Braden scale) were randomised into two groups. The intervention group included 99 patients, and the placebo group comprised 95 patients. Patients were comparable in terms of age, sex and PU risk. In both groups, patients had a high risk of developing PUs. The product was applied on the sacrum, trochanters and heels. Six PUs (incidence = 6·1%) were detected in the intervention group versus seven (incidence = 7·4%) in the placebo group. Differences were not statistically significant (z = 0·08; P = 0·94), relative risk = 0·82 (95% confidence interval = 0·29–2·36). The main limitation of the study was the sample size and, therefore, the main difficulty encountered was in determining whether the product is ineffective or simply has not been used with sufficient patients. In conclusion, it is not possible to confirm that there are any differences between the studied and the placebo treatments in the prevention of PUs. The results obtained were similar to those obtained in studies of PU prevention using products based on topical fatty acids.