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Rêgo ADS, Furtado GE, Bernardes RA, Santos-Costa P, Dias RA, Alves FS, Ainla A, Arruda LM, Moreira IP, Bessa J, Fangueiro R, Gomes F, Henriques M, Sousa-Silva M, Pinto AC, Bouçanova M, Sousa VIF, Tavares CJ, Barboza R, Carvalho M, Filipe L, Sousa LB, Apóstolo JA, Parreira P, Salgueiro-Oliveira A. Development of Smart Clothing to Prevent Pressure Injuries in Bedridden Persons and/or with Severely Impaired Mobility: 4NoPressure Research Protocol. Healthcare (Basel) 2023; 11:healthcare11101361. [PMID: 37239647 DOI: 10.3390/healthcare11101361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/25/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023] Open
Abstract
Pressure injuries (PIs) are a major public health problem and can be used as quality-of-care indicators. An incipient development in the field of medical devices takes the form of Smart Health Textiles, which can possess innovative properties such as thermoregulation, sensing, and antibacterial control. This protocol aims to describe the process for the development of a new type of smart clothing for individuals with reduced mobility and/or who are bedridden in order to prevent PIs. This paper's main purpose is to present the eight phases of the project, each consisting of tasks in specific phases: (i) product and process requirements and specifications; (ii and iii) study of the fibrous structure technology, textiles, and design; (iv and v) investigation of the sensor technology with respect to pressure, temperature, humidity, and bioactive properties; (vi and vii) production layout and adaptations in the manufacturing process; (viii) clinical trial. This project will introduce a new structural system and design for smart clothing to prevent PIs. New materials and architectures will be studied that provide better pressure relief, thermo-physiological control of the cutaneous microclimate, and personalisation of care.
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Affiliation(s)
- Anderson da Silva Rêgo
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3000-232 Coimbra, Portugal
| | - Guilherme Eustáquio Furtado
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3000-232 Coimbra, Portugal
- Polytechnic Institute of Coimbra, Applied Research Institute, Rua da Misericórdia, Lagar dos Cortiços-S. Martinho do Bispo, 3045-093 Coimbra, Portugal
| | - Rafael A Bernardes
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3000-232 Coimbra, Portugal
| | - Paulo Santos-Costa
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3000-232 Coimbra, Portugal
| | - Rosana A Dias
- International Iberian Laboratory of Nanotechnology (INL), 4715-330 Braga, Portugal
| | - Filipe S Alves
- International Iberian Laboratory of Nanotechnology (INL), 4715-330 Braga, Portugal
| | - Alar Ainla
- International Iberian Laboratory of Nanotechnology (INL), 4715-330 Braga, Portugal
| | - Luisa M Arruda
- Fibrenamics, Institute of Innovation on Fibre-Based Materials and Composites, University of Minho, 4800-058 Guimaraes, Portugal
- Centre for Textile Science and Technology (2C2T), University of Minho, 4800-058 Guimaraes, Portugal
| | - Inês P Moreira
- Fibrenamics, Institute of Innovation on Fibre-Based Materials and Composites, University of Minho, 4800-058 Guimaraes, Portugal
- Centre for Textile Science and Technology (2C2T), University of Minho, 4800-058 Guimaraes, Portugal
| | - João Bessa
- Fibrenamics, Institute of Innovation on Fibre-Based Materials and Composites, University of Minho, 4800-058 Guimaraes, Portugal
- Centre for Textile Science and Technology (2C2T), University of Minho, 4800-058 Guimaraes, Portugal
| | - Raul Fangueiro
- Fibrenamics, Institute of Innovation on Fibre-Based Materials and Composites, University of Minho, 4800-058 Guimaraes, Portugal
- Centre for Textile Science and Technology (2C2T), University of Minho, 4800-058 Guimaraes, Portugal
| | - Fernanda Gomes
- CEB-Centre of Biological Engineering, LIBRO-Laboratório de Investigação em Biofilmes Rosário Oliveira, University of Minho, 4710-057 Braga, Portugal
- LABBELS-Associate Laboratory, 4710-057 Braga, Portugal
| | - Mariana Henriques
- CEB-Centre of Biological Engineering, LIBRO-Laboratório de Investigação em Biofilmes Rosário Oliveira, University of Minho, 4710-057 Braga, Portugal
- LABBELS-Associate Laboratory, 4710-057 Braga, Portugal
| | - Maria Sousa-Silva
- CEB-Centre of Biological Engineering, LIBRO-Laboratório de Investigação em Biofilmes Rosário Oliveira, University of Minho, 4710-057 Braga, Portugal
- LABBELS-Associate Laboratory, 4710-057 Braga, Portugal
| | - Alexandra C Pinto
- CEB-Centre of Biological Engineering, LIBRO-Laboratório de Investigação em Biofilmes Rosário Oliveira, University of Minho, 4710-057 Braga, Portugal
- LABBELS-Associate Laboratory, 4710-057 Braga, Portugal
| | - Maria Bouçanova
- Impetus Portugal-Têxteis Sa (IMPETUS), 4740-696 Barcelos, Portugal
| | - Vânia Isabel Fernande Sousa
- Physics Center of Minho and Porto Universities (CF-UM-PT), Campus of Azurém, University of Minho, 4804-533 Guimarães, Portugal
| | - Carlos José Tavares
- Physics Center of Minho and Porto Universities (CF-UM-PT), Campus of Azurém, University of Minho, 4804-533 Guimarães, Portugal
| | - Rochelne Barboza
- Centre for Textile Science and Technology (2C2T), University of Minho, 4800-058 Guimaraes, Portugal
| | - Miguel Carvalho
- Centre for Textile Science and Technology (2C2T), University of Minho, 4800-058 Guimaraes, Portugal
| | - Luísa Filipe
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3000-232 Coimbra, Portugal
| | - Liliana B Sousa
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3000-232 Coimbra, Portugal
| | - João A Apóstolo
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3000-232 Coimbra, Portugal
| | - Pedro Parreira
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3000-232 Coimbra, Portugal
| | - Anabela Salgueiro-Oliveira
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3000-232 Coimbra, Portugal
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Risk factors for the development and evolution of deep tissue injuries: A systematic review. J Tissue Viability 2022; 31:416-423. [PMID: 35450822 DOI: 10.1016/j.jtv.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 03/08/2022] [Accepted: 03/22/2022] [Indexed: 11/22/2022]
Abstract
AIMS The aim of this systematic review is to identify the current epidemiological evidence indicating the unique risk factors for deep tissue injury (DTI) compared to grade I-IV pressure injury (PI), the proportion of DTI which evolve rather than resolve and the anatomical distribution of DTI. METHODS A systematic literature search was undertaken using the MEDLINE and CINAHL Plus databases using the search terms 'Deep tissue injury OR DTI [Title/abstract]'. A google scholar search was also conducted in addition to hand searches of relevant journals, websites and books which were identified from reference lists in retrieved articles. Only peer-reviewed English language articles published 2009-2021 were included, with full text available online. RESULTS The final qualitative analysis included nine articles. These included n = 4 retrospective studies, n = 4 prospective studies and n = 1 animal study. CONCLUSION The literature indicates that the majority of DTI occur at the heel and sacrum although in paediatric patients they are mainly associated with medical devices. Most DTI are reported to resolve, with between 9.3 and 27% deteriorating to full thickness tissue loss. Risk factors unique to DTI appear to include anaemia, vasopressor use, haemodialysis and nicotine use although it is unclear if these factors are unique to DTI or are shared with grade I-IV PI. Factors associated with deterioration include cooler skin measured using infrared thermography and negative capillary refill. With 100% of DTI showing positive capillary refill in one study resolving without tissue loss (p = 0.02) suggesting this may be an effective prognostic indicator. More prospective studies are required focusing on establishing causal links between risk factors identified in earlier retrospective studies. Ideally these should use statistically powered samples and sufficient follow up periods allowing DTI outcomes to be reached. Further work is also needed to establish reliable diagnostic criteria for DTI in addition to more studies in the paediatric population.
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