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Su S, Xiong D, Zeng Z, Ding X, Kuang J, Lin Y, Wu Y. Repair of pressure ulcers in the elderly using autologous microskin implantation and negative pressure wound therapy: A retrospective study. Technol Health Care 2024; 32:1667-1673. [PMID: 37694328 DOI: 10.3233/thc-230707] [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] [Indexed: 09/12/2023]
Abstract
BACKGROUND Pressure ulcers remain a worldwide problem. OBJECTIVE To introduce an intermittent and feasible wound treatment method for the treatment of pressure ulcers in elderly patients. METHODS This surgical procedure was performed on eight elderly patients suffering from pressure ulcers. Microskin measuring 0.1 × 0.1 centimeters was cut from a small amount of thin skin and then grafted onto the wound surface in conjunction with closed negative pressure therapy. RESULTS Seven patients had their wounds closed after a single surgery, while one patient required two surgeries to close the wound. CONCLUSION Autologous microskin implantation for the treatment of pressure ulcers in the elderly is an effective method to close the wound, which can prevent the elderly from living with wounds in their later years and is a viable treatment option.
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Affiliation(s)
- Shunqing Su
- Department of Wound Repair, Dalang Hospital, Dongguan, China
- Department of Wound Repair, Dalang Hospital, Dongguan, China
| | - Disheng Xiong
- Department of Wound Repair, Dalang Hospital, Dongguan, China
- Department of Wound Repair, Dalang Hospital, Dongguan, China
| | - Zhijian Zeng
- Anorectal Department, Dalang Hospital, Dongguan, China
| | - Xiumei Ding
- Department of Wound Repair, Dalang Hospital, Dongguan, China
| | - Jinan Kuang
- Department of Wound Repair, Dalang Hospital, Dongguan, China
| | - Yuechun Lin
- Department of Wound Repair, Dalang Hospital, Dongguan, China
| | - Yongwei Wu
- Department of Wound Repair, Dalang Hospital, Dongguan, China
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Zhang M, Du H, Ma X, Zhao W. Effect evaluation of new dressing URGOTULRANGE in the treatment of pressure injury. Technol Health Care 2024; 32:143-150. [PMID: 37248926 DOI: 10.3233/thc-220604] [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] [Indexed: 05/31/2023]
Abstract
BACKGROUND Pressure injury (PI) is a local injury of the skin and/or soft tissue located at the bone caused by medical or other equipment and is common in long-term bedridden patients. OBJECTIVE To investigate the clinical effect of Urgotul foam dressing in the treatment of stage 3 ∼ 4 PI and deep tissue PI. METHODS A total of 38 patients with stage 3 ∼ 4 PI and deep tissue PI admitted to Jinan Central Hospital from January 2016 to December 2018 were selected and randomly divided into a control group (dressing change plus silver ion cream dressing) and an observation group (dressing change plus Urgotul Absorb non-border foam dressing), with 19 cases in each group. After 4 weeks of treatment, the pain intensity during dressing change and the treatment efficacy for PI wounds were compared between the two groups. RESULTS There were no differences in gender (P= 0.740), age (P= 0.130), single wound area (P= 0.673), consultation department (P= 0.972), stage (P= 0.740), presence of undermining (P= 0.721), deep tissue PI (P= 0.721), and systemic antibiotic therapy (P= 1.000) between the two groups, which were comparable. The treatment effect of the observation group was better than that of the control group (P= 0.003), and the pain score of the observation group was lower than that of the control group (P< 0.001). CONCLUSION Urgotul Absorb non-border foam dressing has a good effect in the treatment of stage 3 ∼ 4 PI and deep tissue PI and can relieve patients' pain, and is thus worth promoting.
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Affiliation(s)
- Mengmeng Zhang
- Department of Burns and Plastic Surgery, Central Hostpital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Hongxia Du
- Department of Nursing, Central Hostpital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xiaoxia Ma
- Department of Digestive Endoscopy, Central Hostpital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Wenxing Zhao
- Department of Burns and Plastic Surgery, Central Hostpital Affiliated to Shandong First Medical University, Jinan, Shandong, China
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Barghouthi ED, Owda AY, Asia M, Owda M. Systematic Review for Risks of Pressure Injury and Prediction Models Using Machine Learning Algorithms. Diagnostics (Basel) 2023; 13:2739. [PMID: 37685277 PMCID: PMC10486671 DOI: 10.3390/diagnostics13172739] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/11/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
Pressure injuries are increasing worldwide, and there has been no significant improvement in preventing them. This study is aimed at reviewing and evaluating the studies related to the prediction model to identify the risks of pressure injuries in adult hospitalized patients using machine learning algorithms. In addition, it provides evidence that the prediction models identified the risks of pressure injuries earlier. The systematic review has been utilized to review the articles that discussed constructing a prediction model of pressure injuries using machine learning in hospitalized adult patients. The search was conducted in the databases Cumulative Index to Nursing and Allied Health Literature (CINAHIL), PubMed, Science Direct, the Institute of Electrical and Electronics Engineers (IEEE), Cochrane, and Google Scholar. The inclusion criteria included studies constructing a prediction model for adult hospitalized patients. Twenty-seven articles were included in the study. The defects in the current method of identifying risks of pressure injury led health scientists and nursing leaders to look for a new methodology that helps identify all risk factors and predict pressure injury earlier, before the skin changes or harms the patients. The paper critically analyzes the current prediction models and guides future directions and motivations.
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Affiliation(s)
- Eba’a Dasan Barghouthi
- Health Sciences Department, Arab American University, Ramallah P600, Palestine; (E.D.B.); (M.A.)
| | - Amani Yousef Owda
- Department of Natural Engineering and Technology Sciences, Arab American University, Ramallah P600, Palestine
| | - Mohammad Asia
- Health Sciences Department, Arab American University, Ramallah P600, Palestine; (E.D.B.); (M.A.)
| | - Majdi Owda
- Faculty of Data Science, Arab American University, Ramallah P600, Palestine;
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Furtado K, Voorham J, Infante P, Afonso A, Morais C, Lucas P, Lopes M. The Relationship between Nursing Practice Environment and Pressure Ulcer Care Quality in Portugal's Long-Term Care Units. Healthcare (Basel) 2023; 11:1751. [PMID: 37372869 DOI: 10.3390/healthcare11121751] [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: 03/30/2023] [Revised: 06/01/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND The morbidity associated with ageing has contributed to an increase in the prevalence of Pressure Ulcers (PUs) in all care settings. The impact of these on people's quality of life and the extent of the associated economic and social burden constitutes today, by their importance, a serious public health problem. This study aims to describe the nursing work environment in Portuguese long-term care (LTC) units and to assess how this environment relates to the quality of PU care. METHODS A longitudinal study among inpatients with PUs was conducted in LTC units. The Nursing Work Index-Revised Scale (NWI-R) was sent to all nurses in these units. Cox proportional hazard models were used to relate the satisfaction degree with the service (measured by the NWI-R-PT items) to the healing time of the PUs, adjusting for confounders. RESULTS A total of 165 of 451 invited nurses completed the NWI-R-PT. Most were women (74.6%) and had 1 to 5 years of professional experience. Less than half (38.4%) had education in wound care. Of the 88 patients identified with PUs, only 63 had their PU documented, highlighting the difficulties in updating electronic records. The results showed that the level of concordance with Q28 "Floating so that staffing is equalised among units" is strongly associated with a shorter PU healing time. CONCLUSION A good distribution of nursing staff over the units will likely improve the quality of wound care. We found no evidence for possible associations with the questions on participation in policy decisions, salary level, or staffing educational development and their relationship with PUs healing times.
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Affiliation(s)
- Katia Furtado
- Out Patient Department, Hospital of Portalegre, Unidade Local de Saúde do Norte Alentejano, 7300-312 Portalegre, Portugal
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Escola Superior de Enfermagem de Lisboa, Av. Prof. Egas Moniz, 1600-096 Lisbon, Portugal
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7000-671 Évora, Portugal
| | - Jaco Voorham
- DTIRS-Data to Insights Research Solutions, 1750-307 Lisboa, Portugal
| | - Paulo Infante
- Research Center in Mathematics and Applications (CIMA), Instituto de Investigação e Formação Avançada (IIFA), Universidade de Évora, 7000-671 Évora, Portugal
- Departamento de Matemática, Escola de Ciências e Tecnologia (ECT), Universidade de Évora, 7000-671 Évora, Portugal
| | - Anabela Afonso
- Research Center in Mathematics and Applications (CIMA), Instituto de Investigação e Formação Avançada (IIFA), Universidade de Évora, 7000-671 Évora, Portugal
- Departamento de Matemática, Escola de Ciências e Tecnologia (ECT), Universidade de Évora, 7000-671 Évora, Portugal
| | - Clara Morais
- Administração Regional de Saúde do Alentejo, Largo do Jardim do Paraíso, nº 1, 7000-864 Évora, Portugal
| | - Pedro Lucas
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Escola Superior de Enfermagem de Lisboa, Av. Prof. Egas Moniz, 1600-096 Lisbon, Portugal
| | - Manuel Lopes
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7000-671 Évora, Portugal
- São João de Deus School of Nursing, Universidade de Évora, 7000-671 Évora, Portugal
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Greenway A, Leahy N, Torrieri L, An A, Fink SA, Witenko C, Shikar M, Winchell RJ, Barie PS, Liu SI. Skin Failure Among Critically Ill Patients Afflicted with Coronavirus Disease 2019 (COVID-19). J Intensive Care Med 2021; 36:1331-1339. [PMID: 34591701 DOI: 10.1177/08850666211046532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objective: To characterize skin integrity among coronavirus disease 2019 (COVID-19) patients treated in the intensive care unit (ICU), and identify risk factors for skin failure (SF) in these patients. Design: The characteristic, profound pro-inflammatory, hypercoagulable state of COVID-19 is manifested by the high severity of illness and extensive organ dysfunction observed in these patients. SF in critically ill patients, although described previously, exhibits a uniquely complex pathogenesis in this population. Patients: Retrospective review of all COVID-19 patients (confirmed positive for severe acute respiratory syndrome coronavirus-2 [SARS-CoV-2]) admitted to a single surgical ICU for at least 48 hours between March-June 2020. Interventions: Data were extracted from a COVID-19 institutional data repository that harvested data from electronic health records and other clinical data sources. Demographics; coagulation/inflammation biomarkers; number, location, and stage of SF lesions; resource utilization; and outcomes were captured. Measurements and Main Results: 64 patients met inclusion criteria; 51 (80%) developed SF (SF+ ). Forty-three (85%) developed stage 3 or higher SF (χ2 = 22.66, P < .0001). Thirty-nine of 51 (76%) SF+ patients developed more than one SF lesion (χ2 = 13.26, P = .0003). SF+ patients manifested a profound pro-inflammatory, hypercoagulable phenotype (lower serum albumin and higher ferritin, interleukin [IL]-6 and D-dimer concentrations [all, P < .001]). Durations of mechanical ventilation, vasopressor therapy, and ICU length of stay were significantly longer (all, P < .05) in the SF + patients. Conclusions: The unique characteristics of COVID-19 dermatopathology and the strong correlation between markers of inflammation and development of SF reflect COVID-19-related organ dysfunction and its deleterious effects on the microcirculation. Considering that skin is invaded directly by SARS-CoV-2 and affected by COVID-19-related immune complex deposition and microthrombosis, SF may reflect disease as opposed to pressure injuries related to processes of care. In the context of COVID-19 critical illness, SF should not be considered a "never event."
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Affiliation(s)
- Andrew Greenway
- 159947NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY
| | - Nicole Leahy
- 159947NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY
| | - Lisa Torrieri
- 159947NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY
| | - Anjile An
- Weill Cornell Medicine, New York, NY
| | - Sarah A Fink
- 159947NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY
| | - Corey Witenko
- 159947NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY
| | - Morgan Shikar
- 159947NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY
| | | | | | - Susan I Liu
- 159947NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY
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