Use of a Powered Coverlet for Moisture Removal, Skin Temperature Reduction, Odor, and Bacteria Control

The effect of uncoated paper application on skin moisture, risk of pressure injury and incidence of pressure injury in neurologic intensive care unit patients: A randomized controlled trial

AIM

This study aimed to evaluate the effects of uncoated paper on skin moisture, pressure injury risk and pressure injury incidence in neurological intensive care unit patients.

METHODS

A randomized controlled design was used. The experimental group (n = 68) received usual care (repositioning every 2 h and use of an air mattress) and application of uncoated paper on the sacral area for 5 days, whereas the control group (n = 67) received only usual care. A repeated measures analysis of variance was used to determine changes in the skin moisture and risk of pressure injury between the groups. A chi-squared test was used to determine the change in the incidence of pressure injuries for sacral area. Data were collected from 20 October 2017 to 6 March 2018.

RESULTS

There were statistically significant differences in the skin moisture and risk of pressure injuries between the experimental and control groups. However, a significant difference was not observed in the incidence of pressure injuries between the groups.

CONCLUSION

The use of uncoated paper may be a valid nursing intervention for the prevention of pressure injuries in neurological intensive care unit patients.

Effectiveness of Tragacanth Gel Cushions in Prevention of Pressure Ulcer in Traumatic Patients: a Randomized Controlled Trial

Introduction: Introduction: Pressure ulcer is one of the most common and painful complications in patients admitted to intensive care units (ICUs). This study aimed to compare the effects of tragacanth gel cushions and foam-filled ones on the prevention of pressure ulcers. Methods: This triple-blind, randomized, clinical trial was performed on 94 patients admitted to the ICU of Taleqhani Hospital of Mashhad, Iran. The participants were divided into two groups of tragacanth gel pad and foam (n=47 for each group). Both groups received all the routine care. The participants were examined on a daily basis during a ten-day period. We considered sacral region as the most affected site, and the patients with erythema were excluded from the study. To analyze the data, Chi-squared test, Fisher's exact test, and t-test were run, using Stata version 12. Results: The data showed significant differences in terms of the incidence of skin redness in the tragacanth gel cushions group and foam cushion group, respectively, 6.84 (1.58) and 5.67 (1.26) days after admission. In addition, in the tragacanth gel cushions group 14 patients (29.7%) did not have skin redness compared with the foam cushion group (8.51%), which indicated a significant difference. Conclusion: This study showed that the use of tragacanth gel cushion is effective in the prevention of pressure ulcers in ICU patients. Cushions filled with tragacanth gel also delayed the onset of erythema. Considering their cost-effectiveness and naturalness, the use of tragacanth gel cushions is recommended to improve the sacral skin health and prevent pressure ulcers.

An evaluation of fluid immersion therapy for the prevention of pressure ulcers

BACKGROUND

Individuals with impaired mobility can spend prolonged periods on support surfaces, increasing their risk of developing pressure ulcers. Manufacturers have developed mattresses to maximise contact area. The present study evaluated both the biomechanical and physiological responses to lying postures on a Fluid Immersion Simulation mattress.

METHODS

Seventeen healthy participants were recruited to evaluate the mattress during three prescribed settings of immersion (high, medium and low). Parameters reflecting biomechanical and physiological responses, and the microclimate were monitored during three postures (supine, lateral and high-sitting) over a 90minute test session. Transcutaneous oxygen and carbon dioxide gas responses were categorised according to three criteria and data were compared between each condition.

FINDINGS

Results indicated that interface pressures remained consistent, with peak sacral values ranging from 21 to 27mmHg across all immersion settings and postures. The majority of participants (82%) exhibited minimal changes in gas tensions at the sacrum during all test conditions. By contrast, three participants exhibited decreased oxygen with increased carbon dioxide tensions for all three immersion settings. Supine and high sitting sacral microclimate values ranged between 30.1-30.6°C and 42.3-44.5% for temperature and relative humidity respectively. During lateral tilt there was a reduction of 1.7-2.5°C and 3.3-5.3% in these values. The majority of participants reported high comfort scores, although a few experienced bottoming out during the high-sitting posture at the high immersion setting.

INTERPRETATION

Fluid Immersion Simulation provides an intelligent approach to increase the support area. Further research is required to provide evidence based guidance on the use of personalised support surfaces.