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Jiang S, Yin L. Incidence of medical adhesive-related skin injury: a reduction by changing posture. J Wound Care 2024; 33:509-514. [PMID: 38967347 DOI: 10.12968/jowc.2022.0075] [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: 07/06/2024]
Abstract
OBJECTIVE Medical adhesive-related skin injuries (MARSI), defined as skin damage associated with the use of medical adhesive products or devices, are a common and under-reported condition that compromises skin integrity. The prevention and management of MARSI that can occur around the needle insertion site of a chest wall implantable port in hospitalised patients with a tumour remain challenging issues. The aim of this study was to explore whether the incidence of MARSI could be reduced by changing the body position during dressing changes. METHOD Participants were recruited between May 2019 and November 2020 in the oncology department of a tertiary hospital. Patients were randomly assigned to Group AB (supine followed by semi-recumbent position) and Group BA (semi-recumbent followed by supine position) with a standard intervening recovery interval of 21-28 days. Assessments for typical MARSI included itching, the combination of erythema and oedema, and blisters in the port area, and were graded according to the level of severity. RESULTS The itch intensity was significantly lower in phase B (semi-recumbent) compared to phase A (supine) (2.35±1.985 versus 5.31±1.332, respectively; p<0.01). Similarly, the severity of erythema and oedema was less severe when comparing phase B to phase A: grade 0 (64.9% versus 10.5%, respectively); grade 1 (28.1% versus 19.3%, respectively); grade 2 (3.5% versus 7.0%, respectively); grade 3 (1.8% versus 45.6%, respectively); and grade 4 (1.8% versus 17.5%, respectively) (Z=5.703; p<0.01). Blisters were found far less frequently in phase B than phase A (1.8% versus 56.1%, respectively; p<0.01). CONCLUSION The study provided statistically significant evidence that patients in a semi-recumbent position receiving dressing at a chest wall implantable port had fewer and less severe injection site MARSI than when in a supine position. DECLARATION OF INTEREST The authors have no conflicts of interest to declare.
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Affiliation(s)
- Shudi Jiang
- Center of Oncology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, China
| | - Lijuan Yin
- Center of Oncology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, China
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Nie S, Wang L, Ma S, Sun H. Trends in the prevalence and risk factors for peripherally inserted central catheter-related complications in cancer patients from 2016 to 2022: a multicenter study. Support Care Cancer 2024; 32:239. [PMID: 38512390 DOI: 10.1007/s00520-024-08444-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 03/16/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE To identify the trends in the prevalence of peripherally inserted central catheter (PICC) related complications in cancer patients and explore the risk factors for complications and occurrence speed. METHODS A total of 3573 cancer patients with PICC were recruited at 17 hospitals from 2016 to 2022. Logistic and COX regression were performed to identify influencing factors of PICC-related complications and incidence speed, respectively. RESULTS The proportion of symptomatic PICC-related thrombosis, phlebitis, and infections reported had decreased from 59.1% (in 2017), 11.9% (in 2016), and 11.1% (in 2016) to 15.3% (in 2022), 2.9% (in 2022), and 7.4% (in 2022), and adhesive-related skin injuries and bleeding/oozing reported had increased from 4.8% (in 2016) and 0.0% (in 2016) to 45.5% (in 2022) and 3.4% (in 2022), respectively. Catheter occlusion showed a trend of first increasing and then decreasing from 2.4 (in 2016) to 12.0 (in 2020) to 5.8% (in 2022). Logistic regression showed that hospital level, nature, the patient's gender, age, diagnosis, history of deep vein catheterization, chemotherapy drug administration, and type of PICC were influencing factors of complications. COX regression showed that the patient's gender, age, diagnosis, history of deep vein thrombosis and thrombophlebitis, history of deep vein catheterization, chemotherapy drug administration, type of PICC, type of connector, and StatLock used for fixation were influencing factors of incidence speed. CONCLUSION The composition ratios of PICC-related complications in cancer patients in China have changed in recent years. Chemotherapy drug administration was a significant risk factor accelerating the occurrence of complications. Maintenance factors had the maximum weight on the COX model, followed by patient factors. It is suggested that patients with high-risk factors be closely monitored and proper maintenance be performed to prevent and delay the occurrence of PICC-related complications.
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Affiliation(s)
- Shengxiao Nie
- Department of Nursing, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 Dahua Road, Dongcheng District, 100730, Beijing, People's Republic of China
| | - Lei Wang
- Department of Nursing, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 Dahua Road, Dongcheng District, 100730, Beijing, People's Republic of China
| | - Shengmiao Ma
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 9 Dong Dan San Tiao, 100144, Beijing, People's Republic of China
| | - Hong Sun
- Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 Dahua Road, Dongcheng District, 100730, Beijing, People's Republic of China.
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Yuceler Kacmaz H, Kahraman H, Cinar SL, Ozkan F. Skin properties associated with skin tears in older adults: A case-control study. J Tissue Viability 2023; 32:585-589. [PMID: 37839901 DOI: 10.1016/j.jtv.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 09/15/2023] [Accepted: 09/24/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND The world population is growing rapidly and skin problems such as skin tears (STs) are more common in aging skin due to changes in the epidermis and dermis. Identification of ageing related skin properties, which are risk factors for STs, is essential for the development of ST prevention protocols. OBJECTIVE The aim of this study was to reveal the skin properties related to epidermal function and dermal associated with STs. MATERIAL AND METHODS A prospective case-control study was conducted with a sample of 36 older adults, 18 participants with ST and 18 participants without ST, in two elderly care centers. Tewameter TM 210 was used to measure transepidermal water loss, the Sebumeter SM810 was used to measure sebum, and Cutometer Dual MPA 580 was used to measure skin viscoelasticity (R0-R9). The differences of skin properties between groups were analyzed using the independent t-test and Mann-Whitney U test. RESULTS The case group had a mean age of 77,17 ± 9,7 and the control group had a mean age of 75,33 ± 6,8. It was determined that there were more ecchymosis (p < 0.000), hematoma (p = 0.008), and ST history (p = 0.001) in the case group. Older adults in the case group were more frail than the control group (p = 0.044). Regarding the score of the skin properties, the case group showed that the TEWL levels of the older adults in the case group were lower (p = 0.031) compared to the control groups. There was a significant difference between the groups and R0, R2, R5, and R7. While R0 was higher in the case group, R2, R5, and R7 were lower than the control group. CONCLUSION Older adults with ST showed differences in skin properties compared to those without ST, especially transepidermal water loss, and viscoelasticity (R0, R2, R5, R7). The results of this study suggest that some changes in skin properties may be a risk factor for STs.
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Affiliation(s)
- Hatice Yuceler Kacmaz
- Erciyes University, Faculty of Health Sciences, Department of Nursing, Kayseri, Turkey.
| | - Hilal Kahraman
- Erciyes University, Faculty of Health Sciences, Department of Nursing, Kayseri, Turkey.
| | - Salih Levent Cinar
- Erciyes University, Faculty of Medicine, Department of Dermatology, Kayseri, Turkey.
| | - Filiz Ozkan
- Erciyes University, Faculty of Health Sciences, Department of Nursing, Kayseri, Turkey.
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Swanson S, Luu V, Smith R, Gross A, Tudor J, MacKenzie D, Taroc AM, Gow KW, Nelson LY, Seibel EJ. A temperature-sensitive, high-adhesion medical tape: a comparative, single-blind clinical trial. J Wound Care 2023; 32:665-675. [PMID: 37830828 PMCID: PMC10798267 DOI: 10.12968/jowc.2023.32.10.665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
OBJECTIVE Medical adhesives are used to secure wound care dressings and other critical devices to the skin. While high peel-strength adhesives provide more secure skin attachment, they are difficult to remove from the skin and are correlated with medical adhesive-related skin injuries (MARSI), including skin tears, and an increased risk of infection. Lower-adhesion medical tapes may be applied to avoid MARSI, leading to dressing or device dislodgement and further medical complications. METHOD This paper reports on the clinical testing of a new, high-adhesion medical tape, ThermoTape (University of Washington, US), designed for low skin trauma upon release. ThermoTape was benchmarked with Tegaderm (3M, US) and Kind Removal Tape (KRT) (3M, US). All three tapes were applied to both the left and right forearm of healthy volunteers and were removed 24 hours later-the right arm without applying heat and the left arm by applying a heat pack for 30 seconds before removal. Tape wear, self-reported pain (0-10 scale) and skin redness 15 minutes after removal were recorded. RESULTS This was a 53-subject comparative, single-blind clinical trial. There were clinically and statistically significant results supporting reduced pain during removal of ThermoTape with warming, with an average 58% decrease in pain, paired with a statistically significant 45% reduction in skin redness (p<0.01 for both values). In contrast, there were statistically insignificant differences in pain and redness for removal of Tegaderm and KRT with warming. ThermoTape after warming, in comparison with Tegaderm without warming, produced a reduced pain score of >1 on the 0-10 Wong-Baker/Face pain scale, which was statistically significant (p<0.01). CONCLUSION These results provide compelling evidence that warming ThermoTape prior to removal can reduce pain and injury when compared with standard medical tapes. This could allow for stronger attachment of wound care dressings and critical medical devices while reducing cases of MARSI.
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Affiliation(s)
- Shawn Swanson
- Human Photonics Laboratory, Department of Mechanical Engineering, University of Washington, Seattle, WA, US
| | - Vivian Luu
- Human Photonics Laboratory, Department of Mechanical Engineering, University of Washington, Seattle, WA, US
| | - Ryan Smith
- Human Photonics Laboratory, Department of Mechanical Engineering, University of Washington, Seattle, WA, US
| | - Allayna Gross
- Human Photonics Laboratory, Department of Mechanical Engineering, University of Washington, Seattle, WA, US
| | - Joelle Tudor
- Human Photonics Laboratory, Department of Mechanical Engineering, University of Washington, Seattle, WA, US
| | - Devin MacKenzie
- Human Photonics Laboratory, Department of Mechanical Engineering, University of Washington, Seattle, WA, US
- Washington Clean Energy Testbeds, University of Washington, Seattle, WA, US
- Department of Materials Science and Engineering, University of Washington, Seattle, WA, US
| | | | - Kenneth W Gow
- Seattle Children’s Hospital, Seattle, WA, US
- Department of Surgery, University of Washington, Seattle, WA, US
| | - Leonard Y Nelson
- Human Photonics Laboratory, Department of Mechanical Engineering, University of Washington, Seattle, WA, US
| | - Eric J Seibel
- Human Photonics Laboratory, Department of Mechanical Engineering, University of Washington, Seattle, WA, US
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Tak SH, Choi H, Lee D, Song YA, Park J. Nurses' Perceptions About Smart Beds in Hospitals. Comput Inform Nurs 2023; 41:394-401. [PMID: 36071665 PMCID: PMC10241421 DOI: 10.1097/cin.0000000000000949] [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: 11/25/2022]
Abstract
The purpose of this study was to examine nurses' perceptions of the smart mattress equipped with Internet of things, which are incorporated into patients' beds. In addition, their concerns and suggestions about smart mattress were explored. A total of 349 nurses in a tertiary hospital participated in a cross-sectional survey. Data were collected using questionnaires. Descriptive statistical analysis was used for survey data, whereas content analysis was used for qualitative data from open-ended questions. The participants' intention to accept the smart mattresses was 12.5 (SD, 1.73) on average, indicating a high level of acceptance. The participants expected the smart mattresses to decrease their physical work burden, improve work efficiency, and prevent pressure ulcers. However, they were concerned about an increase in other aspects of their workload and in patient safety problems due to false alarms, inaccuracies, and malfunctions of the device. Nurses suggested various features that can be integrated into smart mattress. It is critical to address nurses' perceptions, expectations, and concerns during the conceptual and developmental stage of new technology in order to improve the usability, acceptance, and adoption of smart mattresses and other new innovations in hospital settings.
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Abstract
Significance: Healthy skin provides a barrier to contaminants. Breaches in skin integrity are often encountered in the patient health care journey, owing to intrinsic health issues or to various procedures and medical devices used. The time has come to move clinical practice beyond mere awareness of medical adhesive-related skin injury and toward improved care and outcomes. Recent Advances: Methods developed in research settings allow quantitative assessments of skin damage based on the measurement of baseline skin properties. These properties become altered by stress and over time. Assessment methods typically used by the cosmetic industry to compare product performance could offer new possibilities to improve clinical practice by providing better information on the status of patient skin. This review summarizes available skin assessment methods as well as specific patient risks for skin damage. Critical Issues: Patients in health care settings may be at risk for skin damage owing to predisposing medical conditions, health status, medications taken, and procedures or devices used in their treatment. Skin injuries come as an additional burden to these medical circumstances and could be prevented. Technology should be leveraged to improve care, help maintain patient skin health, and better characterize functional wound closure. Future Directions: Skin testing methods developed to evaluate cosmetic products or assess damage caused by occupational exposure can provide detailed, quantitative information on the integrity of skin. Such methods have the potential to guide prevention and treatment efforts to improve the care of patients suffering from skin integrity issues while in the health care system.
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Affiliation(s)
- Stéphanie F. Bernatchez
- 3M Health Care, St. Paul, Minnesota, USA.,Correspondence: 3M Health Care, St. Paul, MN 55144-1000, USA
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Rabelo AL, Bordonal J, de Almeida TL, Oliveira PP, Moraes JT. Medical adhesive-related skin injury in adult intensive care unit: scoping review. Rev Bras Enferm 2022; 75:e20210926. [PMID: 36102472 PMCID: PMC9728873 DOI: 10.1590/0034-7167-2021-0926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 04/22/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES to identify and synthesize scientific evidence on preventing medical adhesive-related skin injuries in adult intensive care patients. METHODS this is a scoping review based on PRISMA-ScR recommendations and the technique proposed by Joanna Briggs Institute. PubMed, CINAHL, Web of Science, Scopus, LILACS, and Embase databases were searched using "Injuries AND Adhesives AND Skin AND Medical" descriptors". RESULTS 1,329 studies were identified, and after analysis, the final sample consisted of nine articles. We obtained two experts' consensus, three case studies, two cross-sectional studies, one prospective cohort study, and one literature review regarding the type of studies. FINAL CONSIDERATIONS the synthesized evidence allowed us to list health care measures to prevent medical adhesive-related skin injuries. The professional must know how to identify the skin injuries associated with medical adhesives and the main strategies for their prevention.
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Affiliation(s)
| | - Jéssica Bordonal
- Universidade Federal de São João Del Rei. Divinópolis, Minas Gerais, Brazil
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Swanson S, Bashmail R, Fellin CR, Luu V, Shires N, Cox PA, Nelson A, MacKenzie D, Taroc AM, Nelson LY, Seibel EJ. Prototype Development of a Temperature-Sensitive High-Adhesion Medical Tape to Reduce Medical-Adhesive-Related Skin Injury and Improve Quality of Care. Int J Mol Sci 2022; 23:7164. [PMID: 35806167 PMCID: PMC9266747 DOI: 10.3390/ijms23137164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 06/23/2022] [Accepted: 06/26/2022] [Indexed: 02/01/2023] Open
Abstract
Medical adhesives are used to secure wound care dressings and other critical devices to the skin. Without means of safe removal, these stronger adhesives are difficult to painlessly remove from the skin and may cause medical-adhesive-related skin injuries (MARSI), including skin tears and an increased risk of infection. Lower-adhesion medical tapes may be applied to avoid MARSI, leading to device dislodgement and further medical complications. This paper outlines the development of a high-adhesion medical tape designed for low skin trauma upon release. By warming the skin-attached tape for 10-30 s, a significant loss in adhesion was achieved. A C14/C18 copolymer was developed and combined with a selected pressure-sensitive adhesive (PSA) material. The addition of 1% C14/C18 copolymer yielded the largest temperature-responsive drop in surface adhesion. The adhesive film was characterized using AFM, and distinct nanodomains were identified on the exterior surface of the PSA. Our optimized formulation yielded 67% drop in adhesion when warmed to 45 °C, perhaps due to melting nanodomains weakening the adhesive-substrate boundary layer. Pilot clinical testing resulted in a significant decrease in pain when a heat pack was used for removal, giving an average pain reduction of 66%.
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Affiliation(s)
- Shawn Swanson
- Human Photonics Laboratory, Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA; (S.S.); (R.B.); (V.L.); (N.S.); (L.Y.N.)
| | - Rahaf Bashmail
- Human Photonics Laboratory, Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA; (S.S.); (R.B.); (V.L.); (N.S.); (L.Y.N.)
| | - Christopher R. Fellin
- Department of Chemistry, University of Washington, Seattle, WA 98195, USA; (C.R.F.); (A.N.)
| | - Vivian Luu
- Human Photonics Laboratory, Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA; (S.S.); (R.B.); (V.L.); (N.S.); (L.Y.N.)
| | - Nicholas Shires
- Human Photonics Laboratory, Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA; (S.S.); (R.B.); (V.L.); (N.S.); (L.Y.N.)
| | - Phillip A. Cox
- Washington Clean Energy Testbeds, University of Washington, Seattle, WA 98105, USA;
| | - Alshakim Nelson
- Department of Chemistry, University of Washington, Seattle, WA 98195, USA; (C.R.F.); (A.N.)
| | - Devin MacKenzie
- Department of Materials Science and Engineering, University of Washington, Seattle, WA 98195, USA;
| | | | - Leonard Y. Nelson
- Human Photonics Laboratory, Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA; (S.S.); (R.B.); (V.L.); (N.S.); (L.Y.N.)
| | - Eric J. Seibel
- Human Photonics Laboratory, Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA; (S.S.); (R.B.); (V.L.); (N.S.); (L.Y.N.)
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Rabelo AL, Moraes JT. BUNDLE: MEDICAL ADHESIVE-RELATED SKIN INJURY PREVENTION IN ADULT INTENSIVE CARE. TEXTO & CONTEXTO ENFERMAGEM 2022. [DOI: 10.1590/1980-265x-tce-2022-0221en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
ABSTRACT Objective to build and validate a bundle for medical adhesive-related skin injury prevention in adult intensive care. Method this is a methodological study, carried out in three stages: development of a Scoping Review, bundle construction and content validity. This scoping review followed the JBI recommendations, and the content validity process was performed using the Delphi technique. Six expert judges participated in this process. For content validity analysis, the Content Validity Coefficient and binomial test were calculated. Items that reached a coefficient ≥0.80 and an agreement proportion of 80% among judges were considered valid for the binomial test. Results the bundle structure had 21 recommendations, grouped into categories: skin assessment, identification of patients at risk, product selection, skin preparation, adhesive application technique, adhesive removal technique and health professionals’ education. The criteria established for assessment achieved satisfactory levels of assessment, being considered adequate by judges. In Delphi I, the assessed items obtained a Content Validity Coefficient ≥0.83 and in Delphi II, ≥0.97. Conclusion in this study, it was allowed to construct and validate a bundle for medical adhesive-related skin injury prevention in adult intensive care.
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Rabelo AL, Bordonal J, Almeida TLD, Oliveira PP, Moraes JT. Lesão de pele relacionada a adesivo médico em unidade de terapia intensiva adulto: scoping review. Rev Bras Enferm 2022. [DOI: 10.1590/0034-7167-2021-0926pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
RESUMO Objetivos: identificar e sintetizar evidências científicas sobre prevenção de lesões de pele relacionadas a adesivo médico nos pacientes adultos em terapia intensiva. Métodos: trata-se de uma scoping review desenvolvida com base nas recomendações do PRISMA-ScR e no método proposto por Joanna Briggs Institute. Realizaram-se buscas nas bases de dados PubMed, CINAHL, Web of Science, Scopus, LILACS e Embase, utilizando os descritores “Injuries AND Adhesives AND Skin AND Medical”. Resultados: identificaram-se 1.329 estudos; após análise, a amostra final foi composta por nove artigos. Quanto ao tipo de estudos, obtiveram-se dois consensos de especialistas, três estudos de caso, dois estudos transversais, um de coorte prospectivo e uma revisão de literatura. Considerações Finais: as evidências sintetizadas possibilitaram elencar cuidados para prevenção de lesões de pele relacionadas a adesivos médicos. É importante que o profissional saiba identificar tanto as lesões de pele relacionadas aos adesivos médicos quanto as principais estratégias para prevenção destas.
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Rabelo AL, Moraes JT. BUNDLE: PREVENÇÃO DE LESÕES DE PELE RELACIONADAS A ADESIVOS MÉDICOS EM TERAPIA INTENSIVA ADULTO. TEXTO & CONTEXTO ENFERMAGEM 2022. [DOI: 10.1590/1980-265x-tce-2022-0221pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
RESUMO Objetivo construir e validar um bundle para a prevenção de lesões de pele relacionadas a adesivos médicos em terapia intensiva adulto. Método trata-se de um estudo metodológico, realizado em três etapas: desenvolvimento de uma Scoping Review, construção do bundle e validação de conteúdo. A Scoping Review seguiu as recomendações do Joanna Briggs Institute, e o processo de validação de conteúdo foi realizado, por meio da técnica Delphi. Participaram desse processo seis juízes especialistas. Para a análise da validação de conteúdo, foram calculados o Coeficiente de Validade de Conteúdo e teste binomial. Foram considerados válidos os itens que atingiram coeficiente ≥0,80 e a proporção de concordância de 80% entre os juízes, para o teste binomial. Resultados a estrutura do bundle contou com 21 recomendações, agrupadas em categorias: avaliação da pele, identificação dos pacientes de risco, seleção do produto, preparo da pele, técnica de aplicação do adesivo, técnica de remoção do adesivo e educação permanente dos profissionais de saúde. Os critérios estabelecidos para a avalição alcançaram níveis de avalição satisfatórios, sendo considerados adequados pelos juízes. Em Delphi I, os itens avaliados obtiveram um Coeficiente de Validação de Conteúdo ≥0,83 e em Delphi II, ≥0,97. Conclusão neste estudo, permitiu-se construir e validar bundle, para a prevenção de leões de pele relacionadas a adesivos médicos em terapia intensiva adulto.
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Kim J, Shin Y. Medical Adhesive-Related Skin Injury Associated with Surgical Wound Dressing among Spinal Surgery Patients: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179150. [PMID: 34501740 PMCID: PMC8430563 DOI: 10.3390/ijerph18179150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/29/2021] [Accepted: 08/29/2021] [Indexed: 11/16/2022]
Abstract
The aim of this cross-sectional study was to determine the incidence, types, and factors associated with medical adhesive-related skin injuries (MARSIs) among spinal surgery patients. Adult patients who underwent planned spinal surgery under general anesthesia at a tertiary hospital in Seoul, Korea were enrolled. Data were collected from March through April 2019. Skins under surgical wound dressings were evaluated for MARSI once every morning until discharge. Skin injuries lasting for 30 min or more were considered as MARSIs. Logistic regression was performed to identify factors associated with MARSI. The incidence of MARSIs in surgical areas was 36.4% and the rate per 100 medical adhesives was 9.8%. All MARSIs occurred on postoperative day 1 or 2. A history of contact dermatitis (OR = 10.517, 95% CI = 3.540–31.241, p < 0.001) and late ambulation (OR = 1.053, 95% CI = 1.012–1.095, p = 0.010) were identified as risk factors for MARSI. Spinal surgery patients were at high risk of MARSIs associated with surgical wound dressings. Patients with a history of contact dermatitis or prolonged bed rest periods need more active skin assessment and more careful skin care to prevent MARSIs after spinal surgery.
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Affiliation(s)
- Jeounghee Kim
- Department of Nursing, Asan Medical Center, Seoul 05505, Korea;
| | - Yongsoon Shin
- College of Nursing, Hanyang University, Seoul 04763, Korea
- Correspondence: ; Tel.: +82-02-2220-0798
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