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Yuceler Kacmaz H, Kahraman H, Topal Hancer A, Uzgor F, Gur S, Kalkan N, Ceyhan O, Yilmaz M, Temel S. Skin tears in older patients in intensive care units: A multicentre point prevalence study. Nurs Crit Care 2024. [PMID: 39032130 DOI: 10.1111/nicc.13131] [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: 10/24/2023] [Revised: 06/26/2024] [Accepted: 07/01/2024] [Indexed: 07/22/2024]
Abstract
BACKGROUND With the ageing of the global population, it is predicted that the population of older adult patients in hospitals and intensive care units (ICUs) will increase. Because of health conditions, care practices and ageing-related skin changes, older adult ICU patients are prone to skin integrity problems, including skin tears (STs). AIM To determine the prevalence of STs and associated factors in older patients hospitalized in ICUs. STUDY DESIGN The study is a regional, multicentre, point prevalence study conducted in five centres in the five largest cities in terms of population in the Central Anatolia Region of Türkiye. Data were collected simultaneously in each centre on the same day. The list of patients hospitalized in the ICUs on the day of data collection was drawn up, and 200 patients who were 65 years of age or older, were hospitalized in ICUs and agreed to participate in the research were included. The researchers formed an "ST chart" to record patient demographic characteristics, clinical variables and skin assessment. RESULTS STs were detected in 14.5% of patients in ICUs, with 72.5% of them having stage 1 ST. A significant relationship was found between individuals' average body mass index (BMI) (p = .043), age (p = .014), length of stay in the ICU (p = .004) and having ST. There was also a statistically significant relationship between skin temperature (p = .002), skin turgor (p = .001) and ST. More STs were observed in patients with cold skin and low turgor. The prevalence of ST was higher in individuals with a history of ST. Additionally, there was a statistically significant relationship between consciousness (p = .014), incontinence (p = .006), the Braden score (p = .004), the Itaki fall risk score (p = .006) and ST. CONCLUSIONS In this multicentre point prevalence study, the prevalence of ST in older patients in ICUs was 14.5%, and many factors associated with ST have been identified. RELEVANCE TO CLINICAL PRACTICE Given the insufficient information and attention to STs in older adults, the study emphasizes the importance of addressing STs. The impact of STs includes increased treatment costs, length of stay and risk of complications. Therefore, understanding the global extent of STs in ICUs and developing effective interventions for prevention and management are crucial.
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Affiliation(s)
- Hatice Yuceler Kacmaz
- Department of Nursing, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey
| | - Hilal Kahraman
- Department of Nursing, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey
| | - Ayşe Topal Hancer
- Department of Nursing, Faculty of Health Sciences, Cumhuriyet University, Sivas, Turkey
| | - Füsun Uzgor
- Department of Nursing, Fethiye Faculty of Health Sciences, Mugla Sitki Kocman University, Mugla, Turkey
| | - Sevgi Gur
- Department of Nursing, Faculty of Health Sciences, Selcuk University, Konya, Turkey
| | - Nevra Kalkan
- Department of Nursing, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Ozlem Ceyhan
- Department of Nursing, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey
| | - Meryem Yilmaz
- Department of Nursing, Faculty of Health Sciences, Cumhuriyet University, Sivas, Turkey
| | - Sahin Temel
- Faculty of Medicine, Department of Internal Medicine, Erciyes University, Kayseri, Turkey
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Kelso MR, Jaros M. Improving Wound Healing and Infection Control in Long-term Care with Bacterial Fluorescence Imaging. Adv Skin Wound Care 2024:00129334-990000000-00051. [PMID: 39023985 DOI: 10.1097/asw.0000000000000177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024]
Abstract
BACKGROUND High bacterial burden stalls wound healing and can quickly progress to infection and sepsis in complex, older-adult patients in long-term care (LTC) or skilled nursing facilities (SNFs). OBJECTIVE To investigate the outcomes of point-of-care fluorescence (FL) imaging (MolecuLight i:X) of bacterial loads, which are frequently asymptomatic, to inform customized wound treatment plans for patients in LTC/SNFs. METHODS In this retrospective pre/postinterventional cohort study, the authors compared the healing and infection-associated outcomes of 167 pressure injuries from 100 Medicare beneficiaries before and after implementation of FL imaging. RESULTS Most patient demographics and wound characteristics did not differ significantly between the standard-of-care (SOC; n = 71 wounds) and FL (n = 96 wounds) cohorts. Significantly more wounds (+71.0%) healed by 12 weeks in the FL cohort (38.5%) versus the SoC cohort (22.5%). Wounds in the FL cohort also healed 27.7% faster (-4.8 weeks), on average, and were 1.4 times more likely to heal per Kaplan-Meier survival analysis (hazard ratio = 1.40; 95% CI, 0.90-2.12). Infection-related complications decreased by 75.3% in the FL cohort, and a significant shift from largely systemic to topical antibiotic prescribing was evidenced. CONCLUSIONS Fluorescence-imaging-guided management of wounds significantly improved healing and infection outcomes in highly complex and multimorbid patients in LTC/SNFs. Proactive bacterial infection management via local treatments was enabled by earlier, objective detection. These reported outcome improvements are comparable to randomized controlled trials and cohort studies from less compromised, selectively controlled outpatient populations. Fluorescence imaging supports proactive monitoring and management of planktonic and biofilm-encased bacteria, improving patient care in a complex, real-world setting.
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Affiliation(s)
- Martha R Kelso
- Martha R. Kelso, RN, CWHS, HBOT, is Founder and Chief Executive Officer, Wound Care Plus LLC, Blue Springs, Missouri, USA. Mark Jaros, PhD, is Senior Vice President, Summit Analytical, Denver, Colorado, USA. Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work, provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Acknowledgment: Myndi M. Stewart, Clinical Assistant (Wound Care Plus, LLC), oversaw the WCP EMR database. Statistical analysis was outsourced to Summit Analytical, LLC (Denver, Colorado, USA). MolecuLight Inc. (Toronto, Canada) reviewed the manuscript and provided editorial assistance from an accuracy and regulatory standpoint. The authors have disclosed no financial relationships related to this article. Submitted October 31, 2023; accepted in revised form March 19, 2024
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Martyts A, Sachs D, Hiebert P, Junker H, Robmann S, Hopf R, Steenbock H, Brinckmann J, Werner S, Giampietro C, Mazza E. Biomechanical and Biochemical Changes in Murine Skin During Development and Aging. Acta Biomater 2024:S1742-7061(24)00385-4. [PMID: 39009208 DOI: 10.1016/j.actbio.2024.07.013] [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: 04/10/2024] [Revised: 06/21/2024] [Accepted: 07/10/2024] [Indexed: 07/17/2024]
Abstract
Aging leads to biochemical and biomechanical changes in skin, with biological and functional consequences. Despite extensive literature on skin aging, there is a lack of studies which investigate the maturation of the tissue and connect the microscopic changes in the skin to its macroscopic biomechanical behavior as it evolves over time. The present work addresses this knowledge gap using multiscale characterization of skin in a murine model considering newborn, adult and aged mice. Monotonic uniaxial loading, tension relaxation with change of bath, and loading to failure tests were performed on murine skin samples from different age groups, complemented by inflation experiments and atomic force microscopy indentation measurements. In parallel, skin samples were characterized using histological and biochemical techniques to assess tissue morphology, collagen organization, as well as collagen content and cross-linking. We show that 1-week-old skin differs across nearly all measured parameters from adult skin, showing reduced strain stiffening and tensile strength, a thinner dermis, lower collagen content and altered crosslinking patterns. Surprisingly, adult and aged skin were similar across most biomechanical parameters in the physiologic loading range, while aged skin had lower stiffening behavior at large force values and lower tensile strength. This correlates with altered collagen content and cross-links. Based on a computational model, differences in mechanocoupled stimuli in the skin of the different age groups were calculated, pointing to a potential biological significance of the age-induced biomechanical changes in regulating the local biophysical environment of dermal cells. STATEMENT OF SIGNIFICANCE: Skin microstructure and the emerging mechanical properties change with age, leading to biological, functional and health-related consequences. Despite extensive literature on skin aging, only very limited quantitative data are available on microstructural changes and the corresponding macroscopic biomechanical behavior as they evolve over time. This work provides a wide-range multiscale mechanical characterization of skin of newborn, adult and aged mice, and quantifies microstructural correlations in tissue morphology, collagen content, organization and cross-linking. Remarkably, aged skin retained normal hydration and biomechanical function in the physiological loading range but showed significantly reduced properties at super-physiological loading. Our data show that age-related microstructural differences have a profound effect not only on tissue-level properties but also on the cell-level biophysical environment.
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Affiliation(s)
- Anastasiya Martyts
- Institute for Mechanical Systems, Department of Mechanical and Process Engineering, ETH Zürich, 8092 Zürich, Switzerland
| | - David Sachs
- Institute for Mechanical Systems, Department of Mechanical and Process Engineering, ETH Zürich, 8092 Zürich, Switzerland
| | - Paul Hiebert
- Institute of Molecular Health Sciences, Department of Biology, ETH Zürich, 8093 Zürich, Switzerland
| | - Håvar Junker
- Institute for Mechanical Systems, Department of Mechanical and Process Engineering, ETH Zürich, 8092 Zürich, Switzerland
| | - Serjosha Robmann
- Institute for Mechanical Systems, Department of Mechanical and Process Engineering, ETH Zürich, 8092 Zürich, Switzerland
| | - Raoul Hopf
- Institute for Mechanical Systems, Department of Mechanical and Process Engineering, ETH Zürich, 8092 Zürich, Switzerland
| | - Heiko Steenbock
- Institute of Virology and Cell Biology, University of Lübeck, 23562 Lübeck, Germany.
| | - Jürgen Brinckmann
- Institute of Virology and Cell Biology, University of Lübeck, 23562 Lübeck, Germany; Department of Dermatology, University of Lübeck, 23562 Lübeck, Germany
| | - Sabine Werner
- Institute of Molecular Health Sciences, Department of Biology, ETH Zürich, 8093 Zürich, Switzerland.
| | - Costanza Giampietro
- Institute for Mechanical Systems, Department of Mechanical and Process Engineering, ETH Zürich, 8092 Zürich, Switzerland; Empa, Swiss Federal Laboratories for Materials Science and Technology, 8600 Dübendorf, Switzerland
| | - Edoardo Mazza
- Institute for Mechanical Systems, Department of Mechanical and Process Engineering, ETH Zürich, 8092 Zürich, Switzerland; Empa, Swiss Federal Laboratories for Materials Science and Technology, 8600 Dübendorf, Switzerland.
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Yang S, Liang X, She J, Tian J, Wen Z, Tao Y, Wang H, Zhang X. Prevalence and incidence of skin tear in older adults:A systematic review and meta-analysis. J Tissue Viability 2024:S0965-206X(24)00085-8. [PMID: 38971682 DOI: 10.1016/j.jtv.2024.06.010] [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: 03/13/2024] [Revised: 05/27/2024] [Accepted: 06/21/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND Skin tear (ST) is a public health problem in older adults; they substantially increase the risk of complications and cause serious adverse consequences and health care burden. AIM To estimate the pooled prevalence and incidence of ST among older adults. METHODS Ten databases were systematically searched from their inception to July 27, 2023. Two researchers performed a systematic review independently according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. All inconsistencies were resolved by a principal researcher. The pooled prevalence and incidence of ST were estimated in R 4.3.1 program. RESULTS Thirteen studies were included in this review. The pooled prevalence of ST was 6.0 % (95 % confidence interval (CI): 3.0%-11.0 %, I2 = 98 %), and the pooled incidence was 11.0 % (95 % CI: 5.0%-19.0 %, I2 = 94 %). The prevalence of ST was 11.0 % (95 % CI: 5.0%-19.0 %, I2 = 95 %) in long-term care facilities, 5.0 % (95 % CI: 3.0%-9.0 %, I2 = 86 %) in Europe, and 7.0 % (95 % CI: 1.0%-16.0 %, I2 = 82 %) in the Skin Tear Audit Research classification system (STAR). It has stabilized at 6.0 % since 2021. The incidence of ST was 15.0 % (95 % CI: 11.0%-20.0 %, I2 = 66 %) in long-term care facilities in Japan and 4.0 % (95 % CI: 2.0%-6.0 %) in Canada. CONCLUSIONS Older adults are at a high risk for ST. Our findings emphasize the importance of epidemiologic studies and further exploring assessment tools for ST. Healthcare professionals should pay attention to ST, identify high-risk individuals and associated factors, and implement targeted prevention strategies for older adults.
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Affiliation(s)
- Shenbi Yang
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Xiaoli Liang
- Sichuan Nursing Vocational College, Chengdu, 610100, China
| | - Jian She
- Department of Health and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Jing Tian
- West China Second University Hospital, Sichuan University,Chengdu, 610044, China
| | - Zhifei Wen
- Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu, 610032, China
| | - Yanmin Tao
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Hongyan Wang
- Sichuan Nursing Vocational College, Chengdu, 610100, China
| | - Xiangeng Zhang
- Sichuan Nursing Vocational College, Chengdu, 610100, China.
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Fulbrook P, Miles SJ, Williams DM. Healing rate of hospital-acquired skin tears using adhesive silicone foam versus meshed silicone interface dressings: A prospective, randomized, non-inferiority pilot study. Int J Nurs Pract 2024; 30:e13229. [PMID: 38123157 DOI: 10.1111/ijn.13229] [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: 03/19/2023] [Revised: 09/21/2023] [Accepted: 11/28/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND A skin tear is a traumatic wound that occurs in up to one in five hospitalized patients. Nursing care includes application of a dressing to create a moist wound healing environment. AIM To compare the effectiveness of two standard dressings (adhesive silicone foam vs. meshed silicone interface) to heal hospital-acquired skin tear. METHODS An intention-to-treat pilot study was designed using a randomized, non-inferiority trial in an Australian tertiary hospital setting. Consenting participants (n = 52) had acquired a skin tear within the previous 24 h and had agreed to a 3-week follow-up. Data were collected between 2014 and 2020. The primary outcome measure was wound healing at 21 days. RESULTS Baseline characteristics were similar in both arms. Per protocol, 86% of skin tears were fully healed at 3 weeks in the adhesive silicone foam group, compared to 59% in the meshed silicone interface group. Greater healing was observed across all skin tear categories in the adhesive silicone foam dressing group. In the intention-to-treat sample, healing was 69% and 42%, respectively. CONCLUSIONS Results suggest the adhesive silicone foam dressing may be superior, as it produced clinically significant healing of skin tears at 3 weeks compared to the meshed silicone interface dressing. Accounting for potential loss to follow-up, a sample of at least 103 participants per arm would be required to power a definitive study.
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Affiliation(s)
- Paul Fulbrook
- School of Nursing, Midwifery and Paramedicine (Brisbane), Faculty of Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia
- Nursing Research and Practice Development Centre, The Prince Charles Hospital, Chermside, Queensland, Australia
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sandra J Miles
- School of Nursing, Midwifery and Paramedicine (Brisbane), Faculty of Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia
- Nursing Research and Practice Development Centre, The Prince Charles Hospital, Chermside, Queensland, Australia
| | - Damian M Williams
- Wound/Stoma Service, Internal Medicine Services, The Prince Charles Hospital, Chermside, Queensland, Australia
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Yu SS, Zhu Z, Fang H, Jiang YN, Tang CQ, Shi Y, Gan LX, Tang HT, Wang HB, Sun Y, Xia ZF. A retrospective study of inpatients diagnosed with degloving skin and soft tissue injuries. Sci Rep 2024; 14:2392. [PMID: 38287035 PMCID: PMC10825152 DOI: 10.1038/s41598-024-52171-8] [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: 08/23/2023] [Accepted: 01/15/2024] [Indexed: 01/31/2024] Open
Abstract
The overall picture of degloving skin and soft tissue injuries (DSTI) remains a blank space in China. Therefore, a retrospective study was designed to summarize the current situation of this injury. Patients diagnosed with DSTI hospitalized between 2013 and 2018 were identified from the Hospital Quality Monitoring System (HQMS) database, of whom demographics, injury characteristics, hospitalization and cost information were analyzed. A total of 62,709 patients were enrolled in this study. Male sex predominated, with a mean age of 43.01 ± 19.70 years. Peasants seemed to be the most vulnerable. East China and Hubei province had the most patients. The most and least frequently injured anatomic site were lower extremity and torso, respectively. Traffic-related accidents and summer accounted for the highest proportion in terms of injury mechanism and season. The operation rate of DSTI roughly showed a growing trend, and the average length of stay was 22.02 ± 29.73 days. At discharge, 0.93% of DSTI patients ended up in death. Medicine accounted mostly for hospitalization cost, while the proportion decreased year by year. More than half DSTI patients paid at their own charge. This study made a relatively detailed description of DSTI patients nationwide, and might provide enlightenments for better prevention and treatment.
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Affiliation(s)
- Shao-Shuo Yu
- Department of Burn Surgery, The First Affiliated Hospital of Naval Medical University, Burn Institute of PLA, Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury, Chinese Academy of Medical Sciences, Shanghai, People's Republic of China
| | - Zhe Zhu
- Department of Burn Surgery, The First Affiliated Hospital of Naval Medical University, Burn Institute of PLA, Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury, Chinese Academy of Medical Sciences, Shanghai, People's Republic of China
- Department of Hepatobiliary Surgery, PLA Naval Medical Center, Shanghai, China
| | - He Fang
- Department of Burn Surgery, The First Affiliated Hospital of Naval Medical University, Burn Institute of PLA, Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury, Chinese Academy of Medical Sciences, Shanghai, People's Republic of China
| | - Yao-Nan Jiang
- Department of Burn Surgery, The First Affiliated Hospital of Naval Medical University, Burn Institute of PLA, Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury, Chinese Academy of Medical Sciences, Shanghai, People's Republic of China
- The 92493 Hospital of the Chinese People's Liberation Army, Huludao, People's Republic of China
| | - Chen-Qi Tang
- Department of Burn Surgery, The First Affiliated Hospital of Naval Medical University, Burn Institute of PLA, Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury, Chinese Academy of Medical Sciences, Shanghai, People's Republic of China
| | - Ying Shi
- China Standard Medical Information Research Centre, Shenzhen, People's Republic of China
| | - Lan-Xia Gan
- China Standard Medical Information Research Centre, Shenzhen, People's Republic of China
| | - Hong-Tai Tang
- Department of Burn Surgery, The First Affiliated Hospital of Naval Medical University, Burn Institute of PLA, Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury, Chinese Academy of Medical Sciences, Shanghai, People's Republic of China
| | - Hai-Bo Wang
- Clinical Trial Unit, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China.
- Centre for Data Science in Health and Medicine, Peking University, Beijing, People's Republic of China.
| | - Yu Sun
- Department of Burn Surgery, The First Affiliated Hospital of Naval Medical University, Burn Institute of PLA, Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury, Chinese Academy of Medical Sciences, Shanghai, People's Republic of China.
| | - Zhao-Fan Xia
- Department of Burn Surgery, The First Affiliated Hospital of Naval Medical University, Burn Institute of PLA, Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury, Chinese Academy of Medical Sciences, Shanghai, 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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Kaçmaz HY, Karadağ A, Çakar V, Ödek Ö. Determination of Nurses' Knowledge Levels on Skin Tears: A Cross-sectional Study. Adv Skin Wound Care 2023; 36:267-274. [PMID: 37079790 DOI: 10.1097/01.asw.0000922700.12014.e7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
OBJECTIVE To determine nurses' knowledge level about skin tears (STs). METHODS This cross-sectional study included 346 nurses working in acute care hospitals in Turkey who completed web- or paper-based surveys in September and October 2021. Researchers used the Skin Tear Knowledge Assessment Instrument, which consists of 20 questions across six domains, to assess nurses' level of ST knowledge. RESULTS The mean age of the nurses was 33.67 (SD, 8.88) years, 80.6% were women, and 73.7% had an undergraduate degree. Nurses' mean number of correct answers on the Skin Tear Knowledge Assessment Instrument was 9.33 (SD, 2.83) of 20 (46.66% [SD, 14.14%]). The mean numbers of correct answers by domain were as follows: etiology, 1.34 (SD, 0.84) of 3; classification and observation, 2.21 (SD, 1.00) of 4; risk assessment, 1.01 (SD, 0.68) of 2; prevention, 2.68 (SD, 1.23) of 6; treatment, 1.66 (SD, 1.05) of 4; and specific patient groups, 0.74 (SD, 0.44) of 1. Significant associations were found among the nurses' ST knowledge scores and whether they had graduated from a nursing program (P = .005), their working years (P = .002), their working unit (P < .001), and whether they provided care to patients with STs (P = .027). CONCLUSIONS Nurses' level of knowledge of the etiology, classification, risk assessment, prevention, and treatment of STs was low. The authors recommend including more information about STs in basic nursing education, in-service training, and certificate programs to increase nurses' ST knowledge.
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Affiliation(s)
- Hatice Yüceler Kaçmaz
- Hatice Yüceler Kaçmaz, PhD, is Assistant Professor, Department of Nursing, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey. At Koç University, Istanbul, Ayişe Karadağ, PhD, ET/WOCN, is Professor, School of Nursing. Vildan Çakar, PhD, is Assistant Professor, Department of Nursing, Istanbul Medipol University School of Health Sciences. Also at Erciyes University, Ömer Ödek, MS, is PhD Student in Nursing, Institute of Health Sciences
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Feng L, Hu C, Li J, Ying Y, Chen L, Wei H, Liang H, Hu H. The Chinese version of the skin tear knowledge assessment instrument (OASES): Cultural adaptation and validation. J Tissue Viability 2023; 32:107-113. [PMID: 36543636 DOI: 10.1016/j.jtv.2022.12.004] [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: 06/14/2022] [Revised: 12/09/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Skin tear knowledge is an important predictor of the decreased incidence and management of skin tears, and the knowledge level among Chinese nurses is unknown so far. A validated instrument for measuring skin tear knowledge is urgent. OBJECTIVE To culturally adapt the skin tear knowledge assessment instrument (OASES) into Chinese and verify its validity and reliability in the Chinese context. METHODS The cultural adaptation process for OASES into Chinese was established on Beaton's translation model. Content validity was determined by the 8-expert group in wound care. A nationwide psychometric validation study was performed on a convenience sample of 3333 nurses from 113 tertiary hospitals, of whom 98 nurses finished the test-retest procedure for reliability analysis. Item validity (item difficulty and discriminating index) and construct validity (known-groups technique) were tested. RESULTS The content validity index was 0.88-1.00. The item validity was as follows: Item difficulty ranged from 0.16 to 0.86, with an average value of 0.52; the discriminating index varied between 0.05 and 0.61. The known-group technique demonstrated excellent construct validity with a significant difference between predefined groups with theoretically expected higher knowledge scores and theoretically expected lower knowledge scores (P < 0.001). For the test-retest reliability, the Intraclass correction coefficient (ICC) during a 14-day interval for the overall tool was 0.79 (95% CI = 0.71-0.86), and Cohen's kappa value for each item varied from 0.17 to 0.62. CONCLUSIONS The Chinese version of OASES was validated to be suitable for skin tear knowledge assessment with acceptable psychometric properties, through which the knowledge and training priorities of skin tear among Chinese nurses can be quantified.
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Affiliation(s)
- Liuqun Feng
- Nursing Department, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Chen Hu
- Nursing Department, School of Medicine, Zhejiang University, Hangzhou, China
| | - Juyun Li
- Department of Nursing, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Yuai Ying
- Nursing Department, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lanpeng Chen
- Kangda College of Nanjing Medical University, Lianyungang, China
| | - Huiyan Wei
- Nursing Department, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Hongyan Liang
- Nursing Department, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Hongyang Hu
- Nursing Department, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
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Zhao B, Kim JE, Moon J, Nam EW. Social engagement and subjective health among older adults in South Korea: Evidence from the Korean Longitudinal Study of Aging (2006-2018). SSM Popul Health 2023; 21:101341. [PMID: 36845671 PMCID: PMC9950723 DOI: 10.1016/j.ssmph.2023.101341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/09/2022] [Accepted: 01/10/2023] [Indexed: 01/15/2023] Open
Abstract
Background Social engagement serves as the foundation for social connections by providing a sense of belonging, social identity, and fulfillment. Previous studies have mainly focused on the one-way relationship between social engagement and subjective health among older individuals, and little attention has been paid to their mutual relationship. Therefore, this study aimed to examine the mutual association relationship between social engagement and their subjective health in older Koreans. Methods Seven waves of data samples (aged ≥60 years) from 2006 to 2018 from the Korean Longitudinal Study of Aging (KLoSA) was used in this study. Descriptive analysis, chi-squared tests, 2-year lagged Generalized estimating equation (GEE) model, and cross-lagged panel model were performed to investigate the mutual association between social engagement and subjective health among six survey periods. Results Results of the GEE model revealed when controlling for other variables, older Koreans who reported good subjective health only had a higher OR (1.678 vs. 1.650, p < 0.001) of participating in social engagement than those who had bad subjective health in 2006-2008 period; the occurrence rate of more social engagement was significantly higher among older adults with good subjective health than among those with bad subjective health (five out six survey periods). Cross-lagged analysis showed similar results that coefficients of social engagement on subjective were relatively larger in three survey periods; coefficients of subjective health on social engagement were relatively larger in the other three survey periods. The impact of social engagement on subjective health might be greater than that of subjective health on social engagement. Conclusion All-around participation and engagement of older people in society have become a consensus among the international community. In view of the single social engagement activities and less relevant participation channels in Korea, government departments should consider not only regional but also local characteristics to create more social participation opportunities for older individuals.
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Affiliation(s)
- Bo Zhao
- Department of Health Administration, Graduate School, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do, South Korea,Yonsei Global Health Center, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do, South Korea
| | - Ji Eon Kim
- Department of Health Administration, Graduate School, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do, South Korea,Yonsei Global Health Center, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do, South Korea
| | - Jiyoung Moon
- Department of Preventive Medicine, Kangwon National University Hospital, Chuncheon, Gangwon-do, South Korea
| | - Eun Woo Nam
- Department of Health Administration, Graduate School, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do, South Korea,Yonsei Global Health Center, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do, South Korea,Corresponding author. Department of Health Administration, Graduate School, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do, South Korea.
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11
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Miles SJ, Fulbrook P, Williams DM. Skin tear prevalence in an Australian acute care hospital: A 10-year analysis. Int Wound J 2022; 19:1418-1427. [PMID: 34951125 PMCID: PMC9493203 DOI: 10.1111/iwj.13735] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 11/17/2021] [Accepted: 12/01/2021] [Indexed: 12/03/2022] Open
Abstract
Hospital-acquired skin tear prevalence is under-reported; thus, the aim of this study was to analyse skin tear point prevalence and characteristics in a tertiary acute care hospital in Queensland, Australia, over a 10-year period. All consenting adult inpatients received a full skin inspection and skin tear category, site, cause, treatment, and whether it was documented as hospital- or community-acquired were recorded. Eleven prevalence audits were analysed with a total sample of 3626 patients. An overall pooled prevalence of 8.9% (95% confidence interval [CI] 7.5-10.4) with an associated hospital-acquired pooled prevalence of 5.5% (95% CI 4.5-6.7) was found. In total, 616 skin tears were reported, of which 374 (60.7%) were hospital-acquired. Over a third of patients (38.7%) had multiple skin tears and most patients (84.8%) with at least one skin tear were aged ≥70 years. The largest proportion of skin tears (40.1%) was those with no skin flap. Of those documented, most were caused by falls or collisions, suggesting combined skin tear and falls prevention strategies may be effective. Over a decade, there was a downward trend in hospital-acquired skin tear, which is encouraging. Skin tear prevalence is recommended as a measure of care quality with an emphasis on good quality documentation.
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Affiliation(s)
- Sandra J. Miles
- School of Nursing, Midwifery and Paramedicine (Brisbane), Faculty of Health SciencesAustralian Catholic UniversityVirginiaQueenslandAustralia
- Nursing Research and Practice Development CentreThe Prince Charles HospitalChermsideQueenslandAustralia
| | - Paul Fulbrook
- School of Nursing, Midwifery and Paramedicine (Brisbane), Faculty of Health SciencesAustralian Catholic UniversityVirginiaQueenslandAustralia
- Nursing Research and Practice Development CentreThe Prince Charles HospitalChermsideQueenslandAustralia
- Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Damian M. Williams
- Wound Management, Clinical Effectiveness ProgramThe Prince Charles HospitalChermsideQueenslandAustralia
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12
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Bandeira da Silva CV, da Costa Silva RS, Serna González CV, Hevia Campos HM, Woo K, Nogueira PC, Gouveia Santos VLCD. Epidemiología de los desgarros de piel: revisión bibliográfica. J Wound Care 2022; 31:7-18. [PMID: 36789899 DOI: 10.12968/jowc.2022.31.latam_sup_6.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Objetivo: Identificar y describir la epidemiología de los desgarros de piel (DP) en el contexto latinoamericano. Método: Revisión bibliográfica de estudios epidemiológicos publicados entre 1946 y mayo de 2021, en inglés, español y portugués, consultados en texto completo. Para la búsqueda, se utilizaron descriptores correspondientes a la estrategia PCC: Población (adultos), Concepto (epidemiología de los DP) y Contexto (hospitalario e institucional). Los estudios fueron recuperados de las bases de datos Scielo, Lilacs, Embase, Cinahl, Medline y BDEnf, y evaluados por dos revisores independientes. Los instrumentos STROBE y Newcastle-Ottawa fueron usados para evaluar la calidad de estudios de prevalencia e incidencia, respectivamente. Resultados: En total, 21 publicaciones fueron incluidas (siete de ellas, de origen latinoamericano). La prevalencia, reportada en 16 estudios, estuvo entre 0,97 y 28,7%. La incidencia, reportada en cinco estudios, varió entre 3,8 y 40%. Los factores de riesgo asociados al desarrollo de DP fueron: historia previa de la lesión, puntajes bajos en la escala de Braden, dependencia para actividades básicas de la vida diaria, y edad avanzada. En América latina, Brasil se destaca como el país con mayor número de publicaciones (n=5; 23,8%). Conclusión: La mayoría de los DP pueden ser considerados eventos adversos evitables, por lo tanto, los valores de incidencia y prevalencia encontrados son elevados. La caracterización de la situación epidemiológica de los DP posibilita la creación de protocolos y políticas públicas para su prevención y detección precoz. Conflicto de interés: Todos los autores son miembros del International Skin Tears Advisory Panel (ISTAP). CVBS es consultora técnica. CVSG es conferencista. KW es miembro del Canadian Pressure Injury Advisory Panel, consultor en centros de heridas en Canadá, y conferencista para varias empresas internacionales en la industria del cuidado de las heridas.
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Affiliation(s)
- Cinthia V Bandeira da Silva
- Programa de Posgrado en Enfermería en la Salud del Adulto (PROESA). Escuela de Enfermería, Universidad de San Pablo (Escola de Enfermagem da Universidade de São Paulo), San Pablo, Brasil.,Grupo de Investigación en Estomaterapia. Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil
| | - Rayanne S da Costa Silva
- Grupo de Investigación en Estomaterapia. Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil
| | - Carol V Serna González
- Programa de Posgrado en Enfermería en la Salud del Adulto (PROESA). Escuela de Enfermería, Universidad de San Pablo (Escola de Enfermagem da Universidade de São Paulo), San Pablo, Brasil.,Grupo de Investigación en Estomaterapia. Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil
| | - Heidi M Hevia Campos
- Grupo de Investigación en Estomaterapia. Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil.,Escuela de Enfermería, Universidad Andres Bello, Viña del Mar, Chile
| | - Kevin Woo
- Escuela de Enfermería, Universidad de Queens (Queen's University), Kingston, Ontario, Canadá
| | - Paula C Nogueira
- Grupo de Investigación en Estomaterapia. Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil.,Departamento de Enfermería Médico-quirúrgica, Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil
| | - Vera L Conceição de Gouveia Santos
- Grupo de Investigación en Estomaterapia. Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil.,Departamento de Enfermería Médico-quirúrgica, Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil
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13
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Bandeira da Silva CV, da Costa Silva RS, Serna González CV, Hevia Campos HM, Woo K, Nogueira PC, Gouveia Santos VLCD. Epidemiología de los desgarros de piel: revisión bibliográfica. J Wound Care 2022; 31:7-18. [PMID: 36787945 DOI: 10.12968/jowc.2022.31.latam_sup_6a.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Objetivo: Identificar y describir la epidemiología de los desgarros de piel (DP) en el contexto latinoamericano. Método: Revisión bibliográfica de estudios epidemiológicos publicados entre 1946 y mayo de 2021, en inglés, español y portugués, consultados en texto completo. Para la búsqueda, se utilizaron descriptores correspondientes a la estrategia PCC: Población (adultos), Concepto (epidemiología de los DP) y Contexto (hospitalario e institucional). Los estudios fueron recuperados de las bases de datos Scielo, Lilacs, Embase, Cinahl, Medline y BDEnf, y evaluados por dos revisores independientes. Los instrumentos STROBE y Newcastle-Ottawa fueron usados para evaluar la calidad de estudios de prevalencia e incidencia, respectivamente. Resultados: En total, 21 publicaciones fueron incluidas (siete de ellas, de origen latinoamericano). La prevalencia, reportada en 16 estudios, estuvo entre 0,97 y 28,7%. La incidencia, reportada en cinco estudios, varió entre 3,8 y 40%. Los factores de riesgo asociados al desarrollo de DP fueron: historia previa de la lesión, puntajes bajos en la escala de Braden, dependencia para actividades básicas de la vida diaria, y edad avanzada. En América latina, Brasil se destaca como el país con mayor número de publicaciones (n=5; 23,8%). Conclusión: La mayoría de los DP pueden ser considerados eventos adversos evitables, por lo tanto, los valores de incidencia y prevalencia encontrados son elevados. La caracterización de la situación epidemiológica de los DP posibilita la creación de protocolos y políticas públicas para su prevención y detección precoz. Conflicto de interés: Todos los autores son miembros del International Skin Tears Advisory Panel (ISTAP). CVBS es consultora técnica. CVSG es conferencista. KW es miembro del Canadian Pressure Injury Advisory Panel, consultor en centros de heridas en Canadá, y conferencista para varias empresas internacionales en la industria del cuidado de las heridas.
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Affiliation(s)
- Cinthia V Bandeira da Silva
- Programa de Posgrado en Enfermería en la Salud del Adulto (PROESA). Escuela de Enfermería, Universidad de San Pablo (Escola de Enfermagem da Universidade de São Paulo), San Pablo, Brasil.,Grupo de Investigación en Estomaterapia. Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil
| | - Rayanne S da Costa Silva
- Grupo de Investigación en Estomaterapia. Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil
| | - Carol V Serna González
- Programa de Posgrado en Enfermería en la Salud del Adulto (PROESA). Escuela de Enfermería, Universidad de San Pablo (Escola de Enfermagem da Universidade de São Paulo), San Pablo, Brasil.,Grupo de Investigación en Estomaterapia. Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil
| | - Heidi M Hevia Campos
- Grupo de Investigación en Estomaterapia. Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil.,Escuela de Enfermería, Universidad Andres Bello, Viña del Mar, Chile
| | - Kevin Woo
- Escuela de Enfermería, Universidad de Queens (Queen's University), Kingston, Ontario, Canadá
| | - Paula C Nogueira
- Grupo de Investigación en Estomaterapia. Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil.,Departamento de Enfermería Médico-quirúrgica, Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil
| | - Vera L Conceição de Gouveia Santos
- Grupo de Investigación en Estomaterapia. Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil.,Departamento de Enfermería Médico-quirúrgica, Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil
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14
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Peres GRP, Bandeira da Silva CV, Strazzieri-Pulido KC, de Gouveia Santos VLC. Skin tears in older adult residents of long-term care facilities: prevalence and associated factors. J Wound Care 2022; 31:468-478. [PMID: 35678790 DOI: 10.12968/jowc.2022.31.6.468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To determine the prevalence of skin tears, and demographic and clinical factors associated with their presence in older adult residents of long-term care facilities. METHOD This observational, quantitative, cross-sectional, epidemiological study was conducted with older adult residents of three long-term care facilities in São Paulo, Brazil. For data collection, four instruments were used: a questionnaire assessing sociodemographic and clinical characteristics of the residents; and the Brazilian-Portuguese versions of the Mini-Mental State Examination, Skin Tear Audit Research (STAR) Skin Tear Classification System, and the Katz Index of Independence in Activities of Daily Living. RESULTS A total of 69 residents took part in the study. The prevalence of skin tears was 11.6%. Skin tears were significantly associated with the presence of haematoma (odds ratio, OR=9.159; p=0.017) and actinic purpura (OR=6.265; p=0.033), which increased the odds of skin tear development nine-fold and six-fold, respectively. CONCLUSION The findings agree with the international literature. Considering that this was the first epidemiological study on skin tears carried out in long-term care facilities for older adults in Brazil, its contribution lies in the systematisation of data collection and making data available on a field that has not yet been studied in this country.
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15
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Yüceler Kaçmaz H, Karadağ A, Kahraman H, Erat A, Ödek Ö, Akın S. The prevalence and factors associated with skin tears in hospitalized older adults: A point prevalence study. J Tissue Viability 2022; 31:387-394. [DOI: 10.1016/j.jtv.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/02/2022] [Accepted: 06/02/2022] [Indexed: 11/25/2022]
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16
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LeBlanc K, Woo K. A pragmatic randomised controlled clinical study to evaluate the use of silicone dressings for the treatment of skin tears. Int Wound J 2021; 19:125-134. [PMID: 33960667 PMCID: PMC8684852 DOI: 10.1111/iwj.13604] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/06/2021] [Accepted: 04/08/2021] [Indexed: 12/31/2022] Open
Abstract
One of the most common types of skin breakdown in ageing populations is skin tears. The International Skin Tear Advisory Panel advocates for special attention to be paid to dressing selection related to skin tear management. The panel recommends choosing dressings that will promote the maintenance of moisture balance, suit the local wound environment, protect peri‐wound skin, control or manage exudate and infection, and optimise caregiver time. It is paramount that dressings protect the fragile nature of the skin associated with those who at heightened risk for skin tear development. To compare the effectiveness of soft silicone dressings (a contact layer and/or foam) for the healing of skin tears with local practices that do not include soft silicone dressings. The study was a pragmatic randomised controlled prospective study. One hundred and twenty‐six individuals from two long‐term care facilities in Ontario Canada who presented with skin tears were randomised into the treatment group using either soft silicone dressings (a contact layer and/or foam) or the control group using non‐adhesive dressings. The current study demonstrated that 96.9% (n = 63) of skin tears in the treatment group healed over a 3‐week period compared with 34.4% (n = 21) in the control group. The proportion of wound healing experienced at week 2 was 89.2% (n = 58) in the treatment group compared with 27.9% (n = 17) in the control group. There was a significantly greater reduction in wound surface area relative to baseline in the treatment group (2.9 cm2) compared with the control group (0.6 cm2) (χ2 = 21.792 P < .0001) at week 1. Survival analysis data supported that skin tears healed 50% faster in the treatment group (11 days) compared with the control group (22 days) (χ2 = 59.677 P < .0001). The expected healing trajectory of acute wounds, including skin tears, if proper wound bed preparation is realised and infection is controlled, is 7 to 21 days. Results of this study suggest the use of silicone dressings support wound healing and aid in wound closure within the expected healing trajectory, with faster complete wound closure and mean healing times compared with non‐silicone dressing for the treatment of STs.
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Affiliation(s)
- Kimberly LeBlanc
- Wound, Ostomy and Continence Institute, Association of Nurses Specialized in Wound Ostomy Continence, Ottawa, Ontario, Canada.,Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Kevin Woo
- Faculty of Health Sciences, Western University, London, Ontario, Canada.,Faculty of Nursing, Queen's University, Kingston, Ontario, Canada
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Risk scoring tool for forearm skin tears in Japanese older adults: A prospective cohort study. J Tissue Viability 2021; 30:155-160. [PMID: 33741206 DOI: 10.1016/j.jtv.2021.02.010] [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: 09/24/2020] [Revised: 02/09/2021] [Accepted: 02/24/2021] [Indexed: 11/21/2022]
Abstract
[Aim] Because painful skin tears frequently occur in older patients, the prevention of skin tears is fundamental to improve their quality of life. However, a risk assessment tool for skin tears has not been established yet in Japan. Therefore, we aimed to propose a risk scoring tool for skin tears in Japanese older adult. [Methods] We conducted a prospective cohort study with 6-month follow-up in two long-term care hospitals in Japan. A total of 257 inpatients were recruited. Patient and skin characteristics were collected at baseline, and the occurrence of forearm skin tears were examined during follow-up. To develop a risk scoring tool, we identified risk factors, and converted their coefficients estimated in the multiple logistic regression analysis into simplified scores. The predictive accuracy of the total score was evaluated. [Results] Of 244 participants, 29 developed forearm skin tears during the follow-up period, a cumulative incidence of 13.5%. Senile purpura, pseudoscar, contracture, and dry skin were identified as risk factors for skin tears. Their weighted scores were 6, 4, 5, and 6, respectively. The area under the receiver operating characteristic curve of the total score was 0.806. At a cut-off score of 12, the sensitivity was 0.86, and the specificity was 0.67. [Conclusion] Our forearm skin tear risk scoring tool showed high accuracy, whereas specificity was low. This tool can contribute to prevent forearm skin tears in Japanese older adults.
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A Sector in Crisis: Meeting the Needs of Long-term Care Residents With Wound, Ostomy, and Continence Issues. J Wound Ostomy Continence Nurs 2020; 47:631-632. [PMID: 33201152 DOI: 10.1097/won.0000000000000717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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