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Shim MO, Kim CG, Min JK, Kwak SY, Ghil H, Park S. The effect of support surface on the prevention of pressure injury in acute care settings: A multi-center prospective observational study. J Tissue Viability 2024:S0965-206X(24)00084-6. [PMID: 38937250 DOI: 10.1016/j.jtv.2024.06.009] [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: 03/29/2024] [Revised: 06/11/2024] [Accepted: 06/21/2024] [Indexed: 06/29/2024]
Abstract
PURPOSE This study aimed to analyze if a multi-foam core mattress with a laminated cover can reduce the incidence of pressure injuries, compared to an alternating air mattress overlay among critically ill patients in acute settings. DESIGN Prospective observational study. PARTICIPANTS and setting: Patients with a Braden scale score ≤16 on intensive care unit admission at five general hospitals in Korea were included in this study between February 2022 and March 2022. METHODS One hundred and twenty patients in acute settings were enrolled and categorized into two groups: a multi-form core mattress with a laminated cover group (n = 60) and an alternating air mattress overlay group (n = 60). Data were collected for 7 days by wound care nurses. RESULTS Pressure injury developed at a significantly lower rate in the multi-form core mattress with a laminated cover group (n = 4/60, 6.7 %) than in the alternating air mattress overlay group (n = 25/60, 25.0 %) (P = 0.011). Using a multi-foam core mattress with a laminated cover demonstrated a protective effect against pressure injuries (odds ratio 0.123, 95 % confidence interval 0.024-0.620, P = 0.011). CONCLUSIONS A multi-foam core mattress with a laminated cover was significantly more effective than an alternating air mattress overlay in preventing pressure injury in critically ill patients.
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Affiliation(s)
- Mi-Ock Shim
- Department of Nursing & Research Institute for Basic Science, Hoseo University, Asna, Republic of Korea
| | - Chul-Gyu Kim
- Department of Nursing Science & Research Institute of Nursing Science, Chungbuk National University, Cheongju, Republic of Korea
| | - Ja Kyung Min
- Graduate School of Cinical Nursing Science, Sungkyunkwan University, Suwon, Republic of Korea
| | - So Yeon Kwak
- Dankook University Hospital, Cheonan, Republic of Korea
| | - Hyunhee Ghil
- Nursing College, Gachon University, Incheon, Republic of Korea
| | - Seungmi Park
- Department of Nursing Science & Research Institute of Nursing Science, Chungbuk National University, Cheongju, Republic of Korea.
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Grzęda D, Węgrzyk G, Nowak A, Komorowska G, Szczepkowski L, Ryszkowska J. Effect of Different Amine Catalysts on the Thermomechanical and Cytotoxic Properties of 'Visco'-Type Polyurethane Foam for Biomedical Applications. MATERIALS (BASEL, SWITZERLAND) 2023; 16:1527. [PMID: 36837156 PMCID: PMC9960946 DOI: 10.3390/ma16041527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
Components for manufacturing polyurethane foams can adversely affect the human body, particularly if they are in contact with it for long periods. In applications where the foam is not placed directly into the body, the study of the product's effects is often neglected. In the case of human skin, distinguishing the increasingly frequent problems of skin atopy, more attention should be paid to this. This paper presents the influence of the different catalytic systems on cytotoxic and thermomechanical properties in polyurethane foams. Among others, foams were produced with the most popular catalysts on the market, DABCO and a metal-organic tin catalyst. The foams were characterized by thermomechanical properties and were subjected to a cytotoxicity test against human keratinocytes. In biocompatibility tests with skin cells, the results were highly variable. VAB 2 with a catalytic system consisting of commercial Diethanolamine and Addocat®105 performed the best. However, with such a catalytic system, the mechanical properties have worsened.
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Affiliation(s)
- Dominik Grzęda
- Faculty of Materials Science and Engineering, Warsaw University of Technology, Wołoska 141, 02-507 Warsaw, Poland
| | - Grzegorz Węgrzyk
- Faculty of Materials Science and Engineering, Warsaw University of Technology, Wołoska 141, 02-507 Warsaw, Poland
| | - Adriana Nowak
- Department of Environmental Biotechnology, Lodz University of Technology, Wolczanska 171/173, 90-530 Lodz, Poland
| | - Gabriela Komorowska
- Faculty of Materials Science and Engineering, Warsaw University of Technology, Wołoska 141, 02-507 Warsaw, Poland
| | | | - Joanna Ryszkowska
- Faculty of Materials Science and Engineering, Warsaw University of Technology, Wołoska 141, 02-507 Warsaw, Poland
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Bai D, Ho MC, Mathunjwa BM, Hsu YL. Deriving Multiple-Layer Information from a Motion-Sensing Mattress for Precision Care. SENSORS (BASEL, SWITZERLAND) 2023; 23:1736. [PMID: 36772776 PMCID: PMC9919926 DOI: 10.3390/s23031736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/26/2023] [Accepted: 01/26/2023] [Indexed: 06/18/2023]
Abstract
Bed is often the personal care unit in hospitals, nursing homes, and individuals' homes. Rich care-related information can be derived from the sensing data from bed. Patient fall is a significant issue in hospitals, many of which are related to getting in and/or out of bed. To prevent bed falls, a motion-sensing mattress was developed for bed-exit detection. A machine learning algorithm deployed on the chip in the control box of the mattress identified the in-bed postures based on the on/off pressure pattern of 30 sensing areas to capture the users' bed-exit intention. This study aimed to explore how sleep-related data derived from the on/off status of 30 sensing areas of this motion-sensing mattress can be used for multiple layers of precision care information, including wellbeing status on the dashboard and big data analysis for living pattern clustering. This study describes how multiple layers of personalized care-related information are further derived from the motion-sensing mattress, including real-time in-bed/off-bed status, daily records, sleep quality, prolonged pressure areas, and long-term living patterns. Twenty-four mattresses and the smart mattress care system (SMCS) were installed in a dementia nursing home in Taiwan for a field trial. Residents' on-bed/off-bed data were collected for 12 weeks from August to October 2021. The SMCS was developed to display care-related information via an integrated dashboard as well as sending reminders to caregivers when detecting events such as bed exits and changes in patients' sleep and living patterns. The ultimate goal is to support caregivers with precision care, reduce their care burden, and increase the quality of care. At the end of the field trial, we interviewed four caregivers for their subjective opinions about whether and how the SMCS helped their work. The caregivers' main responses included that the SMCS helped caregivers notice the abnormal situation for people with dementia, communicate with family members of the residents, confirm medication adjustments, and whether the standard care procedure was appropriately conducted. Future studies are suggested to focus on integrated care strategy recommendations based on users' personalized sleep-related data.
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Affiliation(s)
- Dorothy Bai
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei 110, Taiwan
| | - Mu-Chieh Ho
- Gerontechnology Research Center, Yuan Ze University, Taoyuan 320, Taiwan
| | | | - Yeh-Liang Hsu
- Gerontechnology Research Center, Yuan Ze University, Taoyuan 320, Taiwan
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Pressure Injury Management in Critically Ill Patients with COVID-19 in a Makeshift Hospital in Indonesia: A Report of Two Cases. Adv Skin Wound Care 2022; 35:1-6. [PMID: 36409193 DOI: 10.1097/01.asw.0000891076.19171.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
ABSTRACT Patients who are critically ill with COVID-19 need ventilation support in the ICU. However, ICU patients are at higher risk of developing a pressure injury (PI). Unfortunately, PI prevention is not optimally implemented in Indonesia, especially in the makeshift hospitals created during the COVID-19 pandemic. Here, the authors report two cases of critically ill patients with COVID-19 who developed large sacral PIs during hospitalization in a makeshift hospital in Indonesia. The first patient developed a stage 3, 7 × 7-cm sacral PI on the 14th day of hospitalization. The second patient developed a stage 4, 12 × 8-cm sacral PI on the 16th day of hospitalization. Both patients had elevated d-dimer levels and used a noninvasive ventilator for 1 week. The wounds were treated with surgical debridement, silver hydrogel dressing, and hydrocolloid dressing and complemented with static air mattress overlay. The authors recommend that in situations where there is a shortage of healthcare workers, the government should provide pressure-redistribution devices and silicone foam dressings for all critically ill patients to prevent PI development and lighten the workload of healthcare workers.
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Ippolito M, Cortegiani A, Biancofiore G, Caiffa S, Corcione A, Giusti GD, Iozzo P, Lucchini A, Pelosi P, Tomasoni G, Giarratano A. The prevention of pressure injuries in the positioning and mobilization of patients in the ICU: a good clinical practice document by the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI). JOURNAL OF ANESTHESIA, ANALGESIA AND CRITICAL CARE (ONLINE) 2022; 2:7. [PMID: 37386656 DOI: 10.1186/s44158-022-00035-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 07/01/2023]
Abstract
BACKGROUND The aim of this document is to support clinical decision-making concerning positioning and mobilization of the critically ill patient in the early identification and resolution of risk factors (primary prevention) and in the early recognition of those most at risk (secondary prevention). The addresses of this document are physicians, nurses, physiotherapists, and other professionals involved in patient positioning in the intensive care unit (ICU). METHODS A consensus pathway was followed using the Nominal Focus Group and the Delphi Technique, integrating a phase of focused group discussion online and with a pre-coded guide to an individual phase. A multidisciplinary advisory board composed by nine experts on the topic contributed to both the phases of the process, to reach a consensus on four clinical questions positioning and mobilization of the critically ill patient. RESULTS The topics addressed by the clinical questions were the risks associated with obligatory positioning and therapeutic positions, the effective interventions in preventing pressure injuries, the appropriate instruments for screening for pressure injuries in the ICU, and the cost-effectiveness of preventive interventions relating to ICU positioning. A total of 27 statements addressing these clinical questions were produced by the panel. Among the statements, nine provided guidance on how to manage safely some specific patients' positions, including the prone position; five suggested specific screening tools and patients' factors to consider when assessing the individual risk of developing pressure injuries; five gave indications on mobilization and repositioning; and eight focused on the use of devices, such as positioners and preventive dressings. CONCLUSIONS The statements may represent a practical guidance for a broad public of healthcare professionals involved in the management of critically ill patients.
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Affiliation(s)
- Mariachiara Ippolito
- Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
- Department of Anesthesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, University of Palermo, Palermo, Italy
| | - Andrea Cortegiani
- Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, Via del Vespro 129, 90127, Palermo, Italy.
- Department of Anesthesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, University of Palermo, Palermo, Italy.
| | - Gianni Biancofiore
- UOC Anestesia e Rianimazione Trapianti Dipartimento di Patologia chirurgica, medica, molecolare e dell'Area Critica, Università di Pisa. Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Salvatore Caiffa
- Intensive Care Respiratory Physiotherapy, Rehabilitation and Functional Education, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132, Genoa, Italy
| | - Antonio Corcione
- Unit of Anaesthesia and intensive Care, Monaldi Hospital Naples, Naples, Italy
| | | | - Pasquale Iozzo
- Department of Anesthesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, University of Palermo, Palermo, Italy
| | - Alberto Lucchini
- General Intensive Care Unit, Emergency Department - ASST Monza - San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, Monza, MB, Italy
| | - Paolo Pelosi
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy
- San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Gabriele Tomasoni
- First Division of Anesthesiology and Critical Care Medicine, ASST Spedali Civili, Brescia, Italy
| | - Antonino Giarratano
- Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
- Department of Anesthesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, University of Palermo, Palermo, Italy
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Grzęda D, Węgrzyk G, Leszczyńska M, Szczepkowski L, Gloc M, Ryszkowska J. Viscoelastic Polyurethane Foams for Use as Auxiliary Materials in Orthopedics. MATERIALS 2021; 15:ma15010133. [PMID: 35009278 PMCID: PMC8746291 DOI: 10.3390/ma15010133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/19/2021] [Accepted: 12/20/2021] [Indexed: 12/24/2022]
Abstract
One of the essential factors in prostheses is their fitting. To assemble a prosthesis with the residual limb, so-called liners are used. Liners used currently are criticized by users for their lack of comfort, causing excessive sweating and skin irritation. The objective of the work was to develop viscoelastic polyurethane foams for use in limb prostheses. As part of the work, foams were produced with different isocyanate indexes (0.6–0.9) and water content (1, 2 and 3 php). The produced foams were characterized by scanning electron microscopy, computer microtomography, infrared spectroscopy, thermogravimetry and differential scanning calorimetry. Measurements also included apparent density, recovery time, rebound elasticity, permanent deformation, compressive stress value and sweat absorption. The results were discussed in the context of modifying the foam recipe. The performance properties of the foams, such as recovery time, hardness, resilience and sweat absorption, indicate that foams that will be suitable for prosthetic applications are foams with a water content of 2 php produced with an isocyanate index of 0.8 and 0.9.
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