Fluctuations in Detection Indicators and Their Significance for the Diagnosis of Early Pressure Injury in Rat Models.

IF 1.7 3区 医学 Q2 NURSING Journal of Wound Ostomy and Continence Nursing Pub Date : 2024-01-01 DOI:10.1097/WON.0000000000001043
Ping Hou, Lu Chen, En Takashi, Akio Kamijo, Huiwen Xu, Daiji Miura, Hirotomo Ten, Akio Kitayama, Jianglin Fan
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Abstract

Purpose: The aim of this study was to identify the most meaningful diagnostic indicator for distinguishing blanchable erythema (BE) and stage 1 pressure injury (early PI) in an in vivo (rat) model.

Design: A prospective case-control design was used to complete a horizontal and vertical comparison of detection indicators during the process of fading of BE or the deterioration of early PI into ulcer in rat models.

Materials and setting: The sample comprised 5 hairless rats with 20 injuries, of which 10 were BE and the other 10 were early PI. Data were collected at Nagano College of Nursing in 2020 in Nagano, Japan.

Methods: The BE and PI rat models were established by subjecting the dorsal skin of a hairless rat to compression between 2 neodymium magnets for 45 minutes and 3.45 hours, respectively. The affected skin was observed based on the following: (1) photography, (2) hardness, (3) temperature, (4) moisture, and (5) spectrophotometric (a* value and ultraviolet [UV] reflectance) measurements. All measurements of BE were performed at the beginning to 60 minutes after decompression, and those for early PI were performed until 48 hours after decompression.

Results: Multiple BE factors, such as the degree of erythema (macroscopy and a* value), hardness, temperature, and moisture, were found to have unstable fluctuations. Only UV reflectance gradually decreased from 6 hours and decreased significantly at 48 hours after decompression (P = .001 vs 1 hour). In contrast to early PI, erythema in BE obviously faded within 10 minutes.

Conclusions: Study findings indicate that a continuous decrease in UV reflectance can reflect the worsening of hemorrhage in early (stage 1) PI. In contrast, other indicators including photography, skin hardness, temperature, and moisture fluctuated and did not prove predictive for PI progression. The obvious fading of erythema in BE a short time after decompression can be used for clinical observations.

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大鼠模型中检测指标的波动及其对早期压力损伤诊断的意义。
目的:本研究旨在确定在体内(大鼠)模型中区分焯水性红斑(BE)和第一阶段压力损伤(早期 PI)的最有意义的诊断指标:设计:采用前瞻性病例对照设计,在大鼠模型中完成褪色BE或早期PI恶化为溃疡过程中检测指标的横向和纵向比较:样本包括 5 只无毛大鼠,共 20 处损伤,其中 10 处为 BE,另外 10 处为早期 PI。数据于 2020 年在日本长野县的长野护理学院收集:BE和PI大鼠模型是通过将一只无毛大鼠的背侧皮肤分别在两个钕磁铁之间挤压45分钟和3.45小时而建立的。根据以下方法观察受影响的皮肤:(1) 摄影、(2) 硬度、(3) 温度、(4) 湿度和 (5) 分光光度法(a* 值和紫外线 [UV] 反射率)测量。所有 BE 测量均在减压开始至减压后 60 分钟内进行,早期 PI 测量则在减压后 48 小时内进行:结果:多种 BE 因素,如红斑程度(宏观观察和 a* 值)、硬度、温度和湿度,都有不稳定的波动。只有紫外线反射率从 6 小时开始逐渐下降,并在减压后 48 小时显著下降(P = .001 vs 1 小时)。与早期 PI 相反,BE 中的红斑在 10 分钟内明显消退:研究结果表明,紫外线反射率的持续下降可以反映早期(1 期)PI 的出血恶化情况。与此相反,包括摄影、皮肤硬度、温度和湿度在内的其他指标会出现波动,但并不能预测 PI 的进展。减压后短时间内 BE 红斑的明显消退可用于临床观察。
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来源期刊
CiteScore
3.10
自引率
34.60%
发文量
186
审稿时长
6-12 weeks
期刊介绍: ​​The Journal of Wound, Ostomy and Continence Nursing (JWOCN), the official journal of the Wound, Ostomy and Continence Nurses Society™ (WOCN®), is the premier publication for wound, ostomy and continence practice and research. The Journal’s mission is to publish current best evidence and original research to guide the delivery of expert health care. The WOCN Society is a professional nursing society which supports its members by promoting educational, clinical and research opportunities to advance the practice and guide the delivery of expert health care to individuals with wounds, ostomies and continence care needs.
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