The Effect of Two Types of Subcutaneous Heparin Injections on Pain, Ecchymosis, Hematoma and Drug Absorption: A Quasi-Experimental Study

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES Journal of evaluation in clinical practice Pub Date : 2024-12-11 DOI:10.1111/jep.14266

Sule Biyik Bayram, Emel Gulnar, Nurcan Calıskan, Polat Kosucu, Onur Bektas, Aysun Bayram, Fatma Aksoy

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Abstract

Background

Subcutaneous heparin injections sometimes cause pain, ecchymosis, and hematoma. The prevalence of complications depends on the injection site, technique, and drug absorption. This study investigated the effect of two types of subcutaneous heparin injections on pain, ecchymosis, and hematoma as well as drug absorption rates.

Methods

The study is a quasi-experimental. The research was conducted between September 2021 and May 2022. The sample consisted of 122 patients treated in the general surgery clinic of a university hospital in the Black Sea region of Türkiye. We used ultrasonography (USG) to measure the subcutaneous tissue thicknesses of the sites before heparin injections. We used the tissue-releasing technique (TRT) to administer heparin injections to 68 participants (Group TRT). We used the tissue-pinching technique (TPT) to administer heparin injections to 54 participants (Group TPT). We administered all injections into the arm or abdomen. We used a “Subcutaneous Injection Form” to collect data. We monitored all participants for the injection site, drug absorption after 1 day, pain, ecchymosis, and hematoma for 3 days.

Results

There was no significant difference in the prevalence of pain, ecchymosis, and hematoma between the groups (p > 0.05). Most injections into the arm and abdomen resulted in drug absorption. However, one in ten injections into the arm resulted in the needle reaching the muscle rather than the subcutaneous tissue (11.7%). Abdominal injections caused no complications. The drug was administered in the right place in abdominal injections.

Conclusion

The tissue-releasing and TPTs are not superior to each other as far as drug absorption, pain, ecchymosis, and hematoma are concerned. In this study recommend pinching the tissue or using the abdominal region in cases where the subcutaneous tissue thickness is less than 15.96 mm. The nurse should consider Body Mass Index before choosing the right subcutaneous heparin injection site and the correct injection technique.

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两种肝素皮下注射对疼痛、瘀斑、血肿和药物吸收的影响：一项准实验研究。

背景：皮下注射肝素有时会引起疼痛、瘀斑和血肿。并发症的发生率取决于注射部位、技术和药物吸收。本研究探讨两种肝素皮下注射对疼痛、瘀斑、血肿及药物吸收率的影响。方法：准实验研究。该研究于2021年9月至2022年5月进行。样本包括在黑海地区 rkiye的一所大学医院的普通外科诊所接受治疗的122名患者。在肝素注射前，我们使用超声（USG）测量该部位的皮下组织厚度。我们采用组织释放技术（TRT）给68名参与者注射肝素（TRT组）。我们使用组织夹紧技术（TPT）给54名参与者注射肝素（TPT组）。我们把所有的注射都注射到手臂和腹部。我们使用“皮下注射表格”来收集数据。我们监测所有参与者注射部位、1天后的药物吸收、疼痛、瘀斑和血肿3天。结果：两组患者疼痛、瘀斑、血肿发生率比较，差异均无统计学意义（p < 0.05）。大多数注射到手臂和腹部导致药物吸收。然而，十分之一的手臂注射导致针头到达肌肉而不是皮下组织（11.7%）。腹腔注射无并发症。药物通过腹腔注射在正确的位置。结论：组织释放与TPTs在药物吸收、疼痛、瘀斑、血肿等方面均无明显优势。在本研究中，建议在皮下组织厚度小于15.96 mm的情况下，按压组织或使用腹部区域。在选择合适的皮下肝素注射部位和正确的注射技术前，护士应考虑身体质量指数。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of evaluation in clinical practice 医学-卫生保健

CiteScore

4.80

自引率

4.20%

发文量

143

审稿时长

3-8 weeks

期刊介绍： The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.