Journal of tissue viability最新文献_第3页

Knowledge, attitude, and practice of clinical nurses towards medical device-related pressure injury prevention: A systematic review 临床护士对医疗器械相关压力伤害预防的知识、态度和实践：系统回顾

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability

Pub Date : 2025-02-01 DOI: 10.1016/j.jtv.2024.12.002

Wanwan Fang, Qi Zhang, Yuxuan Chen, Wei Qin

Objective

To evaluate clinical nurses' knowledge, attitude, and practice toward MDRPI prevention.

Background

Medical device-related pressure injury (MDRPI) is a significant concern in healthcare, serving as a critical indicator of patient safety and the quality of nursing care.

Methods

This systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was performed on PubMed, Embase, Web of Science, the Cochrane Library, and CINAHL, as well as Chinese databases including China Biology Medicine Disc (CBM), China National Knowledge Infrastructure (CNKI), Wanfang Database, and VIP Database using the relevant keywords, from the earliest available records to June 27, 2024. The quality of the studies was appraised using the Joanna Briggs Institute (JBI) literature evaluation tool.

Findings

A total of 8847 clinical nurses from 18 studies were included. Of these, 6502 working in intensive care units. While nurses generally exhibited a positive attitude, their knowledge and practice were insufficient. Several factors positively influenced nurses' knowledge, attitude, and practice regarding MDRPI prevention, which include the level of education, work experience, previous training on MDRPU, caring for MDRPI patients, being an ICU specialist nurse, working in tertiary hospitals, and holding wound care certifications.

Conclusion

This review underscores the critical need to develop educational training programs to enhance nurses' competencies in MDRPI prevention. It also highlights the importance of addressing the challenges in implementing these strategies to ensure their effectiveness in clinical practice.

目的：了解临床护士对MDRPI预防的知识、态度和做法。背景：医疗器械相关压力损伤（MDRPI）是医疗保健领域的一个重要问题，是患者安全和护理质量的重要指标。方法：本系统评价按照系统评价和荟萃分析的首选报告项目（PRISMA）指南进行。综合检索PubMed、Embase、Web of Science、Cochrane Library、CINAHL以及中国生物医学光盘（CBM）、中国知网（CNKI）、万方数据库、VIP数据库等中文数据库，检索到相关关键词，从最早可查记录到2024年6月27日。采用乔安娜布里格斯研究所（JBI）文献评价工具对研究的质量进行评价。结果：共纳入18项研究的8847名临床护士。其中6502人在重症监护病房工作。虽然护士普遍表现出积极的态度，但他们的知识和实践不足。教育水平、工作经历、MDRPU培训、护理MDRPI患者、担任ICU专科护士、在三级医院工作、持有伤口护理证书等因素对护士预防MDRPI的知识、态度和行为有积极影响。结论：本综述强调了制定教育培训计划以提高护士预防MDRPI能力的迫切需要。它还强调了在实施这些战略时应对挑战以确保其在临床实践中的有效性的重要性。

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引用次数: 0

Medical device-related pressure injuries: The mediating role of attitude in the relationship between ICU nurses' knowledge levels and self-efficacy 与医疗器械相关的压力损伤：态度在重症监护室护士的知识水平与自我效能之间的中介作用。

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability

Pub Date : 2025-02-01 DOI: 10.1016/j.jtv.2024.12.007

Esra Yilmaz , Öznur Gürlek Kisacik

Aim

This study examines the mediating role of attitude towards preventing pressure injuries (PIs) in the effect of knowledge about Medical Device-Related Pressure Injuries (MDRPI) on self-efficacy in PI management among Turkish intensive care unit (ICU) nurses.

Materials and methods

A descriptive, cross-sectional study was conducted with 302 ICU nurses in Turkey from October 15, 2023, to April 30, 2024. Data were collected using the Nurse Information Form, Medical Device Related Pressure Injury Knowledge Assessment Test (MDRPI-KAT), Attitude towards Pressure Ulcer Prevention Instrument (APuP), and the Pressure Ulcer Management Self-Efficiency Scale (PUMSES).

Results

ICU nurses had a knowledge score of 9.20 ± 2.32, with a correct response rate of 57.5 %. Their attitude score was 42.41 ± 5.46, with 76.5 % showing a satisfactory attitude (≥75 %). The self-efficacy score for PI management was 60.59 ± 21.03. Knowledge level positively and significantly affected attitude (B = 0.963, 95 % CI [0.720–1.206]), and attitude positively and significantly affected self-efficacy (B = 0.837, 95 % CI [0.370–1.304]). The direct effect of knowledge on PI management self-efficacy was non-significant without a mediator (B = 0.339; p = 0.542; 95 % CI [-0.756-1.435]), but the indirect effect through attitude was significant (B = 0.806; 95 % CI [0.289–1.399]).

Conclusion

The study found that Turkish ICU nurses' knowledge of MDRPIs was below desired levels, though their self-efficacy was slightly above average and their attitudes were satisfactory. Attitude fully mediated the relationship between knowledge and self-efficacy, suggesting that enhancing nurses' knowledge and attitudes can improve their self-efficacy in managing PIs.

目的：本研究探讨预防压力伤害（PI）的态度在医疗器械相关压力伤害（MDRPI）知识对土耳其重症监护病房（ICU）护士PI管理自我效能的影响。材料与方法：对2023年10月15日至2024年4月30日土耳其302名ICU护士进行描述性横断面研究。采用护士信息表、医疗器械相关压力损伤知识评估测验（MDRPI-KAT）、压疮预防态度量表（APuP）和压疮管理自我效能量表（PUMSES）收集数据。结果：ICU护士知识得分为9.20±2.32分，正确反应率为57.5%。他们的态度得分为42.41±5.46，满意的占76.5%（≥75%）。自我效能感评分为60.59±21.03。知识水平正向显著影响态度（B = 0.963, 95% CI[0.720-1.206]），态度正向显著影响自我效能（B = 0.837, 95% CI[0.370-1.304]）。在没有中介的情况下，知识对PI管理自我效能感的直接影响不显著(B = 0.339；p = 0.542；95% CI[-0.756-1.435])，但态度的间接影响显著(B = 0.806；95% ci[0.289-1.399])。结论：研究发现，土耳其ICU护士对mdrpi的认知程度低于预期水平，但自我效能感略高于平均水平，态度满意。态度在知识与自我效能的关系中起完全中介作用，表明提高护士的知识和态度可以提高护士管理自我效能感。

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引用次数: 0

Does aromatherapy massage relieve itching?: A randomised controlled trial 香薰按摩能止痒吗？一项随机对照试验。

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability

Pub Date : 2025-02-01 DOI: 10.1016/j.jtv.2024.11.003

Amine Terzi , Yasemin Yıldırım , Fisun Şenuzun Aykar , Ulus Salih Akarca

Background

Based on ancient principles, aromatherapy uses essential oils to target skin receptors and has shown promise in promoting physical and psychosocial well-being.

Objective

This study was conducted in order to examine study effect of aromatherapy massage on itching, and skin pH among individuals with liver diseases.

Method

This study was randomised controlled trial conducted from February 13, 2020, to May 03, 2021. The patients meeting the inclusion criteria were assigned to aromatherapy (n = 11), placebo (n = 12) and control (n = 13) groups. The research data were collected using a questionnaire, and 5-D Itch Scale. Aromatherapy group received aromatherapy massage with classical massage method six times in total, each intervention being 15 min.

Results

The postaromatherapy itching mean score was 10,34 ± 0,92 in the aromatherapy group and 11,92 ± 1,08 in the placebo group and 13,02 ± 0,69 in the control group, and itching scale scores were statistically significant as compared to the groups after the last application (p = 0.000).

Conclusion

According to these results of the study, it can be recommended that aromatherapy massage can be applied by nurses to relieve itching in individuals with liver diseases.

背景：基于古老的原理，芳香疗法使用精油来靶向皮肤受体，并在促进身体和心理健康方面显示出希望。目的：研究香薰按摩对肝病患者瘙痒及皮肤pH值的影响。方法：本研究于2020年2月13日至2021年5月3日进行随机对照试验。符合纳入标准的患者被分为芳香疗法组（n = 11）、安慰剂组（n = 12）和对照组（n = 13）。采用问卷调查和5-D瘙痒量表收集研究数据。香薰组采用经典按摩方法进行香薰按摩，共6次，每次干预15 min。结果：香薰组治疗后瘙痒平均评分为10.34±0.92分，安慰剂组为11.92±1.08分，对照组为13.02±0.69分，与末次应用后各组比较，瘙痒评分差异均有统计学意义（p = 0.000）。结论：根据这些研究结果，可以推荐护士应用芳香疗法按摩来缓解肝病患者的瘙痒。

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引用次数: 0

Comparing the efficacy of two different types of dressings on patients with pressure injuries in long-term care facilities 比较两种不同类型的敷料对长期护理机构中压伤患者的疗效。

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability

Pub Date : 2025-02-01 DOI: 10.1016/j.jtv.2024.12.013

Shu-Fen Lo , Shu-Ting Chuang , Chao-Chih Yang

引用次数: 0

Evaluation of storage parameters of platelet-rich plasma in functional assay of epithelial gap repair 富血小板血浆储存参数在上皮间隙修复功能测定中的评价。

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability

Pub Date : 2025-02-01 DOI: 10.1016/j.jtv.2024.11.005

E. Keren , A. Gafanovich , D. Zilberman-Kraviz , E.C. Lewis , O. Grinstein-Cohen

Platelet-rich plasma (PRP), produced from autologous blood and containing growth factors, has shown promise in treating various conditions, including diabetic wounds. However, as expected, patient compliance is low in the context of repeated treatments as required for hard-to-heal wounds. This study investigates the efficacy of PRP stored under refrigeration for up to 2 weeks in promoting in-vitro human epithelial cell gap closure. PRP was prepared from six healthy individuals and immediately split into sterile test tubes for storage at 4 °C; the impact of fresh PRP on epithelial gap closure was compared to paired PRP samples stored for one and two weeks. According to gap closure analysis, 5 out of 6 individuals depicted accelerated epithelial gap closure compared to control conditions. There was no significant difference between fresh and refrigerated samples. An overall benefit was observed for using 1-week old samples over 2-week-old samples. Interestingly, according to a 6-hr epithelial gap analysis, significantly accelerated cell migration was obtained by 1-week-old refrigerated samples compared to their corresponding fresh PRP samples. The current study provides data in support of increasing the accessibility of PRP treatment for patients with hard-to-heal wounds. Patients can potentially self-treat between wound clinic appointments by using refrigerated sterile aliquots of their fresh PRP. Notably, by the end of two weeks, refrigerated PRP will not act as fresh PRP. More research is needed to fully investigate the effect of refrigeration on PRP sample efficacy, including larger cohorts, clinical wounds, and an evaluation of the molecular fingerprint of refrigerated PRP samples.

富血小板血浆（PRP）由自体血液产生，含有生长因子，在治疗各种疾病，包括糖尿病伤口方面显示出前景。然而，正如预期的那样，在难以愈合的伤口需要反复治疗的情况下，患者的依从性很低。本研究探讨了冷冻保存2周的PRP促进体外人上皮细胞间隙闭合的功效。从6个健康个体中制备PRP，并立即分成无菌试管，在4°C保存；将新鲜PRP对上皮间隙闭合的影响与储存一周和两周的配对PRP样品进行比较。根据间隙闭合分析，与对照组相比，6个个体中有5个描述了加速的上皮间隙闭合。新鲜和冷藏样品之间没有显著差异。总的来说，使用1周的样本比使用2周的样本有好处。有趣的是，根据一项6小时的上皮间隙分析，与相应的新鲜PRP样品相比，1周龄的冷藏样品显著加速了细胞迁移。目前的研究提供的数据支持增加难以愈合的伤口患者的PRP治疗的可及性。患者可以通过使用新鲜PRP的冷藏无菌等量，在伤口门诊预约之间进行潜在的自我治疗。值得注意的是，在两周结束时，冷藏的PRP将不如新鲜的PRP。需要更多的研究来充分研究冷藏对PRP样品疗效的影响，包括更大的队列、临床伤口和冷藏PRP样品的分子指纹评估。

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引用次数: 0

Vibration therapy for patients with hard-to-heal wounds: A systematic review and meta-analysis of experimental studies 振动疗法治疗难以愈合的伤口：实验研究的系统回顾和荟萃分析。

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability

Pub Date : 2025-02-01 DOI: 10.1016/j.jtv.2024.100852

Ita Daryanti Saragih , Herry Susanto , Hsiao-Ching Lin , Bih-O Lee

Introduction

Hard-to-heal wounds lead to functional loss, decreased quality of life, and prolonged hospitalization due to delayed healing. The healthcare costs of managing such wounds are substantial. Vibration therapy has been proposed as an alternative treatment for hard-to-heal wounds but no comprehensive reviews have quantitatively analyzed its efficacy.

Materials and methods

Six databases were systematically searched for relevant articles on August 1, 2024. The methodologies of the studies included in the analysis were assessed using Version 2 of the Cochrane Risk of Bias tool for randomized trials and ROBINS-I tool for non-randomized studies. A random-effects model was applied to aggregate the pooled effect size. Heterogeneity was assessed using I². A forest plot was generated for meta-analysis.

Results

Ten studies were included in the meta-analysis. Vibration therapy significantly reduced neuropathy (pooled standardized mean difference [SMD] = −0.79; 95 % CI = −1.51 to −0.07; p = 0.03; I² = 61.40 %) and enhanced the ulcer healing area (pooled SMD = 0.92; 95 % CI = 0.60 to 1.23; p < 0.001; I² = 0.00 %) of patients with hard-to-heal wounds. However, the intervention did not significantly alleviate pain (pooled SMD = −0.51; 95 % CI = −1.38 to 0.36; p = 0.25; I² = 74.15 %). Significant heterogeneity was identified in the pooled result for pain and neuropathy.

Conclusions

Vibration therapy appears to enhance ulcer healing and reduce neuropathy. These results may help researchers and healthcare providers to further develop vibration therapy to address the underlying requirements for bridging the evidence–practice gap in wound care. Future studies should consider the safety and potential adverse outcomes of vibration therapy to ensure its appropriate application for treating hard-to-heal wounds.

简介：难以愈合的伤口会导致功能丧失，生活质量下降，并因愈合延迟而延长住院时间。处理这类伤口的医疗费用是巨大的。振动疗法已被提出作为难以愈合伤口的替代治疗方法，但尚未有全面的文献对其疗效进行定量分析。材料与方法：系统检索6个数据库，于2024年8月1日检索相关文章。纳入分析的研究方法采用Cochrane第2版随机试验偏倚风险工具和ROBINS-I非随机研究工具进行评估。随机效应模型用于汇总汇总效应大小。采用I2评估异质性。生成森林图进行meta分析。结果：meta分析纳入了10项研究。振动治疗可显著减轻神经病变(合并标准化平均差[SMD] = -0.79；95% CI = -1.51 ~ -0.07；p = 0.03；I2 = 61.40%)，溃疡愈合面积增大(合并SMD = 0.92；95% CI = 0.60 ~ 1.23；P 2 = 0.00 %)。然而，干预并没有显著缓解疼痛(综合SMD = -0.51；95% CI = -1.38 ~ 0.36；p = 0.25；i2 = 74.15%)。在疼痛和神经病变的汇总结果中发现了显著的异质性。结论：振动疗法可促进溃疡愈合，减轻神经病变。这些结果可能有助于研究人员和医疗保健提供者进一步发展振动疗法，以解决弥合伤口护理中证据与实践差距的潜在需求。未来的研究应考虑振动治疗的安全性和潜在的不良后果，以确保其适用于治疗难以愈合的伤口。

{"title":"Vibration therapy for patients with hard-to-heal wounds: A systematic review and meta-analysis of experimental studies","authors":"Ita Daryanti Saragih , Herry Susanto , Hsiao-Ching Lin , Bih-O Lee","doi":"10.1016/j.jtv.2024.100852","DOIUrl":"10.1016/j.jtv.2024.100852","url":null,"abstract":"<div><h3>Introduction</h3><div>Hard-to-heal wounds lead to functional loss, decreased quality of life, and prolonged hospitalization due to delayed healing. The healthcare costs of managing such wounds are substantial. Vibration therapy has been proposed as an alternative treatment for hard-to-heal wounds but no comprehensive reviews have quantitatively analyzed its efficacy.</div></div><div><h3>Materials and methods</h3><div>Six databases were systematically searched for relevant articles on August 1, 2024. The methodologies of the studies included in the analysis were assessed using Version 2 of the Cochrane Risk of Bias tool for randomized trials and ROBINS-I tool for non-randomized studies. A random-effects model was applied to aggregate the pooled effect size. Heterogeneity was assessed using <em>I</em><sup>2</sup>. A forest plot was generated for meta-analysis.</div></div><div><h3>Results</h3><div>Ten studies were included in the meta-analysis. Vibration therapy significantly reduced neuropathy (pooled standardized mean difference [SMD] = −0.79; 95 % CI = −1.51 to −0.07; p = 0.03; <em>I</em><sup>2</sup> = 61.40 %) and enhanced the ulcer healing area (pooled SMD = 0.92; 95 % CI = 0.60 to 1.23; p < 0.001; <em>I</em><sup>2</sup> = 0.00 %) of patients with hard-to-heal wounds. However, the intervention did not significantly alleviate pain (pooled SMD = −0.51; 95 % CI = −1.38 to 0.36; p = 0.25; <em>I</em><sup>2</sup> = 74.15 %). Significant heterogeneity was identified in the pooled result for pain and neuropathy.</div></div><div><h3>Conclusions</h3><div>Vibration therapy appears to enhance ulcer healing and reduce neuropathy. These results may help researchers and healthcare providers to further develop vibration therapy to address the underlying requirements for bridging the evidence–practice gap in wound care. Future studies should consider the safety and potential adverse outcomes of vibration therapy to ensure its appropriate application for treating hard-to-heal wounds.</div></div>","PeriodicalId":17392,"journal":{"name":"Journal of tissue viability","volume":"34 1","pages":"Article 100852"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reporting medical device-related pressure ulcers: An international Delphi consensus study 报告医疗器械相关的压疮：一项国际德尔菲共识研究。

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability

Pub Date : 2025-02-01 DOI: 10.1016/j.jtv.2024.11.006

Ewa Crunden , Susanne Coleman , Lisette Schoonhoven , Peter R. Worsley

Background

Pressure ulcers that are caused from the application of medical devices for diagnostic or therapeutic purposes are commonly observed in acute care environments. Despite an improved understanding of the factors causing these wounds, there is no current consensus on reporting.

Objective

To develop an international consensus for reporting medical device related pressure ulcers.

Design

A modified RAND/UCLA Delphi study.

Settings

International experts from clinical, academic and industrial stakeholder.

Participants

95 international clinicians and tissue viability experts.

Methods

A Delphi survey was developed through literature review and qualitative synthesis. It was electronically disseminated through gate keepers to international experts in the field, with three rounds of consensus feedback. Median values and Disagreement Index from Likert scales were used to establish consensus.

Results

The panel achieved consensus for reporting MDRPUs which included 30 items across 5 Themes which included i) Recording medical device care, ii) Reporting medical device-related pressure ulcer, iii) Device specific reporting, iv) Ulcer reporting and v) patient information.

Conclusions

This is the first international study to develop consensus on medical device related pressure ulcer reporting. This could be used to support standardised international reporting to improve care standards.

Tweetable abstract

This international Delphi consensus study established a core reporting data set for medical device related pressure ulcers. This study will inform the design of future reporting tools to support standardised practice.e.g. Tweetable abstract: international consensus on medical device related pressure injury monitoring @EPUAP @NPIAP @SkinSensing.

背景：用于诊断或治疗目的的医疗器械的应用引起的压疮在急症护理环境中很常见。尽管对造成这些伤口的因素有了更好的了解，但目前在报告上还没有达成共识。目的：建立与医疗器械相关的压疮报告的国际共识。设计：一项改良的兰德/加州大学洛杉矶分校德尔菲研究。设置：来自临床、学术和行业利益相关者的国际专家。参与者：95名国际临床医生和组织活力专家。方法：采用文献法和定性综合法进行德尔菲调查。它通过看门人以电子方式散发给该领域的国际专家，并有三轮协商一致意见反馈。使用李克特量表的中位数和分歧指数来建立共识。结果：专家组就报告mdrpu达成共识，其中包括5个主题的30个项目，包括i)记录医疗器械护理，ii)报告与医疗器械相关的压疮，iii)器械特定报告，iv)溃疡报告和v)患者信息。结论：这是第一个就医疗器械相关压疮报告达成共识的国际研究。这可以用来支持标准化的国际报告，以提高护理标准。摘要：这项国际德尔菲共识研究建立了医疗器械相关压力性溃疡的核心报告数据集。这项研究将为未来报告工具的设计提供信息，以支持标准化实践。例如，推特摘要：医疗器械相关压力损伤监测的国际共识@EPUAP@NPIAP@ skinsensing。

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引用次数: 0

Critical analysis of hot topics in diabetic nephropathy related experimental research: A bibliometric analysis from 2018 to 2024

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability

Pub Date : 2025-02-01 DOI: 10.1016/j.jtv.2025.100854

Youduo Jia , Yunfei Gu , Lijun Wang , Nan Jiang , Xiumei Yu , Hu Tian

Background

Diabetic nephropathy (DN) is a severe complication of diabetes mellitus and a leading cause of end-stage renal disease worldwide. Understanding trends in experimental research on DN is crucial for advancing knowledge and clinical management.

Objective

This study aimed to explore current trends in DN related experimental research, utilizing CiteSpace, VOSviewer, and Bibliometrix to identify key contributors, influential countries, and noteworthy topics. The objective was to provide valuable insights for healthcare professionals and researchers in the field.

Methods

Relevant publications from the Web of Science Core Collection Science Citation Index Expanded were retrieved for the period between 2018 and 2024. CiteSpace, VOSviewer, and Bibliometrix were employed for data analysis, including identifying top authors, institutions, countries, keywords, co-cited authors, journals, references, and research trends.

Results

A total of 1501 relevant articles were included in the study. DN related experimental research exhibited an upward trend, reaching its peak in 2023. Key contributors such as Kretzler Matthias, Li Ping, and Rossing Peter emerged. China, the United States and Japan have the most publications. Keyword analysis revealed "activated protein kinase" as the most central keyword, while "diabetic nephropathy" had the highest citation rate. Recent focus shifted towards keywords like "Traditional Chinese Medicine" and "molecular docking."

Conclusion

This bibliometric analysis provides insights into trends in experimental research on DN from 2018 to 2024. Notable contributors and influential countries were identified, emphasizing global collaboration. Key topics demonstrate diverse approaches and emerging trends, supporting informed decision-making and innovation in combatting DN and enhancing patient outcomes.

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引用次数: 0

Unveiling the dynamics of postoperative edema in free flaps: A hyperspectral insight through linear mixed models 揭示术后自由皮瓣水肿的动力学：通过线性混合模型的高光谱洞察。

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability

Pub Date : 2025-02-01 DOI: 10.1016/j.jtv.2024.11.004

Lukas Viktor Dirschedl, Cosima Prahm, Adrien Daigeler, Jonas Kolbenschlag, Ruth Christine Schäfer

Aims of the study

This prospective cohort study investigates postoperative fluid accumulation in free flaps using hyperspectral imaging, analyzed through linear mixed models. Effects of edema on flap viability and microcirculatory changes during the critical postoperative phase should be detected.

Materials and methods

Patients who underwent free tissue transfer were monitored for six postoperative days (POD) using hyperspectral imaging to quantify tissue water index (TWI) for viable and failing flaps and the recipient site. Secondarily, oxygen saturation (StO2), near-infrared perfusion index (NPI) and tissue hemoglobin index (THI) were assessed. Microvascular blood flow was recorded with laser Doppler flowmetry. Linear mixed models generated prototypical TWI growth curves for estimation of TWI dynamics. Independent predictors of TWI were examined. Simple regression analysis explored correlations between flap TWI and microcirculation parameters.

Results

41 free flaps were monitored, with 4 requiring revision surgery. TWI of viable flaps (b=48.70); p=<.001) increased linearly (b=.76; p=<.001), reaching +9.4 % on POD 6. In contrast, revision flaps, while similar at baseline (b=-.95; p=.854), demonstrated a negative trend (b=-3.34; p=.005), ending at -33.6 % on POD 6. Male sex was associated with higher TWI at the recipient site (b=-3.34; p=.005). Notably, TWI showed no significant correlation with StO2 (p=>.999), NPI (p=.110), blood flow (p=.120) or THI (p=.140).

Conclusion

Hyperspectral imaging is feasible for bedside flap monitoring, enabling quantification of tissue edema progression. Although the sample size of failing flaps was limited, these findings highlight the potential of low TWI as a warning sign and may offer insights into mechanisms involved in ischemia-reperfusion injury.

研究目的：本前瞻性队列研究利用高光谱成像技术，通过线性混合模型分析术后游离皮瓣的积液情况。术后关键阶段应检测水肿对皮瓣活力和微循环变化的影响。材料和方法：对接受游离组织移植的患者进行术后6天（POD）的监测，采用高光谱成像技术量化活瓣和失败皮瓣及受体部位的组织水指数（TWI）。其次，评估氧饱和度（StO2）、近红外灌注指数（NPI）和组织血红蛋白指数（THI）。用激光多普勒血流仪记录微血管血流。线性混合模型生成TWI生长曲线原型，用于TWI动力学估计。研究了TWI的独立预测因子。简单回归分析皮瓣TWI与微循环参数的相关性。结果：41个游离皮瓣监测，其中4个需要翻修手术。活皮瓣TWI (b=48.70)；p = .999), NPI (p = .110),血流量(p = .120)或THI (p = .140)。结论：高光谱成像用于床边皮瓣监测是可行的，可以量化组织水肿的进展。尽管失败皮瓣的样本量有限，但这些发现强调了低TWI作为警告信号的潜力，并可能为缺血-再灌注损伤的机制提供见解。

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引用次数: 0

Mean platelet volume as a prognostic indicator in skin graft viability: A clinical study and retrospective analysis 平均血小板体积作为皮肤移植存活率的预后指标：临床研究和回顾性分析。

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability

Pub Date : 2025-02-01 DOI: 10.1016/j.jtv.2024.11.008

Percin Caskan , Semra Bulbuloglu , Ozge Deryol

Introduction

Skin grafting is the transplantation of partial-thickness or full-thickness skin from the donor to the recipient site, aiming to close tissue defects. However, skin graft transplantation surgery is not always successful and graft loss may occur after a while.

Objective

This study aimed to investigate mean platelet volume (MPV) as a prognostic criterion in patients who underwent wound reconstruction with skin graft.

Method

This study was cross-sectional and descriptive. The study sample consisted of n = 66 patients who underwent skin grafting for tissue loss. Wound and graft characteristics and some blood parameters were analyzed. Friedman, Kruskal Wallis, and Bonferroni tests were used for data analysis.

Results

The results of this study showed that MPV levels were higher in complex wounds and graft loss than in the others. MPV level was higher in patients with full-thickness skin grafts than in patients with split-thickness grafts. The mean MPV of patients who underwent multiple grafting was higher than single-shot (p < 0.01). There was a positive, strong and statistically significant correlation between serum PCT and MPV in the preoperative period (r = 0.288, p = 0.041) and between MPV and CRP on the 5th postoperative day (r = 0.294, p = 0.045).

Conclusion

In this study, MPV increased with increasing wound and graft complexity. Additionally, multiple grafting was statistically associated with an increase in MPV. There was a strong correlation between MPV and serum PCT and CRP at varying measurement times. These results suggest that MPV has the potential to increase in the presence of inflammation just like CRP and serum PCT.

皮肤移植是将部分厚度或全层皮肤从供体部位移植到受体部位，目的是闭合组织缺损。然而，皮肤移植手术并不总是成功的，一段时间后可能会发生移植物丢失。目的：本研究旨在探讨平均血小板体积（MPV）作为植皮创面重建患者的预后标准。方法：本研究采用横断面描述性方法。研究样本包括n = 66例因组织丢失而接受皮肤移植的患者。分析了创面和移植物的特点及一些血液参数。采用Friedman、Kruskal Wallis和Bonferroni检验进行数据分析。结果：本研究结果表明，MPV水平在复杂创面和移植物丢失中高于其他创面。全层植皮患者的MPV水平高于裂层植皮患者。多次移植患者的平均MPV高于单次移植(p)。结论：在本研究中，MPV随创面和移植复杂性的增加而增加。此外，多次嫁接在统计学上与MPV的增加有关。在不同的测量时间，MPV与血清PCT和CRP有很强的相关性。这些结果表明，MPV有可能在炎症存在时增加，就像CRP和血清PCT一样。

{"title":"Mean platelet volume as a prognostic indicator in skin graft viability: A clinical study and retrospective analysis","authors":"Percin Caskan , Semra Bulbuloglu , Ozge Deryol","doi":"10.1016/j.jtv.2024.11.008","DOIUrl":"10.1016/j.jtv.2024.11.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Skin grafting is the transplantation of partial-thickness or full-thickness skin from the donor to the recipient site, aiming to close tissue defects. However, skin graft transplantation surgery is not always successful and graft loss may occur after a while.</div></div><div><h3>Objective</h3><div>This study aimed to investigate mean platelet volume (MPV) as a prognostic criterion in patients who underwent wound reconstruction with skin graft.</div></div><div><h3>Method</h3><div>This study was cross-sectional and descriptive. The study sample consisted of n = 66 patients who underwent skin grafting for tissue loss. Wound and graft characteristics and some blood parameters were analyzed. Friedman, Kruskal Wallis, and Bonferroni tests were used for data analysis.</div></div><div><h3>Results</h3><div>The results of this study showed that MPV levels were higher in complex wounds and graft loss than in the others. MPV level was higher in patients with full-thickness skin grafts than in patients with split-thickness grafts. The mean MPV of patients who underwent multiple grafting was higher than single-shot (p < 0.01). There was a positive, strong and statistically significant correlation between serum PCT and MPV in the preoperative period (r = 0.288, p = 0.041) and between MPV and CRP on the 5th postoperative day (r = 0.294, p = 0.045).</div></div><div><h3>Conclusion</h3><div>In this study, MPV increased with increasing wound and graft complexity. Additionally, multiple grafting was statistically associated with an increase in MPV. There was a strong correlation between MPV and serum PCT and CRP at varying measurement times. These results suggest that MPV has the potential to increase in the presence of inflammation just like CRP and serum PCT.</div></div>","PeriodicalId":17392,"journal":{"name":"Journal of tissue viability","volume":"34 1","pages":"Article 100836"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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