Journal of tissue viability最新文献

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.

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.

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.

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.

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.

Aim: This study aimed to determine the quality of life of patients with pressure injuries and the factors associated with them.

Materials and methods: This descriptive and correlative study was conducted between January 2022 and July 2023 at one private and two state hospitals in Türkiye. Data were collected using a demographic and clinical history form, the Pressure Ulcer Quality of Life Scale- Turkish.

Results: In this study, the mean quality of life score of the patients with pressure injuries was 65.28 ± 12.71, and according to the Pressure Ulcer Quality of Life Scale- Turkish score of the patients, the areas with the worst quality of life were mobility and movement, activity, pain, sleep, odor, and exudate, respectively. The most important variables that negatively affected the quality of life were determined to be the number of pressure injuries, prolonged healing time, and diagnosis of diabetes. In contrast, the variable that positively affected the quality of life was determined as having had any previous surgical experience.

Conclusion: It is recommended that the results obtained from this study should be utilized in determining national and institutional strategies to improve the quality of life of patients with pressure injuries and that interventional studies should be planned to improve the quality of life of patients with pressure injuries.

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.

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.

Aim of the study: This research is a descriptive and cross-sectional study aimed at examining the use of three different scales to assess the risk of pressure injury (PI) in surgical patients.

Materials and methods: This study was conducted between February 1 and July 1, 2022. The study included patients who had planned surgery in general surgery clinic. The sample size was 388 patients. Patients who agreed to participate in the study were asked to fill out the " Introductory Information Form " and perform a risk assessment using the Braden, Munro and 3S Scales. The statistics program IBM SPSS Statistics 25.0 packaged software was used in the analyses of data.

Results: It is evident that the relationship between the scales and the diagnosis of PI, as well as the strength of this relationship, are statistically significant (p < 0.05). The Munro Scale exhibited the highest value of Phi value and validity coefficient c, indicating a stronger association with the diagnosis of PI, thus suggesting its greater effectiveness in discrimination. According to the validity coefficients found, it can be stated that the correct classification percentages for Munro, Braden, and 3S Scales were 91 %, 71 %, and 66 %, respectively.

Conclusion: The findings of this study indicate that both the Braden, Munro, and 3S Scales can be used for PI risk assessment in surgical patients, but the Munro Scale exhibits superior predictive validity compared to the Braden and 3S Scales in terms of overall sensitivity and specificity.

Aim: Pressure injuries, a prevalent issue in healthcare settings, have profound physical and emotional implications for patients and healthcare providers. However, further evidence is needed regarding the level of nursing students' knowledge of pressure injuries in the Middle East, a region where healthcare is rapidly evolving. This study examines the knowledge levels regarding pressure injuries among nursing students in Jordan and Turkey.

Materials and methods: This cross-sectional study collected data from a randomly selected sample of 282 nursing students studying in two private and two Public Universities in Turkey and Jordan. Data was collected using a demographic survey and the Pressure Ulcer Knowledge Assessment Tool (PUKAT 2.0).

Results: The overall knowledge scores among students were alarmingly low, with significant differences between Jordanian and Turkish cohorts, with Turkish students scoring higher. Moreover, a significant difference was observed between students' knowledge levels from public and private universities in Jordan, but no difference was found between students of the two Turkish universities.

Conclusion: The knowledge gap among nursing students regarding pressure ulcers is a critical issue that needs immediate attention. These findings highlight the urgent need for improved educational strategies and standardized competencies in this aspect. This study strongly advocates for changing teaching strategies and incorporating evidence-based pressure injury prevention education into nursing curricula, interprofessional education initiatives, and continuous professional development for faculty. These measures can significantly enhance nursing students' knowledge and improve patient care.