Journal of tissue viability最新文献_第4页

Adults living with dementia and chronic wounds, wound types, care challenges, and impact across dementia stages: A scoping review protocol 患有痴呆症和慢性伤口的成年人，伤口类型，护理挑战和痴呆各阶段的影响：范围审查方案。

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability

Pub Date : 2025-02-01 DOI: 10.1016/j.jtv.2024.12.009

Kimberly LeBlanc , Kevin Woo , Georgina Gethin , Dimitri Beeckman , Corey Heerschap , Madhuri Reddy , Christina Parker , Margaret MacAndrew , Foy White-Chu , Samantha Wiesenfeld

Objective

The objective of this scoping review is to map the existing evidence on the epidemiology, care challenges, and impacts of various wound types among individuals living with dementia across different stages of the disease.

Introduction

Dementia is a growing global health concern, projected to rise significantly as the population ages. This condition not only affects cognitive function but also increases the risk of chronic wounds in part due to impairments in mobility, self-care, and communication. Current wound care guidelines inadequately address the specific needs of individuals with dementia. This scoping review seeks to fill this gap by comprehensively exploring the intersection between dementia and wound care.

Inclusion criteria

This review will include studies involving adults aged 18 and older diagnosed with dementia or cognitive impairment who are experiencing alterations in skin integrity, such as pressure injuries, venous and arterial ulcers, and diabetic ulcers. Both qualitative and quantitative studies will be considered, as well as studies focusing on the challenges faced by caregivers in managing wounds in this population. Excluded are studies such as editorials and opinion articles.

Methods

A comprehensive search strategy will be employed across multiple electronic databases, including MEDLINE, CINAHL, PsycINFO, EMBASE, and PubMed, as well as grey literature sources like ProQuest Dissertations & Theses Global and OpenGrey. The search will include studies published in English and French without date restrictions. Data will be extracted using a pilot-tested tool and presented in graphical, diagrammatic, and tabular formats. A narrative summary will accompany these visuals, providing context and insights into the data in relation to the review's objectives.

目的：本综述的目的是对不同阶段痴呆患者的流行病学、护理挑战和不同伤口类型影响的现有证据进行梳理。导言：痴呆症是一个日益严重的全球健康问题，预计随着人口老龄化将显著上升。这种情况不仅会影响认知功能，而且还会增加慢性伤口的风险，部分原因是活动能力、自我保健和沟通能力受损。目前的伤口护理指南不能充分解决痴呆症患者的具体需求。这一范围审查旨在通过全面探索痴呆和伤口护理之间的交集来填补这一空白。纳入标准：本综述将纳入18岁及以上被诊断为痴呆或认知障碍的成年人，他们正在经历皮肤完整性的改变，如压力损伤、静脉和动脉溃疡以及糖尿病溃疡。定性和定量研究都将被考虑，以及研究的重点是护理人员在处理这一人群的伤口所面临的挑战。不包括社论和评论文章等研究。方法：采用综合检索策略，跨MEDLINE、CINAHL、PsycINFO、EMBASE、PubMed等多个电子数据库，以及ProQuest Dissertations & Theses Global和OpenGrey等灰色文献资源。搜索将包括以英语和法语发表的无日期限制的研究。数据将使用试点测试工具提取，并以图形、图表和表格格式呈现。一个叙述性的总结将伴随着这些视觉效果，提供与审查目标相关的数据的背景和见解。

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引用次数: 0

Patients’ perceptions with high-risk diabetic foot on early access to medical care: A qualitative study

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability

Pub Date : 2025-01-30 DOI: 10.1016/j.jtv.2025.100863

Na Li , Honglin Wang , Ying Ye , Weiwei Dai , Qiuhong Zhou

Aims

To explore the perception of patients with high-risk diabetic foot on early access to medical care.

Design

Qualitative interview study.

Methods

We conducted a qualitative exploratory and descriptive study involving 11 community-based patients with high-risk diabetic foot residing in Hunan, China. Interviews were systematically coded and categorized into thematic groups using Colaizzi's method.

Results

There were five main themes and nine subthemes, namely, (1) Attitude toward healthcare-seeking, (2) Lack of disease knowledge: (a) low symptom alertness, (b) necessity of health education, (3) Hospital visits: (a) doctor-patient relationship, (b) level of medical institutions, (c) obstacles in seeking healthcare, (4) Financial consideration: (a) apprehension about adding to family burden, (b) medical insurance to ease financial stress, (5)Environmental impact: (a) family and social supports, (b) communication between patients.

Conclusions

Patients with high-risk diabetic foot have barriers to early intention to seek medical care, and it is the result of a combination of many factors. Healthcare providers should provide relevant interventions for patients, and health insurance systems should be improved to increase coverage to facilitate timely access.

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引用次数: 0

The effect of a stress ball on pain and anxiety during sharp debridement in patients with diabetic foot ulcers: A randomized controlled, single-blind study

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability

Pub Date : 2025-01-26 DOI: 10.1016/j.jtv.2025.100861

Fatma Aslan , Betul Tosun , Neşe Altınok Ersoy , Nurten Ozen

Objective

The aim of this study was to investigate the effect of using a stress ball during sharp debridement on the pain and anxiety in patients with diabetic foot ulcers.

Methods

This study with a randomized, controlled and single-blind design was conducted at a single-center on patients diagnosed with diabetic foot ulcers who were being treated at the endocrinology and metabolic diseases clinic of a university hospital. Patients in the intervention group started using a stress ball before the debridement procedure and continued to use it until the procedure ended. No intervention was made to the patients in the control group. Data were collected by using the Descriptive Information Form, Diabetic Foot Meggit-Wagner Classification, Visual Analogue Scale (VAS), and State Anxiety Inventory (STAI).

Results

The study was completed with a total of 76 patients, 38 each in the intervention and control groups. The use of stress balls led to a reduction in anxiety and pain symptoms in the intervention group. The anxiety score of the patients in the intervention group was also found to be statistically significantly lower than those in the control group after the procedure (p = 0.008; η2 = 0,091). The VAS scores of the patients in the intervention group were found to be statistically significantly lower than those in the control group both during (p < 0.001; η2 = 0.348) and after (p < 0.001; η2 = 0.438) the procedure.

Conclusions

The use of a stress ball was found to be an effective method of reducing the level of pain and anxiety that occurs during the sharp debridement procedure. Stress ball application is a practical, easy, and cost-effective non-pharmacological method.

Clinical trial number

The study was recorded in the ClinicalTrials.gov website with the number NCT06316115.

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引用次数: 0

Effect of physical activity on tissue perfusion in patients with diabetes mellitus: Systematic review and meta-analysis

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability

Pub Date : 2025-01-25 DOI: 10.1016/j.jtv.2025.100855

Laura Palacios-Abril , Aroa Tardáguila-García , Francisco Javier Álvaro-Afonso , Sara García-Oreja , Sol Tejeda-Ramírez , José Luis Lázaro-Martínez

Aims

The objective of this systematic review and meta-analysis is to identify and assess the literature exploring the impact of physical activity on enhancing tissue perfusion in the feet of patients with diabetes mellitus (DM).

Materials and methods

All the selected studies were evaluated using the Cochrane risk of bias tool, to assess the risk of bias for randomized controlled trials. A thorough search was conducted in April 2024 through PubMed and Web of Science to identify randomized clinical trials (RCTs) and comparative studies that assessed the effect of physical activity enhancing tissue perfusion. Data analysis was performed using RevMan v5.4., employing the Mantel-Haenszel method for dichotomous outcomes.

Results

A total of nine studies compared changes in microcirculation before and after physical exercise in patients with DM. A meta-analysis of the data collected from seven studies estimated a mean difference of 4.87 (95 % CI 2.37–7.38) favouring the improvement of microvascular parameters post-exercise, with a minor level of heterogeneity (x² = 10.54, df = 6, p = 0.1, I² = 43 %) and a statistically significant difference between the two groups (p ≤ 0.001). However, a second evaluation, which included four studies involving patients with and without DM, indicated high heterogeneity (x² = 661.32, df = 3, p ≤ 0.00001, I² = 100 %) with no observable statistically significant differences between the two groups (p = 0.62).

Conclusion

Physical activity in patients with DM may be effective in improving blood microcirculation in the lower limbs.

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引用次数: 0

Evaluation of surgical nurses’ knowledge and attitudes towards pressure ulcer prevention

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability

Pub Date : 2025-01-25 DOI: 10.1016/j.jtv.2025.100862

Gülbanu Zencir , Tuğçe Yeşilyaprak , Esin Peri Ünal , Berken Akın , Fadime Gök

Background

Pressure ulcers are an indicator of healthcare quality. The knowledge and attitudes of nurses are important in the prevention of pressure ulcers.

Objective

This study aimed to evaluate the knowledge and attitudes of surgical nurses regarding the prevention of pressure ulcers.

Design

The research is descriptive and cross-sectional in nature.

Setting

The study was conducted at a university hospital in Turkey between May and November 2022.

Participants

The research population consisted of 310 nurses working in the surgical clinic and intensive care units of a university hospital.

Methods

The study included 203 nurses. Data were collected between May 2022 and November 2022 using the “Descriptive Information Form”, the “Knowledge Towards Pressure Ulcers Prevention Scale”, and the “Attitude Towards Pressure Ulcers Prevention Scale”. The data analysis utilized frequency, percentage, mean, independent groups t-test, one-way ANOVA, Pearson correlation, and linear regression analysis.

Results

The knowledge levels of surgical nurses regarding pressure ulcer prevention were inadequate. Nurses had a positive attitude towards preventing pressure ulcers; however, this positive attitude was not at a satisfactory level. The nurses’ knowledge level was a predictor of their positive attitude.

Conclusions

This study revealed that surgical nurses had insufficient knowledge about preventing pressure ulcers and exhibited a positive attitude that was not at the desired level.

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引用次数: 0

Advancing burn wound healing with an innovative in situ gelling probiotic microparticle formulation employing quality by design (QbD) principles

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability

Pub Date : 2025-01-21 DOI: 10.1016/j.jtv.2025.100860

Fatemeh Moraffah , Nasrin Samadi , Mohammad Abdollahi , Seyed Naser Ostad , Roshanak Dolatabadi , Maryam Pirouzzadeh , Alireza Vatanara

Scientists investigated probiotic-containing dressings to address the challenges associated with burn injuries, namely infection and antimicrobial resistance. The present investigation sought to evaluate the impact of innovative probiotic-loaded microparticles with in situ gelling characteristics on infected burns. The strain, Lactiplantibacillus plantarum, was selected due to its demonstrated wound-healing potential. Subsequently, a formulation was designed to sustain the growth capacity of probiotics. Polymers with a high moisture absorption capacity were exclusively used to avoid powder dispersion from wounds. The formulation was stabilized through the reduction of water content using the spray-drying process. The ideal composition was identified by analyzing the influence of the spray-drying inlet temperature, polymer type, and concentrations on probiotic viability, process efficiency, swelling ratio, and flow properties of powders. Morphological analysis showed the presence of microparticles with significant exchangeable surface areas. The rheological properties of the formulation demonstrated its ability to withstand high temperatures and mechanical stress. Moreover, FTIR and DCS spectra provided evidence of interconnection between the polymers. Examination of the growth profiles of both formulated and free probiotics revealed a consistent growth rate and an extended lag time. Animal studies have shown that the optimal microparticles exhibited superior efficacy compared to the control groups across all parameters and displayed enhanced effectiveness against Pseudomonas aeruginosa. The proposed delivery method, with its simple application and prevention of normal flora transmission, may have the potential to improve burn wound infection treatments.

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引用次数: 0

Corrigendum to "Factors associated with adherence to prevention guidelines of pressure injuries among Jordanian nurses in critical care units", [Journal of Tissue Viability, 34(1), February 2025, 100853]. 《约旦重症监护室护士对压力伤害预防指南的遵守相关因素》的更正，[Journal of Tissue Viability, 34(1)， 2025年2月，100853]。

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability

Pub Date : 2025-01-20 DOI: 10.1016/j.jtv.2025.100859

Eslam Alalawneh, Raghad Abdelkader, Abdulkareem Iblasi, Osama Alkouri, Mohanad Abu Ruz, Anas Ababneh

引用次数: 0

The role of biomaterials-based scaffolds in advancing skin tissue construct 生物材料支架在推进皮肤组织构建中的作用。

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability

Pub Date : 2025-01-14 DOI: 10.1016/j.jtv.2025.100858

Komal Sindhi , Ravindra Babu Pingili , Vishal Beldar , Sankha Bhattacharya , Jiyaur Rahaman , Dhrubojyoti Mukherjee

Despite extensive clinical studies and therapeutic interventions, addressing significant skin wounds remains challenging, necessitating novel approaches for effective regeneration therapy. In the current review, we analyzed and evaluated the application, advancements, and future directions of biomaterials-based scaffolds for skin tissue construct. In addition, we investigated the role of other biological substitutes in promoting wound healing and skin tissue regeneration. The review highlights the impact of biomaterial-based scaffolds on skin tissue regeneration and wound healing. After presenting the physiological process of skin tissue regeneration, the review emphasizes the different biochemical components significant for skin healing and regeneration. Subsequently, it delves into the role of scaffolds in skin tissue engineering. Recent advancements in nanotechnology are also highlighted with a specific focus on the utilization of nanomaterials for enhancing healing, facilitating tissue regeneration, and promoting skin reconstruction. Biomaterial scaffolds have emerged as a potential intervention for wound healing forming the foundation of skin tissue regeneration. These scaffolds, intricate three-dimensional frameworks, serve as carriers for cells, medications, and genes, facilitating their delivery into the body. The integration of degradable porous scaffolds with biological cells offers a promising avenue for tissue repair. Biomaterials play a crucial role in tissue engineering, providing temporary mechanical support and facilitating cellular processes to augment skin tissue regeneration.

尽管有广泛的临床研究和治疗干预，但解决重大皮肤伤口仍然具有挑战性，需要新的有效的再生治疗方法。在本文中，我们分析和评价了生物材料支架在皮肤组织构建中的应用、进展和未来的发展方向。此外，我们还研究了其他生物替代品在促进伤口愈合和皮肤组织再生方面的作用。这篇综述强调了基于生物材料的支架对皮肤组织再生和伤口愈合的影响。在介绍了皮肤组织再生的生理过程后，着重介绍了在皮肤愈合和再生过程中具有重要意义的不同生化成分。随后，深入研究了支架在皮肤组织工程中的作用。纳米技术的最新进展也被强调，特别关注纳米材料在增强愈合、促进组织再生和促进皮肤重建方面的应用。生物材料支架作为一种潜在的干预创面愈合形成皮肤组织再生的基础。这些支架，复杂的三维框架，作为细胞、药物和基因的载体，促进它们进入体内。可降解多孔支架与生物细胞的结合为组织修复提供了一条很有前途的途径。生物材料在组织工程中发挥着至关重要的作用，提供临时的机械支持和促进细胞过程，以增强皮肤组织再生。

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引用次数: 0

The utility of skin surface temperature measurement in the prediction of diabetic foot ulceration

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability

Pub Date : 2025-01-11 DOI: 10.1016/j.jtv.2024.100851

Pauline Wilson , Tom O'Connor , Fiona Boland , Aglecia Budri , Zena Moore , Niamh Phelan , Declan Patton

Aim

Temperature is a marker of inflammation. Research has shown that by measuring skin surface temperature in those with a history of diabetic foot ulceration (DFU), tissue damage can be identified early and reduce rates of subsequent DFU. This study considered whether measuring skin surface temperature using infra-red thermometry can identify early tissue damage and inform clinical practice in a general population with Diabetes Mellitus (DM).

Method

The data presented was taken from a prospective observational study of risk factors in patients with Diabetes. As part of this study, temperature measurements using the Flir E6 Infra-red camera were taken from 216 individuals attending outpatient diabetes clinics in a large urban teaching hospital in Ireland as part of a comprehensive diabetic foot assessment. Measurements were taken at foot sites associated with increased risk at baseline received repeat temperature measurement on 2 subsequent occasions in the following week. Any ulceration was subsequently recorded.

Results

Discussion: Of the 216 participants, 4 % (n = 9) developed visual ulceration within 7 days. All of these had been identified at high risk at baseline assessment and had a history of foot disease. A temperature differential of ≥2.2 °C between sites of interest was recorded. Temperature ranges varied from 29.1 °C to 37.6 °C. High temperature was considered if over 35 °C. Of those who developed a diabetic foot ulceration within the 7 day follow up period, 78 % (n = 7) had a high temperature. The remaining 22 % (n = 2) who developed ulceration had a temperature reading in the normal range.

Conclusion

Elevated skin surface temperature was seen prior to the development of DFU in all cases in this study. Initial analysis suggests that neither the 35 °C threshold nor a 2.2 °C temperature difference is indicative of inevitable tissue damage in this population due to the high number of false positives seen.

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引用次数: 0

Application of infrared thermography for predicting pressure injury healing: A prospective study 应用红外热像仪预测压伤愈合：一项前瞻性研究。

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability

Pub Date : 2025-01-09 DOI: 10.1016/j.jtv.2025.100857

Lulu Lin , Danwen Zhuang , Hailei Guo , Miaomiao Zheng , Qianqian Zhu , Ying Xu , Xiaoqiong Jiang , Fuman Cai

Background

An accurate assessment of pressure injury healing is crucial for the timely implementation of nursing intervention. This study aimed to investigate the accuracy of infrared thermography-based wound temperature measurement in predicting wound outcomes.

Methods

This prospective, 16 days observational study included 156 adults with pressure injury. The temperature of wound bed, periwound skin and normal skin was recorded by using infrared thermography every three days. After that, three relative temperatures of PI were analyzed. The aim was to assess the significance of wound temperature in predicting healing outcomes for pressure injuries.

Results

Relative temperature between periwound skin and normal skin was positively correlated with pressure injury healing (r > 0.64). Particularly the first day of follow up, it was found to be closely related to pressure injury healing (r = 0.687). On the last day and median time (the eighth to ninth day) of follow up, the optimal cutoff values of the indicator were negative values (periwound skin temperature was lower than normal skin). COX proportional hazard regression model analysis showed that relative temperature between periwound skin and normal skin on the first day of follow-up was the most significant predictor of pressure injury healing, and the healing risk increased largest- 8.79 times (95%CI: 4.53, 17.05), when its temperature greater than 0.000 °C.

Conclusion

Relative temperature between periwound skin and normal skin monitoring by infrared thermography better than visual assessment which can objectively serve as an indicator for predicting the healing status of pressure injury.

背景：准确评估压伤愈合情况对及时实施护理干预至关重要。本研究旨在探讨基于红外热像仪的伤口温度测量在预测伤口预后方面的准确性。方法：这项为期16天的前瞻性观察研究纳入了156例成人压伤患者。采用红外热像仪每三天记录一次创面、创面周围皮肤和正常皮肤的温度。然后对PI的三种相对温度进行了分析。目的是评估伤口温度在预测压伤愈合结果中的意义。结果：创面周围皮肤与正常皮肤的相对温度与压伤愈合呈正相关（r < 0.64）。特别是随访第一天，发现与压伤愈合密切相关（r = 0.687）。在随访的最后一天和中位时间（第8 ~第9天），该指标的最佳临界值为负值（创面周围皮肤温度低于正常皮肤）。COX比例风险回归模型分析显示，随访第一天创面周围皮肤与正常皮肤的相对温度是压伤愈合的最显著预测因子，当其温度大于0.000℃时，愈合风险增加最大，为8.79倍（95%CI: 4.53, 17.05）。结论：红外热像仪监测创面周围皮肤与正常皮肤的相对温度优于目测，可作为客观预测压伤愈合状况的指标。

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引用次数: 0