Pub Date : 2025-09-15DOI: 10.1016/j.jtv.2025.100953
Dan Li , Ruming Ye , Nanxi Zhu , Cuimin Su , Deyi Zhuang , Xianghui Huang
<div><h3>Background</h3><div>Due to the fragile skin of preterm infants, the risk of postoperative incision infection is higher. Too high humidity in the incubator can affect the postoperative wound healing of premature infants. To explore the effect of reducing the environmental humidity in the incubator on the postoperative wound healing of premature infants, so as to provide more scientific and effective nursing strategies for premature infants.</div></div><div><h3>Methods</h3><div>From January 2023 to March 2024, premature infants admitted to the SICU of Xiamen Children's Hospital in China after abdominal surgery were selected. According to the random number generated by the computer, all patients were randomly divided into the experimental group and the control group. The humidity of the incubator was set according to the gestational age and weight of the infants in the control group, and the humidity was reduced by 10 % on this basis in the experimental group. The number of colonies on the surface of incubator rubber ring, door handle and mattress were compared between the two groups before operation, 24 h and 7 days after operation. The scores of NSCS on the day before surgery, the 3rd and 8th day after operation, the number of colonies in the tip of nose, neck, umbilical region and perianal region, skin infection, skin healing were also compared. Body weight on the 1st and 2 nd week after operation, and urine volume on the 1st, 3rd and 7th day after operation were compared between the two groups.</div></div><div><h3>Results</h3><div>NSCS of the experimental group and the control group on the 8th day after operation were statistically different (<em>P</em> < 0.05). NSCS in experimental group on the 8th day after operation was smaller than that on the 1st day before operation, and the difference was statistically significant (<em>P</em> < 0.05). There were 2 cases of incision infection in the experimental group and 4 cases in the control group, all of which were limited to incision infection and did not involve deep tissues. The incision healing time of the experimental group was significantly shorter than that of the control group (<em>P</em> < 0.001). There was a significant difference in perianal bacterial load between the two groups on the third day after surgery (<em>P</em> = 0.001). No bacteria were detected in the three parts of the incubator in the experimental group and the control group before operation. The number of bacterial colonies measured in the rubber ring of the experimental group was higher than that of the control group at 24h after operation, but the rest of the total number of bacterial colonies was lower than that of the control group, and the difference between the two groups at three different sites was especially significant at 7d after operation. The weight of children in both groups increased significantly within the first and second postoperative weeks, with statistically significant intra-group differ
{"title":"Assessment of reducing the humidity of the incubator to improve the skin of premature infants with surgical wound","authors":"Dan Li , Ruming Ye , Nanxi Zhu , Cuimin Su , Deyi Zhuang , Xianghui Huang","doi":"10.1016/j.jtv.2025.100953","DOIUrl":"10.1016/j.jtv.2025.100953","url":null,"abstract":"<div><h3>Background</h3><div>Due to the fragile skin of preterm infants, the risk of postoperative incision infection is higher. Too high humidity in the incubator can affect the postoperative wound healing of premature infants. To explore the effect of reducing the environmental humidity in the incubator on the postoperative wound healing of premature infants, so as to provide more scientific and effective nursing strategies for premature infants.</div></div><div><h3>Methods</h3><div>From January 2023 to March 2024, premature infants admitted to the SICU of Xiamen Children's Hospital in China after abdominal surgery were selected. According to the random number generated by the computer, all patients were randomly divided into the experimental group and the control group. The humidity of the incubator was set according to the gestational age and weight of the infants in the control group, and the humidity was reduced by 10 % on this basis in the experimental group. The number of colonies on the surface of incubator rubber ring, door handle and mattress were compared between the two groups before operation, 24 h and 7 days after operation. The scores of NSCS on the day before surgery, the 3rd and 8th day after operation, the number of colonies in the tip of nose, neck, umbilical region and perianal region, skin infection, skin healing were also compared. Body weight on the 1st and 2 nd week after operation, and urine volume on the 1st, 3rd and 7th day after operation were compared between the two groups.</div></div><div><h3>Results</h3><div>NSCS of the experimental group and the control group on the 8th day after operation were statistically different (<em>P</em> < 0.05). NSCS in experimental group on the 8th day after operation was smaller than that on the 1st day before operation, and the difference was statistically significant (<em>P</em> < 0.05). There were 2 cases of incision infection in the experimental group and 4 cases in the control group, all of which were limited to incision infection and did not involve deep tissues. The incision healing time of the experimental group was significantly shorter than that of the control group (<em>P</em> < 0.001). There was a significant difference in perianal bacterial load between the two groups on the third day after surgery (<em>P</em> = 0.001). No bacteria were detected in the three parts of the incubator in the experimental group and the control group before operation. The number of bacterial colonies measured in the rubber ring of the experimental group was higher than that of the control group at 24h after operation, but the rest of the total number of bacterial colonies was lower than that of the control group, and the difference between the two groups at three different sites was especially significant at 7d after operation. The weight of children in both groups increased significantly within the first and second postoperative weeks, with statistically significant intra-group differ","PeriodicalId":17392,"journal":{"name":"Journal of tissue viability","volume":"34 4","pages":"Article 100953"},"PeriodicalIF":2.4,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-09DOI: 10.1016/j.jtv.2025.100951
Yongle Shi , Chenxin Huang , Yanjun Diao , Hanghang Liu , Xiaohui Zhang , Xian Liu
Aim
This study focuses on wound complications after debridement and suture of maxillofacial injuries, aiming to accurately identify the risk factors and construct an effective prediction model.
Methods
A cross-sectional study was conducted in the emergency department of a tertiary dental hospital in southwest China from January to May 2024. Clinical data were obtained from patients who underwent debridement and suturing procedures for maxillofacial injuries under local anesthesia. Lasso regression was employed to identify risk factors, and binary logistic regression was utilized to construct the prediction model. The performance of the model was assessed based on accuracy, sensitivity, specificity, the receiver operating characteristic (ROC) curve, and the area under the curve (AUC).
Results
The incidence of postoperative wound complications was 25 % (196/783). Following Lasso regression analysis, 14 risk factors were identified. Subsequent binary logistic regression analysis, which included variables selected by the Lasso regression, revealed that wound complications were influenced by interval time between injury and visit (hours), endocrine disorder, accompanying caregiver, penetrating injury, tissue defect, duration of surgery (hours), anesthesia, and intraoperative cooperation of patients (p < 0.05). The calibration curve of the predictive model demonstrated high consistency between predicted and actual probabilities, with an AUC of 0.73.(95 % CI: 0.682–0.763).
Conclusions
This study developed a predictive model for postoperative complications in maxillofacial trauma by incorporating key risk factors including injury-to-visit interval, endocrine disorder, penetrating injury status, and tissue defects. The model enables precise perioperative risk stratification and personalized clinical decision-making, providing essential evidence-based guidance for trauma management.
{"title":"Factors influencing wound complication risk in maxillofacial injury patients: Insights from a cross-sectional debridement and suturing study","authors":"Yongle Shi , Chenxin Huang , Yanjun Diao , Hanghang Liu , Xiaohui Zhang , Xian Liu","doi":"10.1016/j.jtv.2025.100951","DOIUrl":"10.1016/j.jtv.2025.100951","url":null,"abstract":"<div><h3>Aim</h3><div>This study focuses on wound complications after debridement and suture of maxillofacial injuries, aiming to accurately identify the risk factors and construct an effective prediction model.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted in the emergency department of a tertiary dental hospital in southwest China from January to May 2024. Clinical data were obtained from patients who underwent debridement and suturing procedures for maxillofacial injuries under local anesthesia. Lasso regression was employed to identify risk factors, and binary logistic regression was utilized to construct the prediction model. The performance of the model was assessed based on accuracy, sensitivity, specificity, the receiver operating characteristic (ROC) curve, and the area under the curve (AUC).</div></div><div><h3>Results</h3><div>The incidence of postoperative wound complications was 25 % (196/783). Following Lasso regression analysis, 14 risk factors were identified. Subsequent binary logistic regression analysis, which included variables selected by the Lasso regression, revealed that wound complications were influenced by interval time between injury and visit (hours), endocrine disorder, accompanying caregiver, penetrating injury, tissue defect, duration of surgery (hours), anesthesia, and intraoperative cooperation of patients (p < 0.05). The calibration curve of the predictive model demonstrated high consistency between predicted and actual probabilities, with an AUC of 0.73.(95 % CI: 0.682–0.763).</div></div><div><h3>Conclusions</h3><div>This study developed a predictive model for postoperative complications in maxillofacial trauma by incorporating key risk factors including injury-to-visit interval, endocrine disorder, penetrating injury status, and tissue defects. The model enables precise perioperative risk stratification and personalized clinical decision-making, providing essential evidence-based guidance for trauma management.</div></div>","PeriodicalId":17392,"journal":{"name":"Journal of tissue viability","volume":"34 4","pages":"Article 100951"},"PeriodicalIF":2.4,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145044033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-03DOI: 10.1016/j.jtv.2025.100952
Julie Deprez , Jan Kottner , Alexandra Eilegård Wallin , Carina Bååth , Ami Hommel , Lisa Hultin , Anna Josefson , Dimitri Beeckman
Background
Incontinence-associated dermatitis (IAD) is a prevalent and distressing form of irritant contact dermatitis caused by prolonged exposure to urine and/or faeces. Not all incontinent individuals develop IAD, suggesting that additional prognostic factors contribute to its onset. The quality of empirical evidence supporting risk factors for IAD development is moderate to very low. Therefore, it is necessary to systematically compile and analyse expert knowledge on this topic.
Aim
This study aimed to identify and prioritise key prognostic factors for IAD development through an international expert consultation.
Materials and methods
A cross-sectional expert survey was conducted among international experts using an electronic survey platform. Participants rated the importance of 26 pre-identified prognostic factors, ranked relevant factors and suggested additional factors. Data were analysed to determine expert consensus and factor rankings.
Results
A total of 45 experts participated, with a response rate of 39 %. The highest-ranked prognostic factors included double incontinence, faecal incontinence, loose stools, stool frequency, urinary incontinence, and impaired mobility. Other important factors were advanced age, friction and shear forces, cognitive impairment, and poor nutrition. In addition, experts highlighted systemic factors such as caregiver knowledge gaps and staff shortages as potential contributors to IAD risk.
Conclusion
Study results support established risk factors for IAD development such as stool frequency and limited mobility. Experts also identified factors, such as higher age and the presence of loose or liquid stool, that are considered relevant by experts but are not yet fully supported by empirical evidence. Findings will inform a future large-scale cohort study.
{"title":"Prognostic factors for incontinence-associated dermatitis (IAD): Results of an international expert survey","authors":"Julie Deprez , Jan Kottner , Alexandra Eilegård Wallin , Carina Bååth , Ami Hommel , Lisa Hultin , Anna Josefson , Dimitri Beeckman","doi":"10.1016/j.jtv.2025.100952","DOIUrl":"10.1016/j.jtv.2025.100952","url":null,"abstract":"<div><h3>Background</h3><div>Incontinence-associated dermatitis (IAD) is a prevalent and distressing form of irritant contact dermatitis caused by prolonged exposure to urine and/or faeces. Not all incontinent individuals develop IAD, suggesting that additional prognostic factors contribute to its onset. The quality of empirical evidence supporting risk factors for IAD development is moderate to very low. Therefore, it is necessary to systematically compile and analyse expert knowledge on this topic.</div></div><div><h3>Aim</h3><div>This study aimed to identify and prioritise key prognostic factors for IAD development through an international expert consultation.</div></div><div><h3>Materials and methods</h3><div>A cross-sectional expert survey was conducted among international experts using an electronic survey platform. Participants rated the importance of 26 pre-identified prognostic factors, ranked relevant factors and suggested additional factors. Data were analysed to determine expert consensus and factor rankings.</div></div><div><h3>Results</h3><div>A total of 45 experts participated, with a response rate of 39 %. The highest-ranked prognostic factors included double incontinence, faecal incontinence, loose stools, stool frequency, urinary incontinence, and impaired mobility. Other important factors were advanced age, friction and shear forces, cognitive impairment, and poor nutrition. In addition, experts highlighted systemic factors such as caregiver knowledge gaps and staff shortages as potential contributors to IAD risk.</div></div><div><h3>Conclusion</h3><div>Study results support established risk factors for IAD development such as stool frequency and limited mobility. Experts also identified factors, such as higher age and the presence of loose or liquid stool, that are considered relevant by experts but are not yet fully supported by empirical evidence. Findings will inform a future large-scale cohort study.</div></div>","PeriodicalId":17392,"journal":{"name":"Journal of tissue viability","volume":"34 4","pages":"Article 100952"},"PeriodicalIF":2.4,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-31DOI: 10.1016/j.jtv.2025.100950
İsmail Sezikli, Murat Kendirci
Background
Diabetic foot ulcers (DFUs) are a common and severe complication of diabetes mellitus, often leading to prolonged hospitalization, high treatment costs, and potential amputations. Despite advances in wound care, current dressing materials often lack bioactive properties to modulate chronic wound environments.
Aim
To evaluate the clinical efficacy of resveratrol-enriched collagen dressings compared to standard collagen dressings in the management of Wagner grade 2 diabetic foot ulcers.
Methods
This retrospective study included 41 patients with Wagner grade 2 DFUs treated at a diabetic foot clinic. Nineteen patients received resveratrol-enriched collagen dressings, while 22 received standard collagen dressings. Patients were matched based on age, glycemic control (HbA1c), and arterial supply (ABPI). Primary and secondary outcomes included wound size reduction, hospitalization duration, and dressing frequency. Statistical analyses included Student's t-test, Mann–Whitney U test, and Kaplan–Meier survival analysis.
Results
The resveratrol group demonstrated significantly greater wound size reduction (49.2 % ± 9.1 vs. 32.8 % ± 8.5; p = 0.021), shorter hospital stay (12.3 ± 2.8 vs. 14.5 ± 3.2 days; p = 0.045), and fewer dressing changes (19.8 ± 5.2 vs. 24.3 ± 6.7; p = 0.038). No adverse events were reported. Improved outcomes were attributed to resveratrol's antioxidant, anti-inflammatory, and antimicrobial effects.
Conclusions
Resveratrol-enriched collagen dressings significantly improved clinical outcomes in DFUs, suggesting a promising adjunctive treatment strategy. Further prospective studies are warranted to confirm these findings and explore long-term benefits.
{"title":"Exploring resveratrol-enriched collagen dressings for diabetic foot ulcers: A retrospective study of wound healing outcomes","authors":"İsmail Sezikli, Murat Kendirci","doi":"10.1016/j.jtv.2025.100950","DOIUrl":"10.1016/j.jtv.2025.100950","url":null,"abstract":"<div><h3>Background</h3><div>Diabetic foot ulcers (DFUs) are a common and severe complication of diabetes mellitus, often leading to prolonged hospitalization, high treatment costs, and potential amputations. Despite advances in wound care, current dressing materials often lack bioactive properties to modulate chronic wound environments.</div></div><div><h3>Aim</h3><div>To evaluate the clinical efficacy of resveratrol-enriched collagen dressings compared to standard collagen dressings in the management of Wagner grade 2 diabetic foot ulcers.</div></div><div><h3>Methods</h3><div>This retrospective study included 41 patients with Wagner grade 2 DFUs treated at a diabetic foot clinic. Nineteen patients received resveratrol-enriched collagen dressings, while 22 received standard collagen dressings. Patients were matched based on age, glycemic control (HbA1c), and arterial supply (ABPI). Primary and secondary outcomes included wound size reduction, hospitalization duration, and dressing frequency. Statistical analyses included Student's t-test, Mann–Whitney <em>U</em> test, and Kaplan–Meier survival analysis.</div></div><div><h3>Results</h3><div>The resveratrol group demonstrated significantly greater wound size reduction (49.2 % ± 9.1 vs. 32.8 % ± 8.5; p = 0.021), shorter hospital stay (12.3 ± 2.8 vs. 14.5 ± 3.2 days; p = 0.045), and fewer dressing changes (19.8 ± 5.2 vs. 24.3 ± 6.7; p = 0.038). No adverse events were reported. Improved outcomes were attributed to resveratrol's antioxidant, anti-inflammatory, and antimicrobial effects.</div></div><div><h3>Conclusions</h3><div>Resveratrol-enriched collagen dressings significantly improved clinical outcomes in DFUs, suggesting a promising adjunctive treatment strategy. Further prospective studies are warranted to confirm these findings and explore long-term benefits.</div></div>","PeriodicalId":17392,"journal":{"name":"Journal of tissue viability","volume":"34 4","pages":"Article 100950"},"PeriodicalIF":2.4,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-12DOI: 10.1016/j.jtv.2025.100949
Carl Stewart Yuile , Vicki Patton
Aim
Sub-epidermal moisture scanning is an emerging tool for the early detection of hospital-acquired pressure injuries. However, the impact of missed interventions following high SEM readings remains underexplored. This study examined the relationship between intervention compliance, missed interventions, and ΔSEM improvement in patients in an intensive care unit and a rehabilitation unit.
Sub-epidermal moisture (SEM) scanning is a validated tool for the early detection of hospital-acquired pressure injuries (HAPIs). However, the impact of missed interventions following high SEM readings remains underexplored. This study examines the relationship between intervention compliance, missed interventions, and ΔSEM improvement in patients from an intensive care unit (ICU) and a rehabilitation unit.
Methods
This prospective observational study was conducted in a metropolitan ICU and a secondary rehabilitation unit in Australia. Daily SEM scanning was conducted alongside standard HAPI prevention measures. A ΔSEM value ≥ 0.6 triggered clinical interventions. Missed interventions were defined as the absence of additional care following a high ΔSEM reading. Descriptive and inferential statistics were used to explore associations between compliance and ΔSEM improvement.
Results
Among 229 patients, including 181 in the rehabilitation unit and 48 in the ICU, high ΔSEM values were observed in 75.5 % and 79.2 % of patients, respectively. SEM-guided interventions were associated with a 63 % reduction in HAPI incidence in the rehabilitation unit and improved ΔSEM outcomes in ICU patients. Three missed interventions resulted in persistent high ΔSEM values in ICU and four in the rehabilitation cohort indicating a potential critical window.
Conclusion
Timely interventions following high SEM readings are critical for improving tissue health and reducing HAPI risk. Further research should explore critical windows for responsive care in different patient cohorts. Scanning protocols and interventions should be tailored to specific clinical environments.
{"title":"Impact of missed interventions on tissue injury outcomes identified via sub-epidermal moisture scanning","authors":"Carl Stewart Yuile , Vicki Patton","doi":"10.1016/j.jtv.2025.100949","DOIUrl":"10.1016/j.jtv.2025.100949","url":null,"abstract":"<div><h3>Aim</h3><div>Sub-epidermal moisture scanning is an emerging tool for the early detection of hospital-acquired pressure injuries. However, the impact of missed interventions following high SEM readings remains underexplored. This study examined the relationship between intervention compliance, missed interventions, and ΔSEM improvement in patients in an intensive care unit and a rehabilitation unit.</div><div>Sub-epidermal moisture (SEM) scanning is a validated tool for the early detection of hospital-acquired pressure injuries (HAPIs). However, the impact of missed interventions following high SEM readings remains underexplored. This study examines the relationship between intervention compliance, missed interventions, and ΔSEM improvement in patients from an intensive care unit (ICU) and a rehabilitation unit.</div></div><div><h3>Methods</h3><div>This prospective observational study was conducted in a metropolitan ICU and a secondary rehabilitation unit in Australia. Daily SEM scanning was conducted alongside standard HAPI prevention measures. A ΔSEM value ≥ 0.6 triggered clinical interventions. Missed interventions were defined as the absence of additional care following a high ΔSEM reading. Descriptive and inferential statistics were used to explore associations between compliance and ΔSEM improvement.</div></div><div><h3>Results</h3><div>Among 229 patients, including 181 in the rehabilitation unit and 48 in the ICU, high ΔSEM values were observed in 75.5 % and 79.2 % of patients, respectively. SEM-guided interventions were associated with a 63 % reduction in HAPI incidence in the rehabilitation unit and improved ΔSEM outcomes in ICU patients. Three missed interventions resulted in persistent high ΔSEM values in ICU and four in the rehabilitation cohort indicating a potential critical window.</div></div><div><h3>Conclusion</h3><div>Timely interventions following high SEM readings are critical for improving tissue health and reducing HAPI risk. Further research should explore critical windows for responsive care in different patient cohorts. Scanning protocols and interventions should be tailored to specific clinical environments.</div></div>","PeriodicalId":17392,"journal":{"name":"Journal of tissue viability","volume":"34 4","pages":"Article 100949"},"PeriodicalIF":2.4,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144907630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-24DOI: 10.1016/j.jtv.2025.100945
Evelin Balaguer López , Isabel María Mora Morillo , Pablo Buck Sainz-Rozas , María Carmen Rodríguez Dolz , Laura Plá Marzo , Pablo Garcia Molina
Aim
This study aimed to obtain updated epidemiological indicators of dependence-related skin lesions (DRSLs) in neonatal units of Spanish hospitals and to analyze preventive interventions and risk factors associated with DRSL development.
Materials and methods
A multicentre, observational, cross-sectional prevalence study was conducted across three data collection phases in 12 Spanish hospitals with neonatal units, and included 398 hospitalised neonates. Data collection was based on direct observation, clinical record review, and caregiver interviews. The Neonatal Skin Risk Assessment Scale (e-NSRAS) was used to assess DRSL risk. Demographic variables, risk factors, and preventive measures were also analyzed.
Results
DRSL prevalence was 29.4 %. Moisture-related lesions (18.6 %) were the most common, especially in intermediate care, followed by pressure injuries (13.07 %), more prevalent in intensive care, and friction-related lesions (3.02 %). Non-invasive mechanical ventilation and urinary catheterisation were significantly associated with DRSL occurrence. Additionally, 34 % of neonates were classified as at risk of pressure injuries.
Discussion
A high DRSL prevalence was observed among hospitalised neonates, exceeding rates reported in other national and international studies. The e-NSRAS appears unsuitable for assessing all DRSL types. The use of multiple medical devices was associated with higher DRSL rates, and preventive measures were often applied late or inadequately. Study limitations include those typical of cross-sectional studies, such as representativeness, confounding factors, and sample size.
Conclusion
DRSLs are a prevalent issue in Spanish neonatal units. The development and implementation of targeted preventive measures, along with the adaptation of assessment tools, are critical for enhancing the quality of neonatal care.
{"title":"Prevalence and risk factors of dependence-related skin lesions in neonatal units: A multicentre study across Spanish hospitals","authors":"Evelin Balaguer López , Isabel María Mora Morillo , Pablo Buck Sainz-Rozas , María Carmen Rodríguez Dolz , Laura Plá Marzo , Pablo Garcia Molina","doi":"10.1016/j.jtv.2025.100945","DOIUrl":"10.1016/j.jtv.2025.100945","url":null,"abstract":"<div><h3>Aim</h3><div>This study aimed to obtain updated epidemiological indicators of dependence-related skin lesions (DRSLs) in neonatal units of Spanish hospitals and to analyze preventive interventions and risk factors associated with DRSL development.</div></div><div><h3>Materials and methods</h3><div>A multicentre, observational, cross-sectional prevalence study was conducted across three data collection phases in 12 Spanish hospitals with neonatal units, and included 398 hospitalised neonates. Data collection was based on direct observation, clinical record review, and caregiver interviews. The Neonatal Skin Risk Assessment Scale (e-NSRAS) was used to assess DRSL risk. Demographic variables, risk factors, and preventive measures were also analyzed.</div></div><div><h3>Results</h3><div>DRSL prevalence was 29.4 %. Moisture-related lesions (18.6 %) were the most common, especially in intermediate care, followed by pressure injuries (13.07 %), more prevalent in intensive care, and friction-related lesions (3.02 %). Non-invasive mechanical ventilation and urinary catheterisation were significantly associated with DRSL occurrence. Additionally, 34 % of neonates were classified as at risk of pressure injuries.</div></div><div><h3>Discussion</h3><div>A high DRSL prevalence was observed among hospitalised neonates, exceeding rates reported in other national and international studies. The e-NSRAS appears unsuitable for assessing all DRSL types. The use of multiple medical devices was associated with higher DRSL rates, and preventive measures were often applied late or inadequately. Study limitations include those typical of cross-sectional studies, such as representativeness, confounding factors, and sample size.</div></div><div><h3>Conclusion</h3><div>DRSLs are a prevalent issue in Spanish neonatal units. The development and implementation of targeted preventive measures, along with the adaptation of assessment tools, are critical for enhancing the quality of neonatal care.</div></div>","PeriodicalId":17392,"journal":{"name":"Journal of tissue viability","volume":"34 4","pages":"Article 100945"},"PeriodicalIF":2.4,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-23DOI: 10.1016/j.jtv.2025.100948
Xiangai Ma , Jialu Fan , Jiehui Wang , He Lin
Aim
Pediatric patients undergoing cardiac surgery are at high risk for perioperative pressure injuries (PPIs). This study aimed to develop an evidence-based protocol for the prevention of PPIs in pediatric cardiac surgery.
Methods
A literature review was conducted to identify and summarize the existing evidence on PPI prevention in pediatric cardiac surgery to construct an initial protocol. Two rounds of Delphi surveys were then performed to refine the protocol. The expert panel consisted of 20 multidisciplinary professionals from five tertiary hospitals, including nurses, surgeons, and anesthesiologists, 85 % of whom possess more than 20 years of clinical experience. The mean values of importance and feasibility of each indicator were calculated. Reliability of the Delphi method assessed by valid response rate, authority coefficient (Cr), coefficient of variation (CV) and Kendall’ W coefficient (Kendall’ W).
Results
Consensus was reached on 4 first-level items, 15 s-level items, and 27 third-level items for the PPI prevention protocol. The valid response rates for the two Delphi rounds were 83.3 % and 100 %, respectively, with Cr of 0.905 and 0.901, CV of less than 0.25, and Kendall’ W of 0.172 and 0.142 (P < 0.001).
Conclusion
The developed PPI prevention protocol for pediatric cardiac surgery is both scientific and feasible, providing a reference for perioperative nurses to implement systematic and standardized PPI prevention care.
{"title":"Development of an evidence-based protocol for the prevention of perioperative pressure injuries in pediatric cardiac surgery: A Delphi study","authors":"Xiangai Ma , Jialu Fan , Jiehui Wang , He Lin","doi":"10.1016/j.jtv.2025.100948","DOIUrl":"10.1016/j.jtv.2025.100948","url":null,"abstract":"<div><h3>Aim</h3><div>Pediatric patients undergoing cardiac surgery are at high risk for perioperative pressure injuries (PPIs). This study aimed to develop an evidence-based protocol for the prevention of PPIs in pediatric cardiac surgery.</div></div><div><h3>Methods</h3><div>A literature review was conducted to identify and summarize the existing evidence on PPI prevention in pediatric cardiac surgery to construct an initial protocol. Two rounds of Delphi surveys were then performed to refine the protocol. The expert panel consisted of 20 multidisciplinary professionals from five tertiary hospitals, including nurses, surgeons, and anesthesiologists, 85 % of whom possess more than 20 years of clinical experience. The mean values of importance and feasibility of each indicator were calculated. Reliability of the Delphi method assessed by valid response rate, authority coefficient (Cr), coefficient of variation (CV) and Kendall’ W coefficient (Kendall’ W).</div></div><div><h3>Results</h3><div>Consensus was reached on 4 first-level items, 15 s-level items, and 27 third-level items for the PPI prevention protocol. The valid response rates for the two Delphi rounds were 83.3 % and 100 %, respectively, with Cr of 0.905 and 0.901, CV of less than 0.25, and Kendall’ W of 0.172 and 0.142 (<em>P</em> < 0.001).</div></div><div><h3>Conclusion</h3><div>The developed PPI prevention protocol for pediatric cardiac surgery is both scientific and feasible, providing a reference for perioperative nurses to implement systematic and standardized PPI prevention care.</div></div>","PeriodicalId":17392,"journal":{"name":"Journal of tissue viability","volume":"34 4","pages":"Article 100948"},"PeriodicalIF":2.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-23DOI: 10.1016/j.jtv.2025.100947
Chloe Jansz , William McGuiness , Sonja Cleary
Concordance rates for compression therapy (CT) among patients with venous leg ulcers (VLU) have consistently been suboptimal, despite efforts to understand influencing factors [2–4]. VLUs arise as a complication of chronic venous insufficiency (CVI), where venous incompetence or stenosis causes increased capillary permeability, fluid retention, and eventual ulceration [1].
CT is the established gold standard for managing CVI and preventing VLUs. CT works by enhancing venous return, reducing venous pressure, and minimising stasis. However, ensuring patient concordance to CT remains a challenge.
A Delphi study explored factors affecting CT concordance among VLU patients. The study identified 16 facilitators and 18 barriers, offering insights into the complexities of patient concordance. The study's analysis using the Kendall W Coefficient showed moderate consensus among participants regarding these influencing factors [9].
Efforts to improve CT concordance may benefit from addressing the identified barriers while leveraging facilitators, with a focus on personalised care approaches to enhance outcomes.
{"title":"Improving concordance with long-term compression therapy amongst people with venous hypertension and lower leg ulceration: A Delphi study- patient cohort","authors":"Chloe Jansz , William McGuiness , Sonja Cleary","doi":"10.1016/j.jtv.2025.100947","DOIUrl":"10.1016/j.jtv.2025.100947","url":null,"abstract":"<div><div>Concordance rates for compression therapy (CT) among patients with venous leg ulcers (VLU) have consistently been suboptimal, despite efforts to understand influencing factors [2–4]. VLUs arise as a complication of chronic venous insufficiency (CVI), where venous incompetence or stenosis causes increased capillary permeability, fluid retention, and eventual ulceration [1].</div><div>CT is the established gold standard for managing CVI and preventing VLUs. CT works by enhancing venous return, reducing venous pressure, and minimising stasis. However, ensuring patient concordance to CT remains a challenge.</div><div>A Delphi study explored factors affecting CT concordance among VLU patients. The study identified 16 facilitators and 18 barriers, offering insights into the complexities of patient concordance. The study's analysis using the Kendall W Coefficient showed moderate consensus among participants regarding these influencing factors [9].</div><div>Efforts to improve CT concordance may benefit from addressing the identified barriers while leveraging facilitators, with a focus on personalised care approaches to enhance outcomes.</div></div>","PeriodicalId":17392,"journal":{"name":"Journal of tissue viability","volume":"34 4","pages":"Article 100947"},"PeriodicalIF":2.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-22DOI: 10.1016/j.jtv.2025.100944
Onur Çor , Arzu Özcan İlçe , Yavuz Demiraran
Objective
This study aimed to monitor skin temperature in pressure-prone areas of post-surgical patients in the intensive care unit using an infrared thermal camera and to examine the factors influencing the development of pressure injuries.
Methods
This prospective descriptive study was conducted on patients admitted to the intensive care unit following surgery lasting more than two hours. Skin temperature differences between the sacrum, right and left gluteal regions, and right and left heels, compared to reference regions, were measured using an infrared thermal camera. Measurements were taken immediately upon admission to the intensive care unit. The correlation between patients' clinical conditions and observed temperature differences was analyzed.
Results
The study included 59 patients and involved 590 thermographic evaluations. Temperature differences were identified between the reference areas and the right heel (−3.61 °C), left heel (−3.34 °C), left gluteal region (−2.9 °C), right gluteal region (−2.89 °C), and sacrum (−2.47 °C). A statistically significant correlation (p < 0.05) was found between patient age, albumin and hemoglobin levels, and temperature differences.
Conclusions
Temperature differences between the high-risk body parts of patients at risk of pressure injury after long-term surgery were measured using an infrared thermal camera. It is observed that, hypoalbuminemia, and low hemoglobin levels affect the temperature difference in the sacrum, gluteal region, and heels in a statistically significant way especially in advanced age. The infrared thermal camera proved to be more effective than the Braden Risk Assessment Scale in assessing skin for pressure injury risk. Further studies with larger sample sizes are recommended to confirm these findings.
{"title":"Evaluation of surgery-related pressure injury with infrared thermal camera in the postoperative intensive care unit","authors":"Onur Çor , Arzu Özcan İlçe , Yavuz Demiraran","doi":"10.1016/j.jtv.2025.100944","DOIUrl":"10.1016/j.jtv.2025.100944","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to monitor skin temperature in pressure-prone areas of post-surgical patients in the intensive care unit using an infrared thermal camera and to examine the factors influencing the development of pressure injuries.</div></div><div><h3>Methods</h3><div>This prospective descriptive study was conducted on patients admitted to the intensive care unit following surgery lasting more than two hours. Skin temperature differences between the sacrum, right and left gluteal regions, and right and left heels, compared to reference regions, were measured using an infrared thermal camera. Measurements were taken immediately upon admission to the intensive care unit. The correlation between patients' clinical conditions and observed temperature differences was analyzed.</div></div><div><h3>Results</h3><div>The study included 59 patients and involved 590 thermographic evaluations. Temperature differences were identified between the reference areas and the right heel (−3.61 °C), left heel (−3.34 °C), left gluteal region (−2.9 °C), right gluteal region (−2.89 °C), and sacrum (−2.47 °C). A statistically significant correlation (p < 0.05) was found between patient age, albumin and hemoglobin levels, and temperature differences.</div></div><div><h3>Conclusions</h3><div>Temperature differences between the high-risk body parts of patients at risk of pressure injury after long-term surgery were measured using an infrared thermal camera. It is observed that, hypoalbuminemia, and low hemoglobin levels affect the temperature difference in the sacrum, gluteal region, and heels in a statistically significant way especially in advanced age. The infrared thermal camera proved to be more effective than the Braden Risk Assessment Scale in assessing skin for pressure injury risk. Further studies with larger sample sizes are recommended to confirm these findings.</div></div>","PeriodicalId":17392,"journal":{"name":"Journal of tissue viability","volume":"34 4","pages":"Article 100944"},"PeriodicalIF":2.4,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144702831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-22DOI: 10.1016/j.jtv.2025.100946
María García-Arrabé, Ángel González-de-la-Flor, Federico Salniccia, Javier López-Ruiz, Guillermo García-Pérez-de-Sevilla
Blood flow restriction (BFR) is an innovative technique widely utilized in sports and rehabilitation for enhancing muscle strength and hypertrophy with low-load exercises. A critical factor for its efficacy and safety is determining the appropriate limb occlusion pressure (LOP). This study aimed to develop predictive formulas for estimating LOP in the upper and lower limbs based on anthropometric and hemodynamic variables, enabling a standardized and personalized approach to BFR application.
A cross-sectional observational study was conducted with 39 healthy participants aged 18–40 years. Variables such as systolic and diastolic blood pressure, limb circumferences, and BMI were analyzed. LOP was measured by two independent raters using Doppler ultrasound, and multiple linear regression models were developed for each limb. Results showed that systolic blood pressure and limb circumferences were key predictors for LOP in both upper and lower limbs, explaining 39.5 % and 40.9 % of the variance, respectively. BMI was not a significant predictor in either model.
High intra- and inter-rater reliability of LOP measurements was demonstrated, with intraclass correlation coefficients (ICC) of 0.99 for intra-rater and 0.98 for inter-rater reliability, indicating excellent agreement. The standard error of measurement (SEM), ranged from 1.08 to 4.10 mmHg across measures, while the minimum detectable change (MDC), ranged from 2.99 to 11.37 mmHg.
The findings provide a reliable framework for personalizing BFR protocols, improving safety and efficacy while reducing variability in clinical and sports settings. Future research should validate these formulas in diverse populations and explore their application during exercise.
{"title":"Development of a predictive formula for arterial complete occlusion pressure in upper and lower limbs during blood flow restriction","authors":"María García-Arrabé, Ángel González-de-la-Flor, Federico Salniccia, Javier López-Ruiz, Guillermo García-Pérez-de-Sevilla","doi":"10.1016/j.jtv.2025.100946","DOIUrl":"10.1016/j.jtv.2025.100946","url":null,"abstract":"<div><div>Blood flow restriction (BFR) is an innovative technique widely utilized in sports and rehabilitation for enhancing muscle strength and hypertrophy with low-load exercises. A critical factor for its efficacy and safety is determining the appropriate limb occlusion pressure (LOP). This study aimed to develop predictive formulas for estimating LOP in the upper and lower limbs based on anthropometric and hemodynamic variables, enabling a standardized and personalized approach to BFR application.</div><div>A cross-sectional observational study was conducted with 39 healthy participants aged 18–40 years. Variables such as systolic and diastolic blood pressure, limb circumferences, and BMI were analyzed. LOP was measured by two independent raters using Doppler ultrasound, and multiple linear regression models were developed for each limb. Results showed that systolic blood pressure and limb circumferences were key predictors for LOP in both upper and lower limbs, explaining 39.5 % and 40.9 % of the variance, respectively. BMI was not a significant predictor in either model.</div><div>High intra- and inter-rater reliability of LOP measurements was demonstrated, with intraclass correlation coefficients (ICC) of 0.99 for intra-rater and 0.98 for inter-rater reliability, indicating excellent agreement. The standard error of measurement (SEM), ranged from 1.08 to 4.10 mmHg across measures, while the minimum detectable change (MDC), ranged from 2.99 to 11.37 mmHg.</div><div>The findings provide a reliable framework for personalizing BFR protocols, improving safety and efficacy while reducing variability in clinical and sports settings. Future research should validate these formulas in diverse populations and explore their application during exercise.</div></div>","PeriodicalId":17392,"journal":{"name":"Journal of tissue viability","volume":"34 4","pages":"Article 100946"},"PeriodicalIF":2.4,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144695463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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