Journal of tissue viability最新文献_第6页

Evaluation of neuropathy in epidermal growth factor administered patients diagnosed with diabetic foot 评估表皮生长因子注射糖尿病足患者的神经病变。

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability

Pub Date : 2024-11-01 DOI: 10.1016/j.jtv.2024.09.008

Ümran Özdemir Sipahioğlu , Sakine Boyraz Özkavak

Aim

This study was conducted to evaluate the effect of epidermal growth factor administered to patients diagnosed with diabetic foot on neuropathy. Secondarily, the effect of EGF on foot ulcer and neuropathic pain has also been evaluated.

Materials and methods

The study is an analytical type study with a single-group pretest-posttest quasi-experimental design. It was conducted with 30 patients diagnosed with Type 1 and Type 2 Diabetes who applied to the wound care unit and cardiovascular surgery outpatient clinic at Pamukkale University Hospitals between March 2021 and November 2022. By not using the sampling method, all patients who received EGF in the units were reached. Data were collected by "structured patient information form", "SINBAD classification", and "LANSS pain scale." Data were obtained as a "pretest" before the administration of epidermal growth factor (EGF), and as a "posttest" applied one month after the completion of EGF administration. Data were analyzed with Wilcoxon, Mann-Whitney U, Kruskal-Wallis H, Spearman's Rank Correlation, Mc Nemar, and Chi-Square Tests.

Findings

It was observed that the average age of individuals with diabetic foot ulcer was 60.1 ± 12.9, 40 % were obese/morbidly obese, 83.3 % were male, and 43.3 % were treated with insulin + oral antidiabetic. It was determined that the number of years with diabetes was 17.37 ± 10.93 years, and the duration of diabetic foot ulcer was 218.83 ± 279.04 days. 46.7 % of the participants were determined to have a previous foot wound, and 33.3 % had a history of amputation in the past. Neuropathy was present in 100 % of the participants in the pre-test, while it was found to be 56.7 % in the post-test. The participants with neuropathy were observed to have a significantly higher SINBAD classification and LANSS pain scale scores: (p = 0,01; p = .00). HbA1c, SINBAD, and LANSS scores decreased significantly after EGF (p = 0,00; p = .01; p = .01). EGF administration was observed to have a statistically significant positive effect on neuropathy (p < .01).

Results

EGF administration was observed to have a positive effect on the healing of foot ulcers, the reduction of neuropathic pain, and on neuropathy in patients diagnosed with diabetic foot.

目的：本研究旨在评估糖尿病足患者服用表皮生长因子对神经病变的影响。此外，还评估了表皮生长因子对足部溃疡和神经病理性疼痛的影响：本研究为分析型研究，采用单组前测后测准实验设计。研究对象为 2021 年 3 月至 2022 年 11 月期间在帕慕卡莱大学医院伤口护理部和心血管外科门诊就诊的 30 名 1 型和 2 型糖尿病患者。由于没有使用抽样方法，因此所有在这些单位接受过 EGF 治疗的患者都被纳入调查范围。通过 "结构化患者信息表"、"SINBAD 分类 "和 "LANSS 疼痛量表 "收集数据。数据采集分为表皮生长因子注射前的 "前测 "和注射表皮生长因子一个月后的 "后测"。数据分析采用 Wilcoxon、Mann-Whitney U、Kruskal-Wallis H、Spearman 等级相关性、Mc Nemar 和 Chi-Square 检验：观察发现，糖尿病足溃疡患者的平均年龄为（60.1 ± 12.9）岁，40%为肥胖/病态肥胖，83.3%为男性，43.3%接受胰岛素+口服抗糖尿病药物治疗。经测定，糖尿病患者的患病年限为（17.37 ± 10.93）年，糖尿病足溃疡的病程为（218.83 ± 279.04）天。46.7%的参与者曾有足部伤口，33.3%的参与者曾有截肢史。在测试前，100%的参与者患有神经病变，而在测试后，56.7%的参与者患有神经病变。有神经病变的参与者的 SINBAD 分级和 LANSS 疼痛量表评分明显更高：（P = 0.01；P = 0.00）。使用 EGF 后，HbA1c、SINBAD 和 LANSS 评分均明显下降（p = 0.00；p = 0.01；p = 0.01）。观察发现，使用 EGF 对神经病变具有统计学意义上的积极影响（p 结果）：观察发现，使用 EGF 对糖尿病足患者足部溃疡的愈合、神经性疼痛的减轻和神经病变有积极影响。

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引用次数: 0

Rapid wound healing with silver nanoparticle-decorated miswak-derived carbon quantum dots 使用银纳米粒子装饰的 miswak 衍生碳量子点快速愈合伤口。

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability

Pub Date : 2024-11-01 DOI: 10.1016/j.jtv.2024.10.008

Esra Hacımüftüoğlu , Fatma Yesilyurt , Aynur Babagil , Ali Sefa Mendil , Hayrunnisa Nadaroglu

Background

Oxidants are pivotal in combating aging, cancer, and weakened immunity. Shielding the body from free radicals is crucial for an extended lifespan. The development of effective systems for this purpose is paramount. This study investigated the impact of miswak carbon quantum dots (M-CQD) on radical elimination and wound healing.

Methods

M-CQD were synthesized via a hydrothermal method using miswak water extract at 220 °C for 8 h. Chitosan-modified Ag@M-CS-CQD were produced. The characterization involved SEM, XRD, and FTIR analysis. M-CQD and Ag@M-CS-CQD emitted bluish-white light under UV excitation.

Results

At 10, 30, and 50 μg/mL, DPPH• and phosphomolybdenum complex radicals inhibited 67 %, 82 %, and 98 %, respectively, with Ag@M-CS-CQD demonstrating the highest activity. The IC₅₀ values for M-CQD and Ag@M-CS-CQD were 0.91 ± 0.010 and 1.183 ± 0.033, respectively. Ag@M-CS-CQD NPs displayed remarkable wound healing efficacy at 20 μg/L, highlighting their potential as potent antioxidants. Immunohistochemical analyzes also showed that Ag@M-CS-CQD increased TGF-β expression levels, which was associated with wound healing.

Conclusion

This eco-friendly synthesis method yielded Ag@M-CS-CQD, which exhibited robust antioxidant properties and efficacy in wound healing. This study emphasizes the potential of these nanoparticles as effective therapeutic agents.

背景：氧化剂是对抗衰老、癌症和免疫力下降的关键因素。保护身体免受自由基的伤害对延长寿命至关重要。为此开发有效的系统至关重要。本研究调查了miswak碳量子点（M-CQD）对自由基消除和伤口愈合的影响：方法：采用水热法合成 M-CQD，使用 miswak 水提取物，在 220 °C 下加热 8 小时。表征包括 SEM、XRD 和 FTIR 分析。在紫外线激发下，M-CQD 和 Ag@M-CS-CQD 发出蓝白色光：在 10、30 和 50 μg/mL 的浓度下，DPPH 和磷钼络合物自由基的抑制率分别为 67%、82% 和 98%，其中 Ag@M-CS-CQD 的活性最高。M-CQD 和 Ag@M-CS-CQD 的 IC50 值分别为 0.91 ± 0.010 和 1.183 ± 0.033。Ag@M-CS-CQD NPs 在 20 μg/L 的浓度下显示出显著的伤口愈合功效，凸显了其作为强效抗氧化剂的潜力。免疫组化分析还显示，Ag@M-CS-CQD 增加了 TGF-β 的表达水平，这与伤口愈合有关：结论：这种生态友好型合成方法制备出的 Ag@M-CS-CQD 具有强大的抗氧化特性和伤口愈合功效。这项研究强调了这些纳米粒子作为有效治疗剂的潜力。

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引用次数: 0

Pressure ulcers during the COVID-19 pandemic in intensive care:A multicenter cohort study COVID-19大流行期间重症监护中的压疮：一项多中心队列研究。

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability

Pub Date : 2024-11-01 DOI: 10.1016/j.jtv.2024.06.007

Paulo Alves , Carina Bååth , Tânia Manuel , Sofia Almeida , Ulrika Källman

Aim

The objective of the present study is twofold: to describe the prevalence and incidence of pressure ulcers (PUs) among ICU patients during the COVID-19 pandemic, and to identify the risk factors associated with the development of PUs in this cohort of ICU patients.

Materials and methods

Retrospective cohort study of adult critical care patients admitted in two general ICUs of two different countries (Sweden and Portugal) between March 1st, 2020, and April 30th, 2021, through the analysis of the electronic health record database. The prevalence and incidence were calculated, and a multivariate logistic-regression model was used to calculate odds ratios (ORs), of possible risk factors of PU development.

Results

The sample consisted of 1717 patients. The overall prevalence of PU was 15.3 %, and the incidence of ICU-acquired PUs was 14.1 %. Most of the pressure ulcers documented in this study were at the anterior part of the body (45.35 %) and regarding classification, Category 2 (38.40 %) and Category 3 (22.71 %) pressure ulcers together accounted for over fifty percent of the cases recorded. In the multivariate logistic regression model for PU, age, having COVID-19 (OR = 1.58, 95 % CI: 1.20–2.09), use of mechanical ventilation (OR = 1.49, 95 % CI: 1.13 = 1.97), use of vasopressors (OR = 1.31, 95 % CI: 1.00–1.70), having a Braden risk score ≤16 at admission (OR = 1.63; 95 % CI: 1.04–2.56), and length of stay (LOS) (OR = 1.43, 95 % CI 1.03–2.00 if LOS 90–260 h, OR = 2.34, 95 % CI: 1.63–3.35 if LOS >260 h) were associated with the likelihood of developing an ICU-acquired PUs.

Conclusion

When adjusted for covariates patients with COVID-19 had a higher risk for PU development during the ICU stay compared to patients without COVID-19. Health care personnel in ICU may consider incorporating COVID-19, age, use of mechanical ventilation, vasopressors and estimated LOS in addition to a comprehensive risk assessment including both a risk score and clinical assessment.

目的：本研究的目的有两个：描述在 COVID-19 大流行期间 ICU 患者中压疮（PU）的流行率和发病率，并确定与这组 ICU 患者压疮发生相关的风险因素：通过分析电子健康记录数据库，对两个不同国家（瑞典和葡萄牙）的两家普通重症监护病房在 2020 年 3 月 1 日至 2021 年 4 月 30 日期间收治的成人重症监护患者进行回顾性队列研究。计算了患病率和发病率，并使用多变量逻辑回归模型计算了PU发生的可能风险因素的几率比（ORs）：样本包括 1717 名患者。压疮的总发病率为15.3%，ICU获得性压疮的发病率为14.1%。本研究记录的大多数压疮发生在身体前部（45.35%），在压疮分类方面，第 2 类（38.40%）和第 3 类（22.71%）压疮共占记录病例的 50%以上。在 PU 的多变量逻辑回归模型中，年龄、COVID-19（OR = 1.58，95 % CI：1.20-2.09）、使用机械通气（OR = 1.49，95 % CI：1.13 = 1.97）、使用血管加压剂（OR = 1.31，95 % CI：1.00-1.70）、入院时 Braden 风险评分≤16（OR = 1.63；95 % CI：1.04-2.56）、住院时间（LOS）（如果LOS为90-260 h，则OR = 1.43，95 % CI：1.03-2.00；如果LOS>260 h，则OR = 2.34，95 % CI：1.63-3.35）与ICU获得性PUs的发生可能性相关：结论：经协变量调整后，与无 COVID-19 的患者相比，COVID-19 患者在重症监护室住院期间发生 PU 的风险更高。重症监护室的医护人员在进行综合风险评估（包括风险评分和临床评估）时，可考虑将 COVID-19、年龄、机械通气的使用情况、血管加压剂和预计的住院时间纳入评估范围。

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引用次数: 0

Patients with diabetic foot ulcers: A qualitative study of patient knowledge, experience, and encountered obstacles 糖尿病足溃疡患者：关于患者知识、经验和所遇障碍的定性研究。

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability

Pub Date : 2024-11-01 DOI: 10.1016/j.jtv.2024.07.010

Vahide Semerci Çakmak , Serap Çetinkaya Özdemir

Background

Patients with diabetes may experience diabetic foot ulcers, which are long-term complications of the disease and can occur due to uncontrolled hyperglycemia. Foot ulcer development is accelerated due to the negligence of the patient and the healthcare professional.

Objective

To determine patient knowledge, experiences, and barriers associated with diabetic foot ulcers.

Methods

This was a qualitative descriptive study based on content analysis. The study was conducted with patients admitted to a wound care outpatient clinic in a public hospital in Turkey. The data were collected through detailed telephone interviews. Data saturation was achieved for 11 patients. MAXQDA 20 software was used for the data analysis. The COREQ checklist was utilized to guide the reporting of the studies.

Results

Five themes and 14 subthemes were identified. Themes: etiology; impact; treatment process; barriers; recommendations. According to Theme 1, neglect, pressure, trauma and chronic diseases can lead to diabetic foot wounds. According to Theme 2, physical and psychological effects were observed in the participants. According to Theme 3, participants' treatment management and compliance with treatment affected the diabetic foot recovery process. In Theme 4, it was observed that participants with diabetic foot wounds had difficulties performing daily living activities and physical activities. In Theme 5, the participants’ recommendations for individuals with diabetic foot ulcers included regulating blood sugar, maintaining a healthy lifestyle, providing foot protection and care, and providing professional health support.

Conclusion

Diabetic foot ulcers developed due to the negligence of patients and physicians. Patients were also afraid of foot amputation. The development of foot ulcers is preventable through the provision of training to spread awareness regarding blood sugar control and diabetic foot ulcers. Early self-recognition of diabetic foot ulcers by patients, along with early intervention attempts by healthcare professionals, are important.

背景：糖尿病患者可能会出现糖尿病足溃疡，这是糖尿病的长期并发症，可因高血糖失控而发生。患者和医护人员的疏忽会加速足部溃疡的发展：目的：了解患者对糖尿病足溃疡的认识、经验和相关障碍：这是一项基于内容分析的定性描述性研究。研究对象为土耳其一家公立医院伤口护理门诊的住院患者。数据通过详细的电话访谈收集。11 名患者的数据达到饱和。数据分析使用了 MAXQDA 20 软件。COREQ 检查表用于指导研究报告：结果：确定了 5 个主题和 14 个次主题。主题：病因；影响；治疗过程；障碍；建议。根据主题 1，忽视、压力、创伤和慢性疾病可导致糖尿病足伤口。根据主题 2，在参与者身上观察到了生理和心理影响。根据主题 3，参与者的治疗管理和治疗依从性影响了糖尿病足的恢复过程。在主题 4 中，观察到患有糖尿病足伤口的参与者在进行日常生活活动和体力活动时遇到困难。在主题 5 中，参与者对糖尿病足溃疡患者的建议包括调节血糖、保持健康的生活方式、提供足部保护和护理以及提供专业的健康支持：结论：糖尿病足溃疡的形成是由于患者和医生的疏忽。结论：糖尿病足溃疡的发生是由于患者和医生的疏忽，患者也害怕截肢。通过提供培训，提高人们对血糖控制和糖尿病足溃疡的认识，足部溃疡是可以预防的。患者对糖尿病足溃疡的早期自我识别以及医护人员的早期干预都非常重要。

{"title":"Patients with diabetic foot ulcers: A qualitative study of patient knowledge, experience, and encountered obstacles","authors":"Vahide Semerci Çakmak , Serap Çetinkaya Özdemir","doi":"10.1016/j.jtv.2024.07.010","DOIUrl":"10.1016/j.jtv.2024.07.010","url":null,"abstract":"<div><h3>Background</h3><div>Patients with diabetes may experience diabetic foot ulcers, which are long-term complications of the disease and can occur due to uncontrolled hyperglycemia. Foot ulcer development is accelerated due to the negligence of the patient and the healthcare professional.</div></div><div><h3>Objective</h3><div>To determine patient knowledge, experiences, and barriers associated with diabetic foot ulcers.</div></div><div><h3>Methods</h3><div>This was a qualitative descriptive study based on content analysis. The study was conducted with patients admitted to a wound care outpatient clinic in a public hospital in Turkey. The data were collected through detailed telephone interviews. Data saturation was achieved for 11 patients. MAXQDA 20 software was used for the data analysis. The COREQ checklist was utilized to guide the reporting of the studies.</div></div><div><h3>Results</h3><div>Five themes and 14 subthemes were identified. Themes: etiology; impact; treatment process; barriers; recommendations. According to Theme 1, neglect, pressure, trauma and chronic diseases can lead to diabetic foot wounds. According to Theme 2, physical and psychological effects were observed in the participants. According to Theme 3, participants' treatment management and compliance with treatment affected the diabetic foot recovery process. In Theme 4, it was observed that participants with diabetic foot wounds had difficulties performing daily living activities and physical activities. In Theme 5, the participants’ recommendations for individuals with diabetic foot ulcers included regulating blood sugar, maintaining a healthy lifestyle, providing foot protection and care, and providing professional health support.</div></div><div><h3>Conclusion</h3><div>Diabetic foot ulcers developed due to the negligence of patients and physicians. Patients were also afraid of foot amputation. The development of foot ulcers is preventable through the provision of training to spread awareness regarding blood sugar control and diabetic foot ulcers. Early self-recognition of diabetic foot ulcers by patients, along with early intervention attempts by healthcare professionals, are important<strong>.</strong></div></div>","PeriodicalId":17392,"journal":{"name":"Journal of tissue viability","volume":"33 4","pages":"Pages 571-578"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788501","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}

引用次数: 0

Student nurses' knowledge levels and attitudes regarding pressure injury prevention 学生护士对预防压力伤害的认识水平和态度。

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability

Pub Date : 2024-11-01 DOI: 10.1016/j.jtv.2024.07.018

Arzu Bahar , Nilüfer Emir Özgürbüz , Esra Akın

Objective

The research was conducted to examine the relationship between student nurses' knowledge levels and attitudes regarding pressure ulcer prevention.

Method

The research was registered between 01.05.2022 and 01.12.2022, and the certification studies of the health sciences faculty of a state and a foundation university in Turkey are carried out on a multi-center basis. The lists of the research were created by 426 student pictures. "Nurse Introduction Form", "Pressure Sore Prevention Information Survey" and "Attitude Scale towards Preventing Pressure Ulcers" were used as data collection tools. Data was collected online via Google Forms and the SPPS 24.0 program was evaluated in detail.

Results

It was determined that the PIPK total score of Student Certificates was 18.29 ± 5.98, and the total score of APUP was 33.96 + 4.66. The change analysis results revealed positive aspects and a low-level significant relationship between the average nutrition total knowledge scores and the pressure prevention attitude total scores (p < 0.05).

Conclusion

In our study results, it was determined that the pressure values of the certificates and the knowledge scores of the students were insufficient and the attitudes were positive. The values of knowledge and attitudes regarding the nurturing of the values of certificates, starting from student life, states where the necessary knowledge and skills must be acquired in educational programs.

目的研究旨在探讨护士学生对预防压疮的知识水平和态度之间的关系：研究注册时间为 2022 年 5 月 1 日至 2022 年 12 月 1 日，在土耳其一所国立大学和一所基金会大学的健康科学系进行多中心认证研究。研究清单由 426 张学生照片创建。数据收集工具包括 "护士介绍表"、"预防压疮信息调查表 "和 "预防压疮态度量表"。数据通过谷歌表格在线收集，并对 SPPS 24.0 程序进行了详细评估：学生证书的 PIPK 总分为 18.29 ± 5.98，APUP 总分为 33.96 + 4.66。变化分析结果显示，营养知识平均总分与压力预防态度总分之间存在积极的方面和低水平的显著关系（P 结论：营养知识平均总分与压力预防态度总分之间存在积极的方面和低水平的显著关系：我们的研究结果表明，学生的证书压力值和知识得分不足，态度积极。关于证书价值观的知识和态度的培养，要从学生生活开始，说明在教育计划中必须掌握必要的知识和技能。

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引用次数: 0

Relationship between gene expression associated with cellular senescence in cells from discarded wound dressings and wound healing: A retrospective cohort study 废弃伤口敷料细胞中与细胞衰老相关的基因表达与伤口愈合之间的关系：回顾性队列研究

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability

Pub Date : 2024-11-01 DOI: 10.1016/j.jtv.2024.07.014

Chihiro Takizawa , Qi Qin , Daijiro Haba , Sanae Sasaki , Akiko Kawasaki , Tomomi Miyake , Jun Oba , Aya Kitamura , Mari Abe , Sanai Tomida , Gojiro Nakagami

Aim

Senescent cells, inducing a senescence-associated secretory phenotype (SASP), lead to chronic inflammation in hard-to-heal wound tissue. However, eliminating senescent cells may impede normal wound healing due to their important role in the wound healing mechanism. Accordingly, we focused on wound exudates in hard-to-heal wounds, which contain many inflammation biomarkers consistent with SASP. Therefore, we hypothesized that senescent cells might be present in the exudates and induce chronic inflammation. This study investigated the relationship between gene expression associated with cellular senescence in exudates from pressure injuries and wound healing status.

Methods

This retrospective cohort study involved patients treated by a pressure injury team. We collected viable cells from wound dressings and analyzed gene expression. Pearson's correlation coefficient was calculated between cellular senescence and SASP expression. The relationship between the gene expression of cellular senescence and the wound area reduction rate by the following week was examined using a mixed-effects model.

Results

CDKN1A—related to cellular senescence—was expressed in 96.3 % of 54 samples, and CDKN1A expression and SASPs positively correlated (PLAU: r = 0.68 and TNF: r = 0.34). Low CDKN1A expression was statistically associated with a large wound area reduction rate (β = 0.83, p < 0.01).

Conclusions

Gene expression of both cellular senescence and SASP factor in wound dressings suggests the presence of cellular senescence. Senescent cells in wound dressings could be associated with delayed wound healing in the following week.

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引用次数: 0

A Markov cost-effectiveness modeling framework for evaluating wound dressings: A concept for practical implementation of economic evaluations in an informed dressing selection process 评估伤口敷料的马尔可夫成本效益模型框架：在知情敷料选择过程中实际实施经济评估的概念。

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability

Pub Date : 2024-11-01 DOI: 10.1016/j.jtv.2024.10.001

Tal Yaniv , Dimitri Beeckman , Amit Gefen

Aims

Exemplify the potential of using health economy modeling and simulations to support and optimize wound dressing purchasing decisions.

Materials and methods

We developed a Markov cost-effectiveness modeling framework fusing clinical and industry sources of healing and cost outcomes for evaluating dressings, focusing on polymeric membrane dressings compared to passive foam dressings without active inflammation modulation components. We calculated the wound care costs for patients with and without diabetes, as well as for infected and non-infected wounds, to illustrate the effectiveness of this model in supporting decision-making.

Results

The model results demonstrated that polymeric membrane dressings reduce the cumulative treatment costs compared to passive foam dressings, due to fewer dressing changes and lower associated labor costs, regardless of the initial product price differences.

Conclusion

Cost-effectiveness calculations should be performed in healthcare facilities to support purchasing decisions based on true cost analyses. Making purchasing decisions focusing on the dressing price alone may provide wrong estimates of the real cost differences.

目的：展示利用卫生经济建模和模拟来支持和优化伤口敷料采购决策的潜力：我们开发了一个马尔可夫成本效益建模框架，该框架融合了临床和行业的愈合和成本结果，用于评估敷料，重点是聚合膜敷料与无主动炎症调节成分的被动式泡沫敷料的比较。我们计算了糖尿病患者和非糖尿病患者以及感染伤口和非感染伤口的伤口护理成本，以说明该模型在支持决策方面的有效性：结果：模型结果表明，与被动式泡沫敷料相比，聚合膜敷料可减少敷料更换次数，降低相关人工成本，从而降低累积治疗成本，而与最初的产品价格差异无关：结论：医疗机构应进行成本效益计算，以支持基于真实成本分析的采购决策。仅根据敷料价格做出采购决定可能会错误估计实际成本差异。

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引用次数: 0

Reducing the risk of seating acquired pressure ulcers: An update on the society of tissue viability clinical guide 降低坐位获得性压疮的风险：组织存活性学会临床指南更新版。

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability

Pub Date : 2024-11-01 DOI: 10.1016/j.jtv.2024.10.002

Peter R. Worsley, Melanie Stephens, Carol Bartley, Sharon Neill, Ayesha Marshall, Clare Greenwood, Deborah Chester Bessell, Samantha Rose, Sharon Scattergood, Samantha Rooney

引用次数: 0

Inter-rater reliability among healthcare professionals in assessing postoperative wound photos for the presence or absence of surgical wound dehiscence: A Pretest - Posttest study 医护人员在评估术后伤口照片是否存在手术伤口开裂时的评分者间可靠性：前测-后测研究。

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability

Pub Date : 2024-11-01 DOI: 10.1016/j.jtv.2024.07.001

Emmy Muller-Sloof , Erik de Laat , Corine Baljé-Volkers , Stefan Hummelink , Hester Vermeulen , Dietmar Ulrich

Background

Surgical wound dehiscence (SWD) has various definitions, which complicates accurate and uniform diagnosis. To address this, the World Union Wound Healing Societies (WUWHS) presented a consensus based definition and classification for SWD (2018).

Aim

This quasi-experimental pretest-posttest study investigates the inter-rater reliability among healthcare professionals (HCP) and wound care professionals (WCP) when assessing wound photos on the presence or absence of SWD before and after training on the WUWHS-definition.

Methods

Wound expert teams compiled a set of twenty photos (SWD⁺: nineteen, SWD⁻: one), and a video training. Subsequently, 262 healthcare professionals received the pretest link to assess wound photos. After completion, participants received the posttest link, including a (video) training on the WUWHS-definition, and reassessment of fourteen photos (SWD⁺: thirteen, SWD⁻: one).

Primary outcomes

1) pretest-posttest inter-rater-reliability among participants in assessing photos in congruence with the WUWHS-definition 2) the impact of training on assessment scores. Secondary outcome: familiarity with the WUWHS-definition.

Results

One hundred thirty-one participants (65 HCPs, 66 WCPs) completed both tests. The posttest inter-rater reliability among participants for correctly identifying SWD was increased from 67.6 % to 76.2 %, reaching statistical significance (p-value: 0.001; 95 % Confidence Interval [1.8–2.2]).

Sub-analyses per photo showed improved SWD posttest scores in thirteen photos, while statistical significance was reached in seven photos.

Thirty-three percent of participants knew the WUWHS-definition.

Conclusion

The inter-rater reliability among participants increases after training on the WUWHS-definition. The definition provides diagnostic criteria for accurate SWD diagnosis. Widespread use of the definition may improve uniformity in care for patients with SWD.

背景：手术伤口开裂（SWD）有多种定义，这使得准确统一的诊断变得复杂。为了解决这一问题，世界伤口愈合学会联盟（WUWHS）提出了基于共识的 SWD 定义和分类（2018 年）。目的：本准实验性研究探讨了医护人员（HCP）和伤口护理专业人员（WCP）在接受 WUWHS 定义培训前后评估伤口照片是否存在 SWD 时的相互评分可靠性：方法：伤口专家小组制作了一组 20 张照片（SWD+：19 张，SWD-：1 张）和一个培训视频。随后，262 名医护人员收到了评估伤口照片的前测链接。完成后，参与者会收到后测链接，其中包括关于 WUWHS 定义的（视频）培训，以及对 14 张照片（SWD+：13 张，SWD-：1 张）的重新评估：次要结果：对 WUWHS 定义的熟悉程度：131 名参与者（65 名 HCP，66 名 WCP）完成了这两项测试。参与者在测试后正确识别社署的评分者间可靠性从 67.6% 提高到 76.2%，达到统计学意义（p 值：0.001；95% 置信区间 [1.8-2.2]）。对每张照片进行的子分析表明，有 13 张照片的后测得分有所提高，有 7 张照片的后测得分达到了统计学意义。有 33% 的参与者知道 WUWHS 的定义：结论：在接受了关于 WUWHS 定义的培训后，参与者之间的互评可靠性有所提高。该定义为准确诊断 SWD 提供了诊断标准。广泛使用该定义可提高对 SWD 患者护理的一致性。

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引用次数: 0

The development of international wound debridement best practice recommendations: Consensus between nurses specialized in Wound, Ostomy and Continence Canada and the society of tissue viability 制定国际伤口清创最佳实践建议：加拿大伤口、造口和尿失禁专科护士与组织活力协会达成共识。

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability

Pub Date : 2024-11-01 DOI: 10.1016/j.jtv.2024.07.003

K. LeBlanc , M. Hill , E. Rajhathy , N. Parslow , C. Greenwood , J. Swan , S. Neill , I. Farrelly , C. Harley

Debridement is an important component of wound management and can improve outcomes for patients. Debridement needs to be done by an appropriately trained health professional, but the scope of practice, credentials, training, competencies, and regulatory requirements regarding wound debridement can differ. Best Practice Recommendations were created to positively influence patient safety related to all methods of debridement, across the continuum of care, and to be implemented widely by nurses at all professional levels in Canada.

Aim

To further develop the Best Practice Recommendations for wound debridement, with an international perspective, by creating a consensus document to support the global adoption of evidence-based debridement practice for health professionals.

Methods

A consensus meeting utilising Delphi methods was conducted between the authors to review the consensus statements. Once 80 % agreement was achieved, a wide range of wound care experts were identified by the authors and invited to participate in an external review of the statements.

Results

Fifteen consensus statements about wound debridement were agreed upon and are presented in this paper.

Conclusions

These best practice recommendations have been reviewed by a wide range of practitioners from across the UK and Canada and aim to provide guidance on the standardisation of debridement practices for healthcare professionals.

清创是伤口管理的重要组成部分，可以改善患者的治疗效果。清创需要由经过适当培训的医疗专业人员进行，但有关伤口清创的执业范围、资质、培训、能力和法规要求可能各不相同。制定最佳实践建议的目的是在整个护理过程中对与所有清创方法相关的患者安全产生积极影响，并由加拿大所有专业级别的护士广泛实施。目的：从国际视角进一步制定伤口清创的最佳实践建议，创建一份共识文件，以支持全球卫生专业人员采用循证清创实践：方法：作者之间利用德尔菲法召开了一次共识会议，对共识声明进行审查。在达成 80% 的一致意见后，作者确定了广泛的伤口护理专家，并邀请他们参与声明的外部评审：结果：就伤口清创达成了 15 项共识声明，并在本文中进行了介绍：这些最佳实践建议经过了英国和加拿大众多从业人员的审核，旨在为医护人员提供清创实践标准化指导。

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