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Randomized clinical trial of the efficacy of the EmoLED medical device in the treatment of stage 2 and stage 3 pressure ulcers: The RISE_UP study EmoLED医疗器械治疗2期和3期压疮疗效的随机临床试验:RISE_UP研究
IF 2.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2025-03-26 DOI: 10.1016/j.jtv.2025.100895
Hamilton Dollaku , Mara Dalladonna , Marika Giuliano , Michele Rossi , Paola Barbetti , Maria Sipontina Marcolongo , Emanuele Buccione , Paolo Iovino , Claudio Macchi

Aim of the study

Pressure ulcers are an important public health issue, impacting quality of life and causing health deterioration. Blue light photobiomodulation has been shown promoting wound healing in vascular, diabetic, rheumatologic ulcers and lesions in spinal cord injury patients. Based on these preliminary results, this study was developed to assess the effectiveness of blue light therapy in second and third stage pressure ulcers.

Materials and methods

This study was a randomized controlled trial enrolling hospitalized patients with poor mobility. The intervention group included blue light treatment in addition to standard care, three times a week, for 4 consecutive weeks. The primary objective is the difference in the healing process by measuring the average difference of the lesion's PUSH score between the first and the last visit.

Results

The analysis shows that the mean PUSH reduction and the probability of belonging to responder patients were higher in the treatment group. A latent profile analysis that identifies two trajectory classes based on treatment response, shows an association in the probability of following best trajectory for the treatment group (30 % vs 2 %).

Conclusions

The result shows that blue light photobiomodulation promotes recovery of tissue repair in pressure ulcers, and in stabilizing wounds that would otherwise worsen despite standard of care treatment. This therapy may be a valuable contribution to the daily management of pressure lesions since it has an excellent safety profile and the addition of this therapy to a treatment program may speed healing, improving the quality of life.
(Clinicaltrials.gov Ref. numb.: NCT05130814)
研究目的压疮是一个重要的公共卫生问题,影响生活质量并导致健康恶化。蓝光光生物调节已被证明可促进血管、糖尿病、风湿病溃疡和脊髓损伤患者的伤口愈合。基于这些初步结果,本研究旨在评估蓝光治疗二期和三期压疮的有效性。材料和方法本研究是一项随机对照试验,纳入了活动能力差的住院患者。干预组在标准治疗的基础上进行蓝光治疗,每周三次,连续4周。主要目的是通过测量第一次和最后一次访问之间病变PUSH评分的平均差异来衡量愈合过程的差异。结果分析显示,治疗组的平均PUSH降低率和属于应答患者的概率较高。根据治疗反应确定两种轨迹类别的潜在剖面分析显示,治疗组遵循最佳轨迹的概率存在关联(30% vs 2%)。结论蓝光光生物调节可促进压疮组织修复的恢复,并可稳定经标准护理治疗后仍会恶化的创面。这种疗法可能对压力性病变的日常管理有价值,因为它具有良好的安全性,并且在治疗方案中加入这种疗法可能会加速愈合,提高生活质量。: NCT05130814)
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引用次数: 0
Assessment of the structural and histopathological challenges of binary electrospun PET-based nanofibers for tissue engineering applications 组织工程应用中基于pet的二元电纺纳米纤维的结构和组织病理学挑战评估
IF 2.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2025-03-25 DOI: 10.1016/j.jtv.2025.100888
Afsaneh Jahani , Davod Mohebbi-Kalhori , Farkhonde Sarhaddi , Gholam Hosein Kazemzadeh , Reza Taheri , Mehdi Ahmadi , Nafiseh Jirofti
Tissue engineering and regenerative medicine aim to address tissue lesions and organ degenerations, enhancing clinical outcomes by restoring damaged tissues and functionalities. Recent progress in materials science and medicine has led to the development of regenerative engineering, revolutionizing the production of polymeric artificial scaffolds by electrospinning method, which mimic the extracellular matrix (ECM). Polyurethane (PU) is recognized for its elastic nature, comprising soft and hard segments, and possesses bioactive as well as biocompatible properties. Polycaprolactone (PCL), on the other hand, is a non-toxic polymer with a viscous nature, known for its favorable mechanical properties. This study focuses on the comprehensive histological evaluation of binary electrospun PET-based nanofiber scaffolds, as widely used in tissue engineering. The structural analysis involved FE-SEM imaging, porosity measurement, FTIR, and DSC examinations. In vitro assessments included degradation rates, water uptake, cell viability, morphological cell examination, and cell attachment studies. Additionally, scaffolds were subcutaneously implanted in rats for pathological examination. After a 30 days implantation period, histological and pathological parameters such as edema, inflammation, foreign body giant cell reaction, fibrosis, necrosis, and calcification were evaluated. The results highlight the successful application of blend electrospinning in producing PET/PCL and PET/PU nanofiber scaffolds with various composition ratios. FE-SEM imaging revealed uniform nanostructures without bead formation. Histological analysis showed favorable biocompatibility, with the PET/PCL (25:75) composition demonstrating superior structural characteristics compared to other ratios. The cell studies indicated that PET-based nanofiber scaffolds exhibited suitable cell viability and attachment, underscoring their potential for tissue engineering applications.
组织工程和再生医学旨在解决组织病变和器官变性,通过恢复受损组织和功能来提高临床效果。近年来,材料科学和医学的进步促进了再生工程的发展,通过静电纺丝方法模拟细胞外基质(ECM),彻底改变了聚合物人工支架的生产。聚氨酯(PU)被认为具有弹性,包括软段和硬段,并具有生物活性和生物相容性。另一方面,聚己内酯(PCL)是一种具有粘性的无毒聚合物,以其良好的机械性能而闻名。本研究对在组织工程中广泛应用的基于pet的二元电纺纳米纤维支架进行了组织学综合评价。结构分析包括FE-SEM成像、孔隙度测量、FTIR和DSC检查。体外评估包括降解率、吸水率、细胞活力、形态学细胞检查和细胞附着研究。大鼠皮下植入支架进行病理检查。植入期30 d后,观察水肿、炎症、异物巨细胞反应、纤维化、坏死、钙化等组织学病理指标。结果表明,共混静电纺丝技术在制备不同配比的PET/PCL和PET/PU纳米纤维支架中的成功应用。FE-SEM成像显示纳米结构均匀,未形成珠状结构。组织学分析显示良好的生物相容性,PET/PCL(25:75)组成与其他比例相比具有优越的结构特征。细胞研究表明,pet基纳米纤维支架具有良好的细胞活力和附着性,具有组织工程应用潜力。
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引用次数: 0
Machine learning methods for determining skin age: A systematic review 确定皮肤年龄的机器学习方法:系统综述
IF 2.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2025-03-22 DOI: 10.1016/j.jtv.2025.100887
Eric McMullen , Rokhshid Aflaki , Pranav Jignesh Khatri , Dea Metko , Kyle Storm , Abu Bakar Butt , Mahan Maazi , Raghav Gupta , Rajan Grewal , Trevor Champagne

Aim

This systematic review explores how machine learning is used in determining skin aging, aiming to evaluate accuracy, limitations, and gaps in the current literature.

Materials and methods

OVID Embase, OVID Medline, IEEE Xplore, and ACM Digitial Library were searched from inception to March 16, 2024.

Results

A total of 1467 non-duplicate articles were screened, and 27 were ultimately included in the systematic review. The machine learning models exhibited a range of accuracies from a mean absolute error of 2.30–8.16 years. The most common approach was full facial image analysis, followed by non-image-based studies utilizing biomarkers such as the methylome and the proteome. The incorporation of dynamic facial expressions in the analysis was shown to improve the accuracy of age estimation, with a mean absolute error of 3.74. Confocal microscopy demonstrated potential for accurate skin aging estimation, with some studies achieving up to 85 % accuracy. Many studies were found with high PROBAST risk of bias scores, most commonly due to small sample sizes.

Conclusion

Future studies should aim for greater diversity in ethnicity and variables within datasets to improve generalizability.
目的:本系统综述探讨了机器学习如何用于确定皮肤老化,旨在评估当前文献中的准确性、局限性和空白。资料与方法检索自建库至2024年3月16日,检索自vid Embase、OVID Medline、IEEE explore和ACM数字图书馆。结果共筛选非重复文献1467篇,最终纳入系统评价27篇。机器学习模型的平均绝对误差范围为2.30-8.16年。最常见的方法是全面部图像分析,其次是利用甲基组和蛋白质组等生物标志物的非图像研究。在分析中加入动态面部表情可以提高年龄估计的准确性,平均绝对误差为3.74。共聚焦显微镜显示了准确估计皮肤老化的潜力,一些研究达到了85%的准确度。许多研究被发现具有较高的PROBAST偏倚风险评分,最常见的原因是样本量小。结论:未来的研究应着眼于更大的种族多样性和数据集中的变量,以提高概括性。
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引用次数: 0
Evaluation methods of pressure injury stages: A systematic review and meta-analysis 压力损伤阶段的评价方法:系统回顾和荟萃分析
IF 2.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2025-03-21 DOI: 10.1016/j.jtv.2025.100894
Qianwen Chao , Juhong Pei , Yuting Wei , Zhuang Yang , Xiaorui Wang , Li Du , Lin Han

Background

Pressure injury is prevalent in clinical settings and demands precise staging for optimal care. Subjectivity and imprecision in traditional visual assessments have sparked the creation of advanced technology-based evaluation tools.

Aims

To systematically assess pressure injury staging methods, analyze their evaluation results, and provide reference for clinical practice.

Design

Systematic review and meta-analysis.

Data sources

PubMed, Embase, Cochrane Library, Web of Science, CINAHL, and manual searches of academic journals and conference proceedings were utilized.

Methods

The study conducted a systematic search of databases in April 2024, utilizing Endnote X9 to document findings. Two reviewers independently extracted data and evaluated its quality using the QUADAS-2 tool. The meta-analysis, conducted in Meta-disc, focused on metrics such as AUC, sensitivity, and specificity. Heterogeneity among the studies was assessed using Cochran's Q and I2 tests.

Results

This review screened 15312 articles and ultimately included 15 studies. These studies described methods for pressure injury staging, including visual assessment, 29 machine learning models, and human-model integrated evaluation. The accuracy of traditional visual assessment was relatively low and showed significant variability. Eight studies involving 24 machine learning models were included in the meta-analysis, demonstrating significantly high accuracy, with an AUC of 0.93, and the combined sensitivity, specificity, and diagnostic odds ratio were 0.81, 0.87, and 20.48, respectively.

Conclusion

The review underscores the advantages of machine learning in diagnosing pressure injuries, offering higher accuracy over traditional methods. Integrating clinical expertise with machine learning enhances medical service quality and efficiency.

Prospero registration number

CRD42023462951.

Prospero registration link

crd.york.ac.uk/prospero/display_record.php?ID=CRD42023462951.
背景:压力性损伤在临床环境中很普遍,需要精确的分期以获得最佳护理。传统视觉评估的主观性和不精确性引发了基于先进技术的评估工具的创造。目的系统评价压伤分期方法,分析其评价结果,为临床实践提供参考。设计系统回顾和荟萃分析。数据来源:pubmed, Embase, Cochrane Library, Web of Science, CINAHL,手工检索学术期刊和会议记录。方法本研究于2024年4月对数据库进行系统检索,利用Endnote X9记录研究结果。两名审稿人独立提取数据并使用QUADAS-2工具评估其质量。Meta-disc上进行的荟萃分析侧重于AUC、敏感性和特异性等指标。采用Cochran’s Q和I2检验评估研究间的异质性。本综述筛选了15312篇文章,最终纳入了15项研究。这些研究描述了压力损伤分期的方法,包括视觉评估、29个机器学习模型和人类模型综合评估。传统的目视评估准确率较低,且存在显著的变异性。meta分析纳入了8项研究,涉及24个机器学习模型,显示出非常高的准确性,AUC为0.93,综合敏感性、特异性和诊断优势比分别为0.81、0.87和20.48。结论本综述强调了机器学习在诊断压力性损伤方面的优势,与传统方法相比,机器学习具有更高的准确性。将临床专业知识与机器学习相结合,可以提高医疗服务质量和效率。普洛斯彼罗注册号crd42023462951。普洛斯彼罗注册linkcrd.york.ac.uk/prospero/display_record.php?ID=CRD42023462951。
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引用次数: 0
Effectiveness of plant and animal-based interventions in preventing and reducing pressure injuries: A systematic review and meta-analysis 植物和动物为基础的干预措施在预防和减少压力伤害的有效性:系统回顾和荟萃分析
IF 2.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2025-03-21 DOI: 10.1016/j.jtv.2025.100893
Esra Özkan , Burçak Şahin Köze , Meryem Yavuz van Giersbergen

Background

Pressure injuries (PIs) are a significant concern among the elderly and bedridden patients, often resulting from prolonged pressure on the skin. Various interventions, including plant and animal-based therapies, are used to prevent and treat PIs. However, there is a lack of comprehensive understanding of the effectiveness of these natural interventions.

Aim

This study aims to systematically review and conduct a meta-analysis of studies using plant and animal-based interventions to prevent and treat pressure injuries.

Methods

A systematic review and meta-analysis were performed according to the PRISMA guidelines. Searches were conducted in PubMed, Web of Science, SCOPUS, and Cochrane databases using keywords related to pressure injuries and natural interventions. Studies published between 2003 and 2023 were included. The inclusion criteria were experimental, quasi-experimental, and case-control studies. Data extraction and quality assessment were performed independently by two researchers. The effect size was calculated using Hedges' g, and heterogeneity was assessed using Cochrane Q and I2 tests.

Results

A total of 13,563 records were identified, with 20 studies meeting the inclusion criteria after screening and full-text review. The total sample size was 2541 participants. The meta-analysis revealed a significant overall effect size (g = −0.614, 95 % CI: −0.890 to −0.337) indicating moderate effectiveness of plant and animal-based interventions in preventing and reducing PIs. Aloe vera, olive oil, and fish oil showed significant effects with p-values <0.05. High heterogeneity was observed among the studies (Q = 91.007, p < 0.05; I2 = 79.123 %), leading to the use of a random effects model.

Conclusions

Plant and animal-based interventions are moderately effective in preventing and reducing pressure injuries. These findings support the integration of natural therapies into clinical practice for PI management. Further research is needed to standardize protocols and explore the long-term effects of these interventions.
压力性损伤(PIs)是老年人和卧床不起的患者非常关注的问题,通常是由于皮肤长期受压造成的。各种干预措施,包括以植物和动物为基础的疗法,用于预防和治疗pi。然而,人们对这些自然干预措施的有效性缺乏全面的了解。目的对植物和动物干预预防和治疗压力性损伤的研究进行系统回顾和荟萃分析。方法根据PRISMA指南进行系统评价和meta分析。在PubMed、Web of Science、SCOPUS和Cochrane数据库中使用与压力损伤和自然干预相关的关键词进行检索。2003年至2023年间发表的研究也被纳入其中。纳入标准为实验性、准实验性和病例对照研究。数据提取和质量评估由两名研究人员独立完成。效应量采用Hedges' g计算,异质性采用Cochrane Q和I2检验评估。结果经筛选和全文审阅,共纳入文献13563篇,符合纳入标准的文献20篇。总样本量为2541名参与者。荟萃分析显示,总体效应值显著(g = - 0.614, 95% CI: - 0.890至- 0.337),表明植物和动物干预措施在预防和减少pi方面效果中等。芦荟、橄榄油和鱼油的影响显著,p值为0.05。研究间存在高度异质性(Q = 91.007, p <;0.05;I2 = 79.123 %),导致使用随机效应模型。结论以植物和动物为基础的干预措施对预防和减少压力性损伤具有中等效果。这些发现支持将自然疗法整合到PI管理的临床实践中。需要进一步的研究来规范方案并探索这些干预措施的长期影响。
{"title":"Effectiveness of plant and animal-based interventions in preventing and reducing pressure injuries: A systematic review and meta-analysis","authors":"Esra Özkan ,&nbsp;Burçak Şahin Köze ,&nbsp;Meryem Yavuz van Giersbergen","doi":"10.1016/j.jtv.2025.100893","DOIUrl":"10.1016/j.jtv.2025.100893","url":null,"abstract":"<div><h3>Background</h3><div>Pressure injuries (PIs) are a significant concern among the elderly and bedridden patients, often resulting from prolonged pressure on the skin. Various interventions, including plant and animal-based therapies, are used to prevent and treat PIs. However, there is a lack of comprehensive understanding of the effectiveness of these natural interventions.</div></div><div><h3>Aim</h3><div>This study aims to systematically review and conduct a meta-analysis of studies using plant and animal-based interventions to prevent and treat pressure injuries.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis were performed according to the PRISMA guidelines. Searches were conducted in PubMed, Web of Science, SCOPUS, and Cochrane databases using keywords related to pressure injuries and natural interventions. Studies published between 2003 and 2023 were included. The inclusion criteria were experimental, quasi-experimental, and case-control studies. Data extraction and quality assessment were performed independently by two researchers. The effect size was calculated using Hedges' g, and heterogeneity was assessed using Cochrane Q and I<sup>2</sup> tests.</div></div><div><h3>Results</h3><div>A total of 13,563 records were identified, with 20 studies meeting the inclusion criteria after screening and full-text review. The total sample size was 2541 participants. The meta-analysis revealed a significant overall effect size (g = −0.614, 95 % CI: −0.890 to −0.337) indicating moderate effectiveness of plant and animal-based interventions in preventing and reducing PIs. Aloe vera, olive oil, and fish oil showed significant effects with p-values &lt;0.05. High heterogeneity was observed among the studies (Q = 91.007, p &lt; 0.05; I<sup>2</sup> = 79.123 %), leading to the use of a random effects model.</div></div><div><h3>Conclusions</h3><div>Plant and animal-based interventions are moderately effective in preventing and reducing pressure injuries. These findings support the integration of natural therapies into clinical practice for PI management. Further research is needed to standardize protocols and explore the long-term effects of these interventions.</div></div>","PeriodicalId":17392,"journal":{"name":"Journal of tissue viability","volume":"34 3","pages":"Article 100893"},"PeriodicalIF":2.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Synthesising the evidence for patient and public involvement in pressure ulcer research: A scoping review protocol 综合患者和公众参与压疮研究的证据:范围审查方案
IF 2.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2025-03-19 DOI: 10.1016/j.jtv.2025.100892
Hannah Wilson , Aglecia Moda Vitoriano Budri , Liane Araujo Teixeira , Pinar Avsar , Linda Nugent , Niamh Dillon , Declan Naughton , Wendy Chaboyer , Tom O'Connor , Killian Walsh , Sharon Latimer , Zena Moore

Introduction

There is a growing shift toward greater inclusion of patients and the public in the design, conduct, and implementation of research to ensure it is more meaningful, relevant and impactful. This involvement creates a partnership in which patients and the public contribute to decisions throughout the research lifecycle. While the impact and importance of patient and public involvement (PPI) in research is becoming increasingly recognised, the extent of PPI in pressure ulcer (PU) research has yet to be fully established. This scoping review aims to provide insights into how PPI has been included and reported in PU research, ultimately placing a spotlight on the impact and importance of reporting PPI to guide future PU research.

Methods and analysis

Through synthesising literature from a diverse global landscape, this scoping review aims to achieve the following objectives (1) To explore and map the stage(s) of the PU research cycle where PPI has been incorporated (2) To identify and describe the range of participatory methods, including frameworks, guidelines, or tools, that have been used to facilitate the involvement of patients and the public in PU research. (3) To identify and synthesise reporting impacts of including PPI in PU research, and (4) To map and analyse the terminology commonly used to describe PPI in PU research.
The Joanna Briggs Institute scoping review methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews framework will guide the conduct and reporting of this review. Nine databases will be included in the search strategy and all articles will be independently screened for eligibility by two authors. Data from eligible articles will be extracted using a pre-defined data extraction table, and the results will be analysed and synthesised using the PAGER (Patterns, Advances, Gaps, Evidence for practice and Research recommendations) framework.

Ethics and dissemination

Ethics approval will not be required considering the nature of this scoping review. PPI advisory partners will be consulted for disseminating the results in a format that is accessible and understood by a layperson, in order to communicate the findings to a wide audience and diverse communities. This scoping review will be published in a peer reviewed journal and results will be disseminated at local national and international conferences.

Registration

This scoping review is registered on the Open Science Framework (https://doi.org/10.17605/OSF.IO/JHT34). As is typical with scoping reviews, this protocol may evolve over time. Any updates will be documented on the Open Science Framework platform, along with a clear rationale for the changes.
在研究的设计、实施和实施过程中,越来越多的患者和公众参与进来,以确保研究更有意义、更相关、更有影响力。这种参与创造了一种伙伴关系,患者和公众在整个研究生命周期中为决策做出贡献。虽然患者和公众参与(PPI)在研究中的影响和重要性日益得到认可,但PPI在压疮(PU)研究中的程度尚未完全确定。本综述旨在深入了解PPI在PU研究中是如何被纳入和报告的,最终将重点放在报告PPI的影响和重要性上,以指导未来的PU研究。方法和分析通过综合来自不同全球景观的文献,本范围综述旨在实现以下目标:(1)探索和绘制纳入PPI的PU研究周期的阶段(2)确定和描述用于促进患者和公众参与PU研究的参与性方法的范围,包括框架,指南或工具。(3)识别和综合将PPI纳入PU研究的报告影响,以及(4)绘制和分析用于描述PU研究中PPI的常用术语。乔安娜布里格斯研究所的范围审查方法以及范围审查框架的系统审查和元分析扩展的首选报告项目将指导本审查的实施和报告。9个数据库将被纳入搜索策略,所有文章将由两位作者独立筛选是否合格。将使用预定义的数据提取表从符合条件的文章中提取数据,并使用PAGER(模式、进展、差距、实践证据和研究建议)框架对结果进行分析和综合。伦理和传播考虑到此范围审查的性质,不需要伦理批准。为了将调查结果传达给广泛的受众和不同的社区,将与PPI咨询合作伙伴协商,以一种外行人可以获得和理解的格式传播结果。这项范围审查将发表在同行评议的期刊上,结果将在地方、国家和国际会议上传播。此范围审查已在开放科学框架(https://doi.org/10.17605/OSF.IO/JHT34)上注册。正如典型的范围界定审查一样,该协议可能会随着时间的推移而发展。任何更新都将在开放科学框架平台上进行记录,并提供明确的更改理由。
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引用次数: 0
Bridging the gap: ICU nurses’ experiences in detecting pressure injuries across diverse skin tones 弥合差距:ICU护士在检测不同肤色压力损伤方面的经验
IF 2.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2025-03-19 DOI: 10.1016/j.jtv.2025.100891
Herminigildo II Lo , Eleanor Hollywood , Rosemarie Derwin

Background

Pressure Injury detection remains a challenge in patients with darker skin tones due to the absence of visible erythema, resulting in delayed diagnosis and poorer patient outcomes. Despite international guidelines, nurses face barriers in early recognition due to knowledge gaps and inadequate training in skin tone diversity. A timely assessment is critical for effective treatment. This necessitates that healthcare professionals recognise how early pressure ulcer signs may present in patients of all skin tone types.

Aim

To explore ICU nurses’ experiences in assessing pressure areas in patients with dark skin tones and identify challenges and solutions.

Methodology

Following ethical approval, semi-structured interviews were conducted with 11 ICU Nurses. Interview data were analysed using thematic analysis using NVivo software.

Findings

Three key themes emerged: (1) Gaps in education and training on diverse skin tones, (2) Challenges in early detection due to “white normativity” in assessment tools, and (3) The need for inclusive education and advanced diagnostic tools to mitigate disparities.

Conclusion

Urgent improvements in nursing curricula and clinical training are required to ensure equitable pressure injury detection for all skin tones. The study advocates for greater inclusivity in educational materials, continuous professional development, and the integration of advanced tools like infrared thermography and subepidermal moisture scanners.
对于肤色较深的患者,由于没有可见的红斑,损伤检测仍然是一个挑战,导致诊断延迟和患者预后较差。尽管有国际指导方针,但由于知识差距和肤色多样性培训不足,护士在早期识别方面面临障碍。及时评估对有效治疗至关重要。这就需要医疗保健专业人员认识到早期压疮症状可能出现在所有肤色类型的患者中。目的探讨ICU护士对深肤色患者压力区评估的经验,找出挑战和解决方案。方法经伦理批准后,对11名ICU护士进行半结构化访谈。访谈数据采用NVivo软件进行专题分析。研究结果提出了三个关键主题:(1)不同肤色的教育和培训存在差距;(2)由于评估工具的“白人规范性”,早期发现面临挑战;(3)需要全纳教育和先进的诊断工具来缓解差异。结论迫切需要改进护理课程和临床培训,以确保所有肤色的压力损伤检测公平。该研究提倡在教育材料中增加包容性,持续的专业发展,并整合先进的工具,如红外热成像和皮下水分扫描仪。
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引用次数: 0
Modification and validation of the Bluebelle Wound Healing Questionnaire (WHQ) for assessing surgical site infection in wounds healing by secondary intention Bluebelle伤口愈合问卷(WHQ)用于评估伤口愈合手术部位感染的修改和验证
IF 2.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2025-03-18 DOI: 10.1016/j.jtv.2025.100889
Rhiannon Macefield , Laura Mandefield , Jane M. Blazeby , Caroline Fairhurst , Kalpita Baird , Catherine Arundel , Ian Chetter , Belen Corbacho Martin , Catherine Hewitt , Athanasios Gkekas , Andrew Mott , Dr Pedro Saramago Goncalves , Samantha Swan , David Torgerson , Jacqueline Wilkinson , Sabeen Zahra , Stephen Dixon , Josie Hatfield , Angela Oswald , Jo Dumville , E. Packer

Background

Surgical wounds healing by secondary intention are common. Healing is often complicated by surgical site infection (SSI). SSI assessment is important to guide treatment but existing methods generally require in-person assessment, making them resource intensive. A validated patient-reported SSI outcome measure may be useful to overcome this limitation.

Aim

To modify and validate the Bluebelle Wound Healing Questionnaire (WHQ) for wounds healing by secondary intention.

Methods

The 18-item Bluebelle WHQ developed for wounds healing by primary intention was modified to make it applicable to secondary healing wounds. Testing was performed as part of the SWHSI-2 randomised trial assessing negative pressure wound dressings versus standard care. Participants completed the WHQ at five timepoints; in-person (baseline, post-healing) and by post (3, 6, 12 months). A reference SSI assessment was performed by a research nurse at the time of wound healing. Acceptability and criterion validity (ability of the Bluebelle WHQ to discriminate between SSI/no SSI) were explored by examining questionnaire return rates, levels of missing data and total score sensitivity/specificity values (receiver operating characteristic curve (ROC)).

Results

Baseline in-person questionnaire return rates were highest (672/686; 98 %), with postal return rates of 428/615 (68.5 %), 274/416 (65.9 %) and 186/296 (62.8 %) at follow up points. Overall, low levels of item-missing data were observed with few problems completing the questionnaire reported. Ability to discriminate between SSI/no SSI was good (Area under ROC = 0.796).

Conclusion

The modified Bluebelle WHQ is a valuable tool for post-discharge assessment of wounds healing by secondary intention. It is recommended for use in research and clinical practice.
背景:手术伤口继发性愈合是常见的。手术部位感染(SSI)常使愈合复杂化。SSI评估对指导治疗很重要,但现有的方法通常需要亲自评估,使其资源密集。经过验证的患者报告的SSI结果测量可能有助于克服这一局限性。目的对蓝美人伤口愈合问卷(WHQ)进行修改和验证。方法对原创面创面愈合的18项蓝美人健康量表进行改进,使其适用于二次创面愈合。测试作为评估负压伤口敷料与标准护理的SWHSI-2随机试验的一部分进行。参加者在五个时间点完成WHQ;当面(基线、康复后)和邮寄(3、6、12个月)。研究护士在伤口愈合时进行参考SSI评估。可接受性和标准效度(Bluebelle WHQ区分SSI/no SSI的能力)通过检查问卷回收率、缺失数据水平和总分灵敏度/特异性值(受试者工作特征曲线(ROC))来探讨。结果基线问卷回复率最高(672/686;98%),而邮递回复率分别为428/615(68.5%)、274/416(65.9%)及186/296(62.8%)。总体而言,观察到低水平的项目缺失数据,完成问卷报告的问题很少。区分SSI/no SSI的能力较好(ROC下面积= 0.796)。结论改良的蓝百花血清率是一种有价值的伤口二次愈合出院后评估工具。建议在研究和临床实践中使用。
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引用次数: 0
A new conceptual model for how pressure ulcer risk is negotiated and adherence to preventative advice in the community setting 一个新的概念模型,如何协商压疮风险和遵守预防建议在社区设置
IF 2.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2025-03-18 DOI: 10.1016/j.jtv.2025.100890
Lisa Ledger , Jo Hope , Lisette Schoonhoven , Peter R. Worsley

Aim(s)

To identify potential factors affecting patient adherence to preventative advice and to explore how pressure ulcer risk is negotiated between nurse and patient in the community setting.

Design

A qualitative research design using a pragmatist approach.

Methods

Observation of interactions between nurse and patient, evaluation of documentation, and semi-structured interviews with 15 community patients following the nursing interaction. Data was analysed using the principles of Thematic Analysis.

Results

Five overarching themes affected patient adherence to pressure ulcer preventative advice: Patient decision-making, difficulty implementing advice, carer involvement, trust in the nurse and the nursing approach. These factors were complex, individualised, dynamic, and context and time specific. How pressure ulcer avoidance was negotiated diverged according to the type of nursing approach adopted, which impacted on adherence.

Conclusion

The new conceptual model identifies the importance of an open, participatory nursing approach to support shared decision-making. It accommodates the dynamic nature of patient factors, which affect their ability to acquire and understand PU advice and adhere to preventative strategies.
目的:确定影响患者依从预防性建议的潜在因素,并探讨在社区环境中,护士和患者如何协商压疮风险。采用实用主义方法的定性研究设计。方法观察护患互动,评估文献资料,并对15例社区患者进行半结构化访谈。数据分析采用主题分析的原则。结果影响患者对压疮预防建议依从性的主要因素有:患者决策、建议实施难度、护理人员参与、对护士的信任和护理方法。这些因素是复杂的、个性化的、动态的、特定于环境和时间的。如何避免压疮协商分歧,根据采取的护理方法的类型,这对依从性的影响。结论新的概念模型确定了开放、参与式护理方法对支持共同决策的重要性。它适应了患者因素的动态性质,这些因素会影响他们获得和理解PU建议并坚持预防策略的能力。
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引用次数: 0
Understanding recurrent pressure injuries: A scoping review of current research and risk factors 了解复发性压力损伤:当前研究和危险因素的范围综述
IF 2.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2025-03-15 DOI: 10.1016/j.jtv.2025.100886
Li Du , Ning Wang , Juhong Pei , Yanxia Jiao , Jie Xu , Xinyue Xu , Anna Wen , Lin Han , Lin Lv

Aim

To describe published studies on the current status of recurrent pressure injuries.

Background

Pressure injuries burden patients and the health care system, so it is essential to prevent their recurrence and prevent patients from experiencing secondary injury. However, most current studies focus on primary pressure injury and less on its recurrence.

Design and methods

We employed a scoping review methodology. From the database construction until December 9, 2024, we searched PubMed, Embase, Web of Science, CINAHL, and the Cochrane Library. Two researchers independently screened and extracted data.

Results

Twenty-eight articles met our criteria, most published after 2000. The included studies showed that 13 articles dealt with the definition of recurrent pressure injuries, but no uniform standard has been formed yet. The incidence of recurrent pressure injuries is 5.4 %–73.6 %. The most commonly reported site of recurrence is the ischium. The high-risk population for recurrence is the patient with spinal cord injury. Eleven studies described 26 risk factors for recurrent pressure injuries, of which albumin was the most commonly reported risk factor, followed by spinal cord injuries, age, hospital stay, and ulcer size. The 26 risk factors were summarised into five aspects: personal factors, social-environmental factors, disease-related factors, physiological and biochemical parameters, and Initial ulcer characteristics.

Conclusions

The incidence of recurrent pressure injuries varies widely, and specific definitions and standardised staging criteria must be further determined to improve clinical judgment and reporting accuracy. The risk factors for recurrent pressure injuries involve many aspects. Some studies have described local flaps and overall recurrence risk factors separately, and further verification is needed to determine whether there is a difference between the two.
目的描述已发表的关于复发性压力损伤现状的研究。背景压力损伤给患者和医疗保健系统造成了负担,因此必须防止其复发并防止患者遭受二次损伤。然而,目前大多数研究都侧重于原发性压力损伤,而较少关注其复发情况。从数据库建立到 2024 年 12 月 9 日,我们检索了 PubMed、Embase、Web of Science、CINAHL 和 Cochrane 图书馆。结果有 28 篇文章符合我们的标准,其中大部分发表于 2000 年之后。纳入的研究显示,13 篇文章涉及了复发性压力损伤的定义,但尚未形成统一的标准。复发性压力损伤的发生率为 5.4 %-73.6 %。最常报道的复发部位是骶骨。脊髓损伤患者是复发的高危人群。有 11 项研究描述了 26 个导致压力损伤复发的风险因素,其中白蛋白是最常见的风险因素,其次是脊髓损伤、年龄、住院时间和溃疡大小。这 26 个风险因素被归纳为五个方面:个人因素、社会环境因素、疾病相关因素、生理生化参数和初始溃疡特征。结论复发性压力损伤的发病率差异很大,必须进一步确定具体定义和标准化分期标准,以提高临床判断和报告的准确性。复发性压力损伤的风险因素涉及多个方面。一些研究将局部皮瓣和整体复发风险因素分开描述,需要进一步验证以确定两者之间是否存在差异。
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引用次数: 0
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Journal of tissue viability
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