Wound management & prevention最新文献

Background: Wound debridement is one of the key treatment methods for chronic and acute wounds. Various tools are used to perform debridement, but the force applied to the tissue by these different instruments has been poorly documented in a limited number of past research efforts.

Purpose: The aim of this study was to provide insight into the actual amount of pressure exerted on wound tissue.

Methods: We used a digital force transducer to measure the pressure applied by multiple combinations of angiocatheter needles (catheters), syringes, and other common debridement tools. The data obtained were compared with the pressure measurements reported by previous studies. The common standard used in research is a 35-mL syringe with a 19-gauge catheter with a pressure of 7 to 8 pounds per square inch (psi), which is regarded as the most effective for wound care.

Results: Many of the instruments measured in this experiment closely reflected the pressure measurements previously published in the research literature and are safe to use to properly irrigate wounds. However, some discrepancies were also found, ranging from a small psi variability to several psi. Further studies and testing may be beneficial to confirm the results of this experiment.

Conclusion: Certain tools produced higher pressures that were not suitable for routine wound care. Findings from this study can also be used by clinicians to choose appropriate tools and to monitor pressure when they use various common irrigation tools.

Background: Pressure injuries are associated with skin temperature changes, but little is known about skin temperature characteristics of the Kennedy Lesion (KL).

Purpose: The purpose of this study was to describe early skin temperature changes in KLs using long-wave infrared thermography.

Methods: KLs were identified from chart review in 10 ICU patients. Skin assessments were performed within 24 hours of new skin discoloration. Temperature measurements were performed using a long-wave infrared thermography imaging system. Relative Temperature Differential (RTD) between the discolored area and a selected control point was calculated. RTDs of > +1.2 degrees C and < -1.2 degrees C were considered abnormal. Demographic data and observable characteristics of the KL were collected when available. Descriptive statistics (Mean plus/minus SD; % ) were used.

Results: The major finding of this study was that there were no early skin temperature differences between the KLs and surrounding skin.

Conclusion: The early stage of the KL may be limited to microvascular injury which results in a normal skin temperature. More studies are needed to verify this finding and to ascertain whether KL skin temperature changes over time. The study also supports the bedside use of thermography in skin temperature assessment.

Background: Pain management is important for patient comfort in the treatment of partial-thickness burn wounds. The topical application of ibuprofen provides analgesic and anti-inflammatory effects.

Purpose: To evaluate the efficacy of ibuprofen-containing foam dressing in partial-thickness burns.

Methods: The study included 50 patients with superficial second-degree burn wounds. Ibuprofen-containing foam dressing was used in 25 patients and paraffin gauze dressing in 25 patients as controls. The visual analogue score (VAS) was evaluated 30 min after dressing. On the 90th day following wound healing, the Vancouver scar scale (VSS) was administered to the patients to evaluate healing and scar formation.

Results: The rate of wound healing significantly increased in the study (ibuprofen-containing foam dressing) group compared to control group (8.84±2.97 vs 11.32±4.39, P = 0.010), and the frequency of dressing change significantly decreased in the study group vs control group (1.36±0.49 vs 5.68±2.07, P = 0.000). The oral analgesic needs and VAS scores of the patients were also found to be statistically significantly lower in the study group (5.04 ± 2.44) than for the control group (8.64 ± 1.29, P = 0.000). In the evaluation of the VSS, the total score was lower in the study group, but no statistically significant difference was observed.

Conclusion: The use of ibuprofen-containing foam dressing in patients with superficial second-degree burns eligible for outpatient follow-up provides effective pain management and increases patient comfort. It does not have a negative effect on wound healing. We consider that ibuprofen-containing foam dressing can be safely used in partial-thickness burns.

Background: Understanding nurses' knowledge and attitudes might be important in influencing their behaviors of complying with pressure injury prevention measures in the operating room.

Purpose: The aim of this descriptive and cross-sectional study was to determine operating room nurses' knowledge and attitudes about pressure injury prevention.

Methods: This study was performed with 174 nurses working in the operating rooms of 5 hospitals in Istanbul between July and October 2020. The data were collected with the Modified Pieper Pressure Ulcer Knowledge Test-MPPUKT and Attitude Towards Pressure Ulcer Prevention Instrument-APuP and analyzed with parametric and nonparametric tests using the SPSS 20.0 package program. The statistical significance level was accepted as P < .05.

Results: The total mean score of the MPPUKT of the operating room nurses was 32.72 ± 6.65, and the knowledge level of only 57.5% of the nurses was considered sufficient (MPPUKT score ≥ 70%); the total mean score of the APuP was 44.67 ± 3.10, and almost all (94.8%) had a satisfactory attitude (≥75%). In addition, there was a significant positive correlation between the knowledge and attitudes of the operating room nurses about pressure injury prevention (P = .000).

Conclusion: This study has shown that the knowledge level of the operating room nurses was weak and their attitudes were satisfactory. It is recommended to improve the knowledge and attitudes of operating room nurses to prevent pressure injuries through effective in-service training programs.

Background: Standardized treatment of split-thickness skin graft (STSG) donor sites is not established. Bleeding can necessitate premature dressing changes, interrupting the healing process and increasing pain.

Purpose: A collagen/oxidized regenerated cellulose (C/ORC) dressing was used on the donor site. The authors hypothesized that the collagen matrix could decrease bleeding-related complications, reduce pain, and foster epithelialization.

Methods: The C/ORC matrix was applied to the donor site after hemostasis was achieved. Dressings were removed between postoperative days 4 and 7, and the patients' pain levels, bleeding complications, and percentage healed were recorded.

Results: Thirty-nine patients were treated with the C/ORC donor site dressing. Of these, 35 patients (89.7%) were receiving at least prophylactic anticoagulation, and no bleeding complications were recorded. The average area of donor sites was 123.8 cm2 (range, 20-528 cm2). Utilizing the Numerical Rating Scale, 25 patients (64.1%) reported no pain with dressing removal while 5 (12.8%) reported a decrease in pain. The percentage of epithelialization as assessed by treating clinician was at least equivalent to other modalities.

Conclusions: The application of a C/ORC matrix to STSG donor wound sites resulted in no bleeding complications and excellent pain control while promoting epithelialization in the patients studied. Following this study, the C/ORC dressing has been incorporated into the authors' standard protocol.