Journal of Wound Ostomy and Continence Nursing最新文献

Background: Incontinence-associated dermatitis (IAD) is a painful skin condition resulting from prolonged exposure to moisture, friction, and irritants found in urine and feces. Category 2 IAD involves partial-thickness skin loss with open lesions, causing severe pain due to exposed nerve endings. Effective management in clinical settings is vital to alleviate discomfort and prevent secondary infections, though treatment options for severe IAD remain is limited despite its occurrence.

Cases: We report the successful management of Category 2 IAD involving the dermis and subcutaneous layers in 3 patients using a polymer cyanoacrylate. This intervention provided a protective barrier, shielding the skin from moisture and irritants while promoting healing. All patients exhibited significant improvement in skin condition and reported reduced pain within weeks of initiating treatment.

Conclusion: Each case demonstrated improvement in IAD, wound healing, and reduced pain. These case studies aim to inform clinicians about the potential benefits of polymer cyanoacrylate in the management of severe IAD.

Purpose: The purpose of the study was to compare a web-based education program designed for purposes of this study to a control group receiving usual care in patients undergoing colostomy and ileostomy. Groups were compared on the basis of three outcome measures: health-related quality of life, knowledge of ostomy care, and incidence of stomal or peristomal complications.

Design: Randomized controlled trial.

Subjects and setting: The sample comprised 70 patients who had undergone colorectal surgery with formation of colostomy and ileostomy; 35 patients were enrolled in the experimental and control groups. The study was conducted in a 761-bed tertiary research and training hospital in Istanbul, Turkey, between December 2017 and May 2018.

Methods: Research data were collected using an Information Form, City of Hope-Quality of Life-Ostomy Questionnaire (CoH-QoL-OQ), Ostomy Care Knowledge Assessment Test (OCKAT), and Ostomy Complications Assessment Form (OCAF). Data were analyzed with Student t test, paired sample t test, Fisher's exact chi-square test, Fisher-Freeman-Halton test, and Yates continuity correction test.

Results: No significant differences were identified between the intervention group and control group for quality-of-life total scores (t = 0.030; P = .97) and ostomy care knowledge scores (t = 0.80; P = .42) before training (baseline). A significant difference was found between the two groups following training (t = 4.117; P = .00; t = 11.87; P = .00). Health-related quality-of-life scores and ostomy care knowledge of the intervention group were higher than those in the control group.

Conclusion: Web-based education may be provided as a time-effective option to patients with colostomy and ileostomy to improve their quality of life.

Purpose: The aim of this study was to identify predictors for self-efficacy level in patients with venous leg ulcer (VLU).

Design: Observational, cross-sectional, correlational study.

Subjects and setting: The sample comprised 263 participants recruited from 4 tertiary grade A general hospitals (high acuity and technology) in Qingdao and Tianjin, China from February to December 2022.

Methods: Data collection was carried out by distributing a questionnaire that included the Venous Leg Ulcer Self-efficacy Tool, Medical Coping Modes Questionnaire, and Social Support Rating Scale to potential respondents. Independent sample t test, 1-way analysis of variance, Pearson correlation, and multiple linear regression were used for data analysis.

Results: Participants' mean self-efficacy score was 210.50 (standard deviation: 48.15). Multiple linear regression indicated that social support (β = 0.359, P = .001) and confrontation coping mode (β = 0.258, P < .001) were the most significant predictors of self-efficacy in participants with VLUs.

Conclusions: Study findings suggest that psychosocial interventions that strengthen social support and adopting confrontation coping mode may contribute to the improved self-efficacy in VLU patients.

Purpose: This purpose of this study was to evaluate the effects of topical St. John's wort (Hypericum perforatum) oil on wound healing in Stages 1 and 2 pressure injuries (PI).

Design: Randomized controlled trial.

Methods: The study was conducted between September 2020 and June 2021 in a nursing home in Istanbul, Turkey. The sample comprised 48 participants: 24 were randomly allocated to the intervention group and 24 individuals to the control group. The intervention was 0.9% NaCl and St. John's wort oil; 0.9% NaCl was administered to control group participants. The Pressure Ulcer Scale for Healing was used to measure wound healing.

Results: No significant between-group differences were found when control and intervention groups were evaluated at weeks 1, 2, 3, or 4.

Conclusion: The findings of this randomized controlled trial revealed no difference between wound healing outcomes when St' John's wort oil was compared to saline in a group of patients. We recommend additional research using various stages and categories of PI to more fully determine the potential effects of topical St. John's wort oil on PI healing.

Purpose: The purpose of this study was to examine the effect of placement on an air-fluidized therapy (AFT) bed or a low-air-loss (LAL) surface bed on wound healing and progression in patients with deep tissue pressure injuries (DTPIs).

Design: Retrospective, comparative descriptive study.

Subjects and setting: The electronic medical records of 18 patients diagnosed with DTPI involving the sacral, coccygeal, and ischial locations were reviewed. The sample comprised 10 men and 8 women with a mean age of 62.6 (SD 15.9) years. The study setting was an academic, level 1 trauma health center located in the Southeastern United States.

Methods: Medical records were identified by a query from the Hospital-Acquired Pressure Injury (HAPI) Debrief Tool, a secure clinical database completed by nursing wound care specialists. The size of the initial, worst, and final DTPI was operationalized as the surface area in cm2. Changes in the surface area from initial measure to worst measure, from worst measure to final measure, and from initial to final measure were compared between patients in the air-fluidized therapy (AFT) and LAL groups using Wilcoxon rank-sum tests.

Results: Ten patients were placed on the AFT bed and compared with 8 patients placed on an LAL surface bed. The median and interquartile [Q1, Q3] initial wound size was similar for both bed-type groups: 11.9 [IQR 6.0, 19.5] cm2 for the AFT group and 4.7 [IQR 3.3, 22.5] cm2 for the LAL group, respectively (P = .2636). The median and interquartile change in wound size from initial to worst was 0.0 [IQR 0.0, 0.0] cm2 for the AFT group compared to 6.8 [IQR 1.8, 61.5] cm2 for the LAL group (P = .0050), while the change from initial to final was -7.4 [IQR -16.5, - 3.7] cm2 for the AFT group compared to 5.1 [IQR 1.8, 25.8] cm2 for the LAL group (P = .0178). These findings indicate less wound progression and better healing for the AFT group.

Conclusion: Placing a patient diagnosed with a DTPI on an AFT bed rather than an LAL bed may prevent wound progression and promote more effective wound healing.