Advances in Skin & Wound Care最新文献

Abstract:

Objective: This study was conducted to adapt the revised Skin Management Needs Assessment Checklist (SMnac) into Turkish and determine the reliability and validity by using the Rasch model.

Methods: Data were collected between February and July 2023 from a total of 201 patients using a demographics and clinical history form, Braden Scale, and the revised SMnac. This methodological study used forward translation, expert opinion, back translation, pilot test, and finalization for the language adaptation of the instrument. The feasibility of the questionnaire for the Turkish population with pressure injury was assessed through the Rasch measurement model. Internal consistency reliability with Rasch analysis was calculated with the Person Reliability Index and Item Reliability Index. For content validity, the first Turkish version was evaluated by seven experts.

Results: The Content Validity Index of the Turkish version of the revised SMnac was determined to be 0.87. In the Rasch analysis, the person reliability coefficient was detected as 0.87 and the item reliability coefficient as 0.94. In accordance with the results of the adaptation and reliability validity analyses of the original scale, three items were excluded from the scale.

Conclusions: According to the results of the study, the revised SMnac scale was determined to be valid and reliable in Turkish.

Objective: The aim of this study was to evaluate the effect of music therapy on dressing pain in unconscious intensive care patients with pressure injuries (PIs).

Methods: A one-group quasi-experimental study was conducted with 39 patients hospitalized in the intensive care unit of a hospital in Istanbul, Turkey. Intubated, hemodynamically stable patients with Stage 2 to 4 PI and Glasgow Coma Score of 8 or higher were included. All patients underwent 2 wound dressing applications, one with music therapy and the other using the conventional method. The patients' behavioral pain scores and vital signs were measured before, during, and after each dressing.

Results: The patients had a mean age of 73.23 ± 1.44 years, and 56% were females. Patients who underwent wound dressing with the conventional method had higher diastolic blood pressure ( P = .038) and mean arterial blood pressure ( P = .034) after dressing when compared with patients who received music therapy. There was no statistically significant difference in other vital signs ( P >.05). Music therapy resulted in significantly lower behavioral pain scores at all time points ( P <.01).

Conclusions: Music therapy is a low-cost, easy, and effective method to reduce dressing pain in unconscious patients. The use of music therapy during dressing can contribute to both the physical and mental comfort of patients. Personal preferences should be taken into consideration in music therapy interventions. Further studies on the utility of this method are needed.

Objective: The performance of a gelling fiber dressing (GFD) was evaluated in adult patients undergoing split-thickness skin graft (STSG) transplantation.

Methods: A gelling fiber dressing was applied directly to the donor sites; a soft-silicone-coated foam was used as the secondary dressing. Follow-ups were scheduled for days 3 and 14, and day 21 for patients with donor sites that had not healed. The primary outcome measure was donor site progression from baseline to last visit when GFD was used. Secondary outcome measures included clinicians' and patients' evaluations of GFD performance, patients' evaluations of pain severity, dressing wear time, and adverse events.

Results: Twenty-nine of 33 participants (87.9%) had donor sites considered as "improved" at the final visit. Twenty (60.6%) donor sites were healed during the period when the GFD was used. High percentages of "good"/"very good" clinicians' ratings for the ability of GFD to absorb/retain exudate (93.3%), absorb/retain blood (96.6%), conform to the wound bed (96.8%), and maintain integrity when wet on removal (100%) were recorded. High percentages of "good"/"very good" patient ratings for comfort during wear (93.9%) and experience during dressing changes (86.6%) were also recorded. Mean pain score at GFD removal was 1.3, on a scale from 0 = no pain to 10 = worst imaginable. Median wear time per individual dressing was 14 days. Four adverse device events were reported.

Conclusions: The findings indicate the suitability of GFD for donor site management. The dressing, rated highly by clinicians and patients, was associated with good healing progression.

More than 650 new articles were added to the pressure injury (PI) literature in 2024, challenging clinicians, educators, and researchers who are trying to stay current. This article summarizes 6 articles newly published in 2024 that provide important new data or insights about PIs. Articles cover a range of topics, including composition of slough, etiology of skin failure, role of zinc, and prevention and implications of PIs in people with spinal cord injury and other long-term neurological conditions. For each article, a description of the study results is provided, along with a comment on why the results are important. This information will help the PI community remain current with the field and incorporate new data into clinical practice.

Abstract: The mpox outbreak has continued in the US since 2022. Although most patients with intact immune systems recover from mpox with supportive care, some patients, especially those who are immunocompromised, can develop severe skin manifestations. The role of wound care in severe mpox cases has not yet been firmly established. The authors report a case of a 43-year-old male with untreated HIV infection who developed severe and progressive cutaneous verrucous lesions due to mpox infection. This case required intense wound care, including syringe-based wound irrigation, gentle debridement, hypochlorous acid solution soaking, and topical cidofovir thick application with occlusive dressing application, as well as prolonged antiviral treatments and vaccinia immune globulin.

Objective: Contactless wound size measurement is an important element for monitoring the wound healing process and the effects of treatment both in people and animals. The purpose of this study was to evaluate the metrologic performances of a contactless digital planimetry app (imitoMeasure, Imito AG) for cutaneous wound area measurement.

Methods: Precision, accuracy, agreement, and reliability of six different combinations of smart devices (smartphone or tablet), calibration modes (manual mode or marker mode), and tracing modes (manual finger tracing or digital pencil tracing) were tested and compared with the standard method on already known canine wound area shapes traced on transparent sheets.

Results: Using the app, all methods showed an acceptable metrologic performance. Methods using a tablet were more precise, accurate, and reliable compared with a smartphone. Calibration marker mode was faster than manual calibration. Methods using pencil tracing were more accurate than manual finger tracing, showed a higher agreement with the standard method, and needed fewer retouching-ups to obtain fine-tuning of the shape.

Conclusions: This study contributed to the advancement of noncontact wound area measurement using smart digital mobile devices, identifying the most suitable method to use the imitoMeasure app in clinical and research settings. The imitoMeasure app showed excellent metrologic characteristics in contactless wound area measurement. The evidence indicates that the use of the tablet with digital pencil tracing is a noteworthy improvement in the wound measurement process.

Objective: The aim of this study was to describe a cohort of patients participating in a 12-week supervised exercise program as part of a comprehensive cardiovascular rehabilitation program for patients with peripheral artery disease (PAD) with or at risk of wound on maximal walking distance, wound healing, and cardiovascular outcomes in the year following participation.

Methods: A retrospective cohort study was conducted, and all adult patients with PAD admitted to the rehabilitation program between January 1, 2021, and January 1, 2023 were included.

Results: Forty-two patients with PAD were enrolled, of whom 85.7% had intermittent claudication and 38.1% had severe PAD (toe pressure measurement <30 mm Hg). Mean maximal walking distance at the 6-minute walking test was 301.8 m (median: 300.0, SD: 106.3) at baseline and increased to 408.3 m (median: 440, SD: 123.8) at the end of the program. All patients with a wound at baseline (n = 8) were healed, except for 1 patient who died before healing. One year following the program, only 1 patient developed a new wound, 4 benefited from a percutaneous angioplasty, none required a surgical revascularization, and 1 had a major lower limb amputation.

Conclusions: A 12-week supervised exercise program appears beneficial to improve walking distance for patients with moderate to severe PAD. It also appears safe for patients with or at risk of a lower limb wound, providing tailored exercises prespecified for each patient and adequate supervision. However, prospective studies are required before making clinical recommendations of such a program for the at-risk foot with PAD.

Objective: To evaluate the state anxiety levels and concerns expressed by patients with a stoma at hospital discharge and identify predictors.

Methods: The investigators recruited 136 patients with a stoma who were discharged from the hospital between March and December 2021. Participants completed the demographic questionnaire, the State-Trait Anxiety Inventory state anxiety subscale (STAI-S), and questions about stoma-related concerns. Data were analyzed with descriptive statistics, independent-sample t test, and analysis of variance. Multiple regression analysis was conducted to identify the significant predictors of STAI-S score.

Results: The mean STAI-S score of all patients was 44.75 ± 9.53 at discharge, and approximately 84.5% consistently experienced stoma-related concerns. Stoma status, cause of stoma, marital status, stoma self-care ability, and patients' thoughts on stoma care self-efficacy were all significant predictors of anxiety levels. Patients' primary concerns at discharge related to the sufficiency of stoma care training, stool leakage, stoma bag puncture while sleeping, touching the stoma region, and the appearance of the stoma.

Conclusions: Patients with a stoma experience moderate anxiety and significant concerns at discharge; if left unaddressed, patients may be prematurely discharged with high anxiety. Healthcare providers should pay attention to at-risk patients: those with permanent stomas, who have undergone colorectal cancer surgery, who are single, who believe their stoma care self-efficacy is insufficient, and who primarily rely on others for stoma care. Clinicians should assess anxiety levels and concerns of stoma patients before discharge and refer patients for psychological counseling as needed.

Advanced pressure injuries (PI), the debilitating consequence of prolonged pressure on the skin, are devastating wounds that are commonly refractory to treatment and are a source of significant patient morbidity and monetary strain on the healthcare system. This article outlines the fundamental principles for the conservative management of PIs, emphasizing risk factor mitigation, patient optimization, and preventive strategies. In addition, the article explores different surgical interventions for cases where PIs have progressed beyond conservative treatment options. GENERAL PURPOSE: To demonstrate knowledge of the evidence-based fundamental measures and surgical options to manage advanced pressure injuries (PIs). JOURNAL/aswca/04.03/00129334-202508000-00001/figure1/v/2025-07-18T083052Z/r/image-jpeg LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant will 1. Identify factors that place a patient at risk for PI. 2. Differentiate between the various stages and types of PI. 3. Apply evidence-based management strategies to treat patients with PI.