Advances in Skin & Wound Care最新文献

Objective: This study aimed to explore the awareness and use of skincare products among individuals with acne and to analyze their impact on acne severity.

Methods: The study included 450 patients with acne vulgaris (337 females and 113 males). These patients were surveyed about their awareness and usage of skincare products such as cleansers, moisturizers, and sunscreens. Dermatologists assessed the severity of acne using the Global Acne Grading System (GAGS).

Results: Out of 450 patients, 299 (66.4%) were aware of the need to use skincare products, including 250 women and 49 men. Awareness of skincare products increased significantly with higher education levels ( P =.003). The prevalence of mild acne was notably higher among individuals who used sunscreen, cleansing gel, or moisturizer, whereas the incidence of severe acne was significantly lower ( P =.001, P =.033, P =.018, respectively). Patients on isotretinoin treatment had the highest level of skincare knowledge, whereas those on topical therapy had the lowest.

Conclusions: Patients who used skincare products had milder acne, and this use correlated positively with their education level and frequency of medical consultations. Notably, patients undergoing topical therapies exhibited the lowest level of skincare knowledge. Dermatologists should recommend the use of skincare products at all stages of acne treatment to help maintain the skin barrier and protect against potential adverse effects of treatments.

An infant diagnosed with sacrococcygeal teratoma was referred to the authors' hospital. On day 5 of admission, the infant underwent complete surgical resection of the tumor. Unfortunately, the wound was infected by Enterobacter cloacae and dehisced. Advanced dressings combined with vacuum sealing drainage were applied to facilitate wound healing. Eighteen days postsurgery, the wound showed good epithelialization, and the patient was discharged. The patient received regular dressing changes at a local hospital, and follow-up was conducted through telephone for 3 months. After 3 months, scar tissue formation was observed, and no complications were reported.

Objective: To update knowledge about the effectiveness of olive oil and hyperoxygenated fatty acids for the prevention of pressure injuries (PI).

Data sources: The authors searched Medline (PubMed), Web of Science (WOS), The Cochrane Library, Enfispo, Dialnet, Embase, and Scopus.

Study selection: A literature review was conducted by searching databases from September to April 2024. A total of 10 articles were selected, which met the eligibility criteria.

Data extraction: Researchers used the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) reporting guidelines for this systematic review. Two authors independently reviewed and evaluated the articles.

Data synthesis: Both olive oil and hyperoxygenated fatty acids are effective for PI prevention, with no statistically significant difference between them indicating any inferiority. Both options provide therapeutic safety for the patient. There is a 50% economic difference between them, in favor of olive oil.

Conclusions: Olive oil and hyperoxygenated fatty acids are therapeutic alternatives for PI prevention. Despite this assertion, further research is needed to corroborate the absence of disparity between both products.

Objective: The presence or absence of pressure injury is generally considered a quality measure of nursing care performance. This study aimed to adapt the Pressure Injury Prevention Barriers questionnaire to the Turkish version and to determine its validity and reliability.

Methods: A methodological study design was used. The instrument was translated into Turkish and back-translated into English. The questionnaire's language equivalence, content validity, test-retest reliability, internal consistency, and construct validity were evaluated. The research was conducted with 600 nurses at a university hospital who volunteered to participate. The number, percentage distributions, intraclass correlation coefficient, kappa coefficient test, and Mann-Whitney U test were used to analyze the data.

Results: Ten experts in wound care evaluated content validity, and the content validity index was 0.92. The intraclass correlation coefficients obtained for all subdimensions of the questionnaire and the overall questionnaire were high. As a result of factor analysis, the questionnaire was grouped under 3 factors as in the original questionnaire. The questionnaire's overall internal consistency coefficient (Cronbach α) was highly reliable, with a coefficient of 0.914.

Conclusions: This questionnaire is a valid and reliable tool for cross-cultural studies to identify barriers faced by nurses in preventing pressure injuries in patients. It will contribute to the identification of barriers and the determination of strategies for solutions.

Abstract:

Objective: To develop and validate a nomogram model for pressure injury (PI) risk assessment in hospitalized patients, and provide a visual tool for hospital-acquired pressure injury (HAPI) risk assessment.

Methods: This retrospective case-control study included 973 patients between January 2021 and December 2022 from 2 hospitals: the First Hospital of Lanzhou University and the Gansu Provincial Hospital. Patients were randomly divided into the development cohort (n=682) and validation cohort (n=291) according to a ratio of 7:3. In the development cohort, univariate and multivariate logistic regression analyses were used to identify PI risk factors of the nomogram. The nomogram model was validated by the concordance index (C-index), receiver operating characteristic curve analysis (ROC curve), and calibration curves with the Hosmer-Lemeshow goodness-of-fit test. The clinical utility of the model was assessed through decision curve analysis (DCA).

Results: The nomogram model comprised 9 variables: age, length of hospital stay, alcohol consumption, self-care ability, changes in bowel status, Braden score, indwelling nasogastric tube, taking sedative analgesics, and taking diuretic drugs. The area under the ROC curve (AUC) was 0.862. In the validation cohort, the nomogram still had good discrimination (AUC: 0.871). The calibration curve and DCA showed that the risk assessment nomogram had good consistency and clinical utility.

Conclusions: A high-performance nomogram model was established, which can accurately assess the risk of PI among hospitalized patients. Notably, this nomogram provides an accurate visual tool to nursing staff and caregivers for risk assessment, early intervention, and risk management of HAPI.

Objective: The aims of this pilot study were to determine whether (1) a modified version of the Robinson-Ho Skin Type Color Bar would identify early, subtle skin tone variations in patients with dark skin tones because of injury, and (2) if the tool was reliable between clinicians.

Methods: This was a prospective, observational cohort study in a surgical intensive care/acute care unit located in an urban, academic hospital. Patients who were ≥18 years old without a skin injury, but with a confirmed dark skin tone based on the modified Robinson-Ho Skin Type Color Bar, were included in the pilot study.

Results: The first aim could not be supported because of the lack of patients who developed subtle skin tone changes indicative of a skin injury. Two patients developed a skin injury (deep tissue pressure injury, trauma). These wounds did not manifest as subtle changes, therefore rendering the tool ineffective for these cases. The second aim was supported as inter-rater reliability of the Robinson-Ho Skin Type Color Bar showed moderate agreement between multiple raters. It was also noted that race/ethnicity was not an objective marker for determining skin tone per the tool.

Conclusions: Although the modified Robinson-Ho Skin Type Color Bar was not an effective method to detect subtle skin tone changes indicative of injury because of the 2 wounds that did occur, it was reliable to use between multiple users. The tool also served as an objective marker for determining baseline skin tone.

Abstract:

Objective: Respiratory therapists (RTs) commonly use medical devices to assist breathing, which increases the risk for hospital-acquired pressure injuries. Prophylactic skin measures can help reduce these device-related skin injuries. The primary aim of this study was to determine how many hospitals within the United States utilize RT-driven protocols to prevent respiratory device-related skin injuries.

Methods: This was a descriptive, cross-sectional survey of US hospitals, conducted between March 2023 and May 2023 through an online survey. Information related to the hospital setting, RT involvement with hospital skin committees, and RT departmental initiatives related to preventing respiratory device skin breakdown was collected.

Results: A total of 100 participants fully completed the survey: 50 directors/managers, 27 direct care staff, 22 clinical educators, and 1 quality improvement specialist. Among the respondents, 60% worked in academic hospitals with >300 beds. At the institution level, 77% of respondents collaborated with the hospital-wide skin committee, and 80% were involved in respiratory device-related skin breakdown initiatives. In terms of RT departments, 63% respondents had RT-driven protocols to prevent respiratory device-related skin breakdown, and 47% had RT departmental committees to review these skin breakdowns. For education, 84% of the respondents received education on skin breakdown prevention, and 40% of the respondents received training annually. In the past year, 41% of the respondents reported 5 or fewer incidences of respiratory device-related skin breakdown.

Conclusions: This survey study found that approximately two-thirds of the respondents utilize RT-driven protocols and approximately half employ an internal RT committee to review skin breakdown.

Nicolau syndrome (NS) is a rare but serious iatrogenic complication characterized by cutaneous necrosis following intramuscular injections. Hyperbaric oxygen therapy (HBOT) has shown promise in enhancing tissue oxygenation and promoting wound healing in NS cases. The authors report the case of a 51-year-old female who developed a painful necrotic ulcer on her left gluteal region, diagnosed as NS following an intramuscular injection of etofenamate administered for knee osteoarthritis. The patient was treated with a combination of local wound care and a series of 30 HBOT sessions. This treatment regimen led to complete ulcer healing with residual hypopigmented scarring. Hyperbaric oxygen therapy can be an effective treatment for NS induced by intramuscular etofenamate injection, facilitating complete ulcer healing and minimizing sequelae. This case underscores the importance of early recognition and comprehensive management of NS, including the potential benefits of HBOT.