Advances in Skin & Wound Care最新文献

Objective: To evaluate research on medical adhesive-related skin injury (MARSI), focusing on its incidence, prevalence, risk factors, causes, assessments, and prevention.

Data sources: Searches were conducted on Wanfang Data, China National Knowledge Infrastructure, PubMed, Web of Science Core Collection, MEDLINE, EMBASE, and the Cumulative Index of Nursing and Allied Health Literature Plus with Full Text.

Study selection: Using search terms "medical adhesive related skin injury", "MARSI", "adhesive skin injury", and "medical tape-induced skin injury", the authors selected 43 original articles published between January 1, 2001, and May 12, 2022, in English or Chinese.

Data extraction: Extracted details included the first author; publication year; study location; study type; and specifics on MARSI, such as causes, affected body areas, assessment methods, incidence, prevalence, and prevention.

Data synthesis: Medical adhesive-related skin injury frequently occurred on the face and at venipuncture sites. Acrylate-containing adhesives were more likely to cause MARSI. Risk factors include extended hospital stays, lower Braden Scale scores, mechanical ventilation, edema, poor skin condition, and use of certain medications. Incidence or prevalence exceeded 10% across populations, peaking at 60.3% in the pediatric surgical ICU. Mechanical injury had the highest incidence and prevalence among MARSI types. Studied interventions and quality improvement measures were effective in reducing MARSI.

Conclusions: Despite increasing interest, evidence for reducing MARSI is limited. Future research should focus on distinguishing MARSI types, clarifying incidence and prevalence, assessing risk factors, and implementing screening and quality improvement initiatives.

Abstract: This case report describes a patient who developed solar purpura after treatment for angioedema associated with ramipril, an angiotensin-converting enzyme inhibitor. The patient presented to the ED with angioedema. She had been using ramipril for 2 years. Two days after she was admitted, a malar "butterfly" rash occurred on her face and purpura on her lower lip and chin, as well as the extensor part of her forearm. After testing and review of the patient history, she was diagnosed with solar purpura and began topical corticosteroid and antiscar cream treatment. The patient's lesions healed with an atrophic scar in 3 weeks. To the authors' knowledge, this is the first such case to be reported in the literature.

Objective: To evaluate the clinical outcome of the Karydakis flap procedure performed by a single surgeon for the treatment of pilonidal sinus, focusing on postoperative complications, recurrence rate, wound healing time, and return to daily life.

Methods: Authors performed a retrospective data analysis of patients who underwent reconstruction of pilonidal sinus using the Karydakis technique at the Department of Plastic, Reconstructive and Hand Surgery, Center for Severe Burn Injuries of Paracelsus Medical University, Klinikum Nürnberg, Germany, between 2014 and 2021. All cases were performed by a single surgeon. Patients were requested to attend a follow-up appointment in person or, if this was not possible, by telephone.

Results: A total of 103 patients were enrolled in the study. The postoperative complication rate was 11.7%. Revision surgery was required in 4.9% of patients because of a complication. Wound healing time was on average 21.4 days postoperatively. A total of seven patients (6.8%) had a recurrence within 59 months postoperatively.

Conclusions: The Karydakis flap is a robust reconstructive off-midline procedure for the treatment of pilonidal sinus. Relatively few postoperative complications and a low recurrence rate are advantages of the surgical procedure. Based on the results of quality-of-life factors, patients experience early functional return to daily life after the Karydakis flap procedure.

Background: Patient adherence to performing self-wound care (SWC) has a direct influence on the success of telewound care, a healthcare delivery mode that emerged in 2016 in National Healthcare Group Polyclinics in Singapore to relieve the healthcare burden. This mode of delivery was useful during the pandemic, when nonurgent face-to-face visits were switched to the use of telecommunications for consultation. Telewound care requires that patients be willing to perform wound care on their own; however, whether patients are willing to do so remains unknown.

Objective: To identify factors influencing patients' willingness to undertake SWC using a locally validated tool, the Self-Wound Care Acceptance Survey (SWCAS).

Methods: The authors recruited 328 participants with wounds from six polyclinics using convenience sampling. Participants rated the 17 items on the SWCAS using a 5-point Likert-type scale, from 1 (strongly disagree) to 5 (strongly agree). Higher scores indicate greater willingness to perform wound self-care.

Results: Only 34.2% of the participants were willing to perform SWC. Patients who had a wound on their back and had transport provided and medical bills paid by family scored lower on the SWCAS. In contrast, patients who had higher education levels, were in the younger age group, were employed, were students, and had medical bills partially or fully paid by their company or insurance scored higher on the SWCAS. Post hoc tests indicated that patients with a wound on the back scored significantly lower on the SWCAS than did patients with wounds in other locations (Ps < .05).

Conclusions: Additional patient education is needed to increase patients' acceptance of the SWC concept. Actively promoting SWC by distributing patient education information sheets and pamphlets to eligible patients, addressing negative thoughts or concerns, and encouraging positive thinking and autonomy may encourage patients to accept this concept.

Objective: To determine the effects of sunflower seed oil and coconut oil on the skin integrity and weight gain of preterm infants in the neonatal ICU.

Methods: In this randomized controlled trial, 66 preterm neonates (34-37 weeks' gestation) in the neonatal ICU of a training and research hospital were equally divided into three groups: sunflower seed oil, coconut oil, and control. The weights of neonates in all three groups were measured at admission to the neonatal ICU, at discharge, and at 1 month postdischarge. Their skin conditions were evaluated using the Neonatal Skin Condition Score and the Revised Northampton Neonatal Skin Assessment Tool at the same three time points.

Results: At 1 month postdischarge, neonates in the sunflower seed oil and coconut oil groups weighed significantly more than those in the control group (P = .004). Mean Neonatal Skin Condition Score scores were significantly higher in the control group at 1 month postdischarge than in the sunflower seed oil and coconut oil groups (P = .000).

Conclusions: Skin care with coconut oil and sunflower seed oil was effective in maintaining the skin integrity and weight of neonates at 1 month postdischarge. The authors recommend that randomized controlled trials on skin care in preterm infants using sunflower, coconut, and other oils be conducted with larger sample sizes.

Abstract: Generative artificial intelligence (AI) models are a new technological development with vast research use cases among medical subspecialties. These powerful large language models offer a wide range of possibilities in wound care, from personalized patient support to optimized treatment plans and improved scientific writing. They can also assist in efficiently navigating the literature and selecting and summarizing articles, enabling researchers to focus on impactful studies relevant to wound care management and enhancing response quality through prompt-learning iterations. For nonnative English-speaking medical practitioners and authors, generative AI may aid in grammar and vocabulary selection. Although reports have suggested limitations of the conversational agent on medical translation pertaining to the precise interpretation of medical context, when used with verified resources, this language model can breach language barriers and promote practice-changing advancements in global wound care. Further, AI-powered chatbots can enable continuous monitoring of wound healing progress and real-time insights into treatment responses through frequent, readily available remote patient follow-ups.However, implementing AI in wound care research requires careful consideration of potential limitations, especially in accurately translating complex medical terms and workflows. Ethical considerations are vital to ensure reliable and credible wound care research when using AI technologies. Although ChatGPT shows promise for transforming wound care management, the authors warn against overreliance on the technology. Considering the potential limitations and risks, proper validation and oversight are essential to unlock its true potential while ensuring patient safety and the effectiveness of wound care treatments.

Objective: To determine how training on the nursing care of pressure injuries (PIs) affects knowledge levels and satisfaction.

Methods: This study was semiexperimental, conducted in the form of a pretest and posttest in one group of 105 nurses working in a training and research hospital. The training took place in person and via video. All nurses included in the study group first received in-person training in 15-person groups followed by weekly video training for 4 consecutive weeks. Before training, investigators assessed the nurses' PI knowledge using the Nurses' Knowledge Level Assessment for PI Care (NKLAPIC; pretest). After the in-person module (posttest 1) and video-based module (posttest 2), investigators provided the NKLAPIC again. The independent-sample test, one-way analysis of variance, repeated-test-measures analysis of variance, Bonferroni test, and pairwise comparisons were used in data analysis.

Results: Mean NKLAPIC scores were 47.71 ± 13.5 (out of 100 points) at pretraining, 68.5 ± 12.32 after the in-person training, and peaked at 72.38 ± 4.74 after video-based training (P < .001). Video-based training appeared to lead to a larger increase in knowledge levels than in-person training alone (P < .001). Further, although the average satisfaction score given to the in-person training was 3.97 ± 0.93, the same score for the online training was 4.12 ± 0.95 (P > .05).

Conclusions: Outcomes suggest that in-person training and video-based training regarding PI care improve the knowledge levels of nurses.

Background: Hidradenitis suppurativa is a chronic, inflammatory disease involving the pilosebaceous unit of apocrine gland-bearing skin. Wide surgical excision, wherein margins extend beyond active lesions, is considered curative.

Objective: To evaluate the safety and efficacy of wide surgical excision in the treatment of hidradenitis suppurativa.

Methods: This single-surgeon, single-site analysis included all patients undergoing radical surgical excision of hidradenitis suppurativa between 2015 and 2019. Using paper case notes and electronic health records, researchers identified a total of 71 patients who underwent 262 surgeries.

Results: The mean number of surgeries per patient was 3.7, and the total number of sites addressed was 309. Wound dehiscence, infection, and flap necrosis were the most common complications. Disease recurrence in surgically treated areas was noted in two patients (3%).

Conclusions: For patients with failed medical management of hidradenitis suppurativa or who have otherwise developed severe disease, wide surgical excision remains a safe, effective treatment with comparatively low recurrence rates. Surgeons should consider staging surgeries, rather than performing a single-stage reconstruction, and anticipate complications.