Advances in Skin & Wound Care最新文献

Objective: Numerous studies have examined the epidemiology of skin tears; however, inconsistent definitions, classification systems, and data collection methods have highlighted the need for a validated and standardized tool. The primary objective of this study was to validate a data collection tool for skin tears. A secondary aim was to provide a freely accessible tool for health care providers or researchers to collect consistent and reliable data on skin tears.

Methods: The development of the tool was guided by the 2018 International Skin Tear Advisory Panel (ISTAP) Best Practice Recommendations for the prevention, assessment, and management of skin tears in aged skin. Between June and October 2024, a multimethod validation process was undertaken. Content validity ratio and content validity index calculations were used to quantify content validity, supported by qualitative feedback from 15 experts to assess face validity and provide suggestions for refinement.

Results: The final tool consists of 22 questions addressing a patient's demographics, clinical features of the skin tear, associated risk factors, and contextual data. The content validity index was calculated at 0.72, indicating an acceptable level of content validity. International experts reached consensus following a 2-round qualitative review, resulting in subsequent adjustments to the tool.

Conclusions: The ISTAP DC-Tool was developed based on evidence-informed recommendations and validated by an international panel of experts. Its implementation will support health care providers and researchers in gathering standardized epidemiological data contributing to clinical practice improvements, quality initiatives, and further research in skin tear prevention and management.

Objective: Foot pathologies among older people have increased considerably, especially as life expectancy has increased, becoming a common reason for podiatric and medical foot care. The purpose of this investigation was to determine the variances in the quality of life (QoL) linked to overall foot health in older population with presence or absence of foot problems.

Methods: A retrospective case-control investigation was performed in an outpatient health center, where a senior clinician recorded information linked to clinical and sociodemographic features. Besides, self-reported information on QoL and overall foot health were analyzed through the specific tool known as Foot Health Status Questionnaire in all older participants.

Results: A total sample consisted of 120 older people (60 controls and 60 cases), with a median age of 73.50 years and recorded the interquartile range as 23 years of age. The older adults recorded lower values for all domains related with foot health and the overall health compared with the control group.

Conclusions: Older people with foot problems such as hallux abducto valgus, pes planus, metatarsalgias, keratotic disorders, heel pain, toenail deformities, deformed toes, Morton neuroma, and cavus foot present a negative influence linked to QoL and to overall foot health, which seems to be marked with the aging process and the presence of alterations on the foot in the older population.

Objective: To evaluate the predictive validity of the Cubbin & Jackson scale and the COMHON index in intensive care units in China.

Methods: This study was conducted in the intensive care unit of a tertiary grade A hospital in Shenzhen, China, from February 2022 to December 2023. Two senior nurses independently performed each assessment using both the Cubbin & Jackson scale and the COMHON index simultaneously. Baseline characteristics were collected at the first evaluation. Sensitivity, specificity, positive and negative predictive value, Youden Index, and the area under the curve of the receiver operating characteristic were used to compare the predictive performance.

Results: A total of 253 patients were included in the evaluation, out of which 25 patients developed pressure injuries. The cut-off score of 32 for the Cubbin & Jackson scale and 9 for the COMHON index demonstrated the highest predictive validity. The sensitivity, specificity, positive and negative predictive value, Youden Index, and area under the curve of the receiver operating characteristic were determined to be 100%, 63.89%, 21.21%, 100%, 0.64, and 0.88, respectively, for the Cubbin & Jackson scale. Similarly, the COMHON index exhibited values of 100%, 64.58%, 21.54%, 100%, 0.65, and 0.80 for the same parameters.

Conclusions: The Cubbin & Jackson scale and the COMHON index demonstrated comparable moderate predictive efficacy in assessing pressure injury risk among patients in the intensive care unit.

Objective: To develop a three-dimensional (3D) spacer mattress for pressure relief and to evaluate its effectiveness during cardiac surgery.

Methods: This study consisted of 3 phases: development, initial assessment, and randomized controlled trial (ClinicalTrials.gov, NCT06071039). Sixty patients underwent cardiac surgery divided into 2 groups, 30 patients each. The data were collected in a public hospital in Istanbul Provincial Health Directorate Sancaktepe Sehit Prof Dr Ilhan Varank Training and Research Hospital between February and September 2023. A 3D spacer mattress was used for the intervention group, and a standard operating theatre mattress (foam) was used for the control group. Pressures on the sacrum, left heel, and right heel were measured throughout surgery using a continuous pressure measurement system.

Results: The mean pressure values were 49.73 ± 17.40, 15.65 ± 5.19, and 18.01 ± 9.34 mm Hg for sacrum, left heel, and right heel, respectively, in the control group, whereas the mean pressure values were 28.21 ± 11.70, 5.88 ± 1.88, and 6.56 ± 2.81 mm Hg for the sacrum, left heel, and right heel, respectively, in the intervention group. The means of the maximum pressure values were 90.36 ± 8.63, 62.51 ± 13.77, and 54.19 ± 16.71 mm Hg for sacrum, left heel, and right heel, respectively, in the control group, whereas the means of the maximum pressure values were 49.31 ± 12.61, 28.82 ± 13.56, and 31.17 ± 16.65 mm Hg for the sacrum, left heel, and right heel, respectively, in the intervention group. There were statistically significant differences between the groups for mean and maximum pressure on the sacrum, left heel, and right heel ( P < .05).

Conclusions: The use of a 3D spacer mattress is an effective method to relieve pressure during cardiac surgery.

Abstract:

Objective: This study aimed to analyze the effectiveness of health education interventions related to self-care in patients at risk of developing complications associated with peripheral diabetic neuropathy.

Data sources: A quantitative systematic literature review was conducted using the Joanna Briggs Institute methodology. The guiding question was, "Is health education effective for self-care in patients at risk for peripheral neuropathy?" The databases used included MEDLINE (via Ovid), BVS, CINAHL, PubMed (PMC), Cochrane Library, EMBASE, OasisBR, SCIELO, and Google Scholar as of May 22, 2023. Studies were identified using Health Sciences Descriptors (DeCS) from the Virtual Health Library (BVS in Portuguese), and Medical Subject Headings (MeSH) from the National Library of Medicine, United States (US NLM).

Study selection: The search results were imported into the reference manager, Rayyan, and then duplicate documents were removed. Studies that met the selection criteria based on abstract reading proceeded to the second stage, which included full-text article analysis.

Data extraction: Data on health education and care of patients with diabetic neuropathy were extracted from the studies.

Data synthesis: A total of 426 articles were identified after completion of the searches. After selection, 3 articles were included in the review. Two had a low risk of bias and 1 had a high risk of bias. Health education was found to be effective in controlling various signs and symptoms associated with diabetic neuropathy.

Conclusions: Key findings in the literature support the effectiveness of health education in managing the signs, symptoms, and complications of diabetic neuropathy.

The optimal treatment modality for diabetic foot osteomyelitis (DFO) remains unclear. The current guidelines from Diabetes Canada recommend the use of oral antibiotics and/or intravenous antibiotics with no preferred agent or route of administration. This report aimed to evaluate the current evidence surrounding oral antibiotic therapy for DFO. Embase and MEDLINE databases were searched for original articles written in English that reported efficacy and safety data on oral antibiotic use for this indication. Twenty-six unique studies were included, encompassing 972 patients treated with oral antibiotics. The mean age was 64.6 years (range: 30 to 90 y). When used as monotherapy, the complete resolution and partial resolution rate for oral antibiotic therapy were 75.2% (539/717) and 3.2% (23/717), respectively. When used as a step-down therapy after intravenous antibiotics, the complete and partial resolution rate for oral antibiotics were 56.5% (155/255) and 20.4% (52/255), respectively. No resolution of DFO resulting in refractory infection or amputation was observed in 155 (21.6%) cases of oral antibiotics monotherapy and 59 (23.1%) of step-down therapy. Recurrence rates for oral antibiotics monotherapy and step-down therapy were 5.4% (39/717) and 3.9% (10/255), respectively. Oral antibiotic therapy demonstrates favorable outcomes in DFO comparable to intravenous treatment. Oral antibiotic therapy may be especially useful in low-resource settings where hospital beds are limited and in situations where patients require ambulation. Nonetheless, patients should be counselled on the vital importance of adherence, and resource stewardship should be practiced by health care providers to avoid antibiotic resistance. GENERAL PURPOSE: To present a systematic review article evaluating the utility of oral antibiotics for the treatment of diabetic foot osteomyelitis. JOURNAL/aswca/04.03/00129334-202511000-00004/figure1/v/2025-11-11T122732Z/r/image-jpeg TARGET AUDIENCE: This continuing education activity is intended for physicians; physician assistants; nurse practitioners; podiatrists/other foot specialists; and registered nurses with an interest in skin, wound, and diabetic foot care. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing education activity, the participant should be better able to: Summarize the evidence the authors considered when evaluating the utility of oral antibiotics for diabetic foot osteomyelitis.Select the characteristics of the participants and settings in which oral antibiotic therapy was utilized.Identify the results of the authors' study assessing the use of oral antibiotics.Discuss potential situations in which oral antibiotic therapy may provide favorable outcomes as monotherapy or in conjunction with intravenous antibiotics for diabetic foot osteomyelitis.