Advances in Skin & Wound Care最新文献

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.

Objective: To determine if an escape room game approach, which has emerged as a novel and engaging education tool, is an effective method to improve nursing students' knowledge of pressure injury (PI) prevention and attitudes toward the care of patients with a PI.

Methods: This study evaluated 33 university nursing students using a quasi-experimental pretest/posttest design. Students completed five questionnaires before the escape room experience and again 1 month after.

Results: After the intervention, the students' mean scores on their self-reported PI knowledge level, Pressure Ulcer Knowledge Assessment Tool 2.0, Pressure Injuries Prevention Knowledge Questionnaire, and Attitude towards Pressure Ulcer Prevention Instrument all significantly increased (Ps < .001). Further, the mean score on the State-Trait Anxiety Inventory was significantly lower postintervention (P < .001), indicating decreased anxiety.

Conclusions: The results indicate that the escape room game approach is an effective method to improve nursing students' knowledge of PI prevention and attitudes toward the care of patients with PIs. This method also improved students' knowledge retention by promoting facilitated learning in solving complex cases.

Background: The management of chronic leg ulcers, including venous leg ulcers (VLUs), causes a considerable economic and clinical burden to healthcare systems. Factors such as nursing time, hospital care, and wound dressings account for approximately 85% of the total cost. Superabsorbent dressings (eg, superabsorbent polymers [SAPs]) are recommended as a first-line treatment for moderately to highly exuding VLUs.

Objective: To assess the cost-effectiveness of utilizing SAPs compared with the standard of care (SoC) for managing patients with moderately to highly exuding VLUs within the Slovakia healthcare settings.

Methods: The decision-analytic modeling method used a Markov process as microsimulation, with a time horizon of 6 months, from the perspective of the third-party payer in Slovakia. All model inputs were based on data identified through systematic literature reviews.

Results: According to model predictions, the use of SAPs instead of SoC in patients with moderately to highly exuding leg ulcers in Slovakian settings would lead to an improved healing rate of 2.2%, incremental health-related quality of life of 0.143 quality-adjusted life-weeks, and total direct cost savings of €75 (USD $82) per patient over a 6-month period.

Conclusions: The evaluation's results align with clinical recommendations that endorse superabsorbent wound dressings as the preferred first-line treatment for moderately to highly exuding VLUs. The findings support the use of these dressings as a cost-saving solution for the National Insurance in Slovakia, when compared with SoC.

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.

Abstract: Diabetic foot bacterial osteomyelitis is a serious infection that can lead to major amputations. However, fungal osteomyelitis in a diabetic foot ulcer is uncommon and has been underrecognized. It typically occurs in patients with underlying immunocompromised status and is associated with poor outcomes. Fungal osteomyelitis might be overlooked or diagnosed late because of underrecognition and the inability to differentiate it from bacterial osteomyelitis without specific laboratory testing, such as fungal culture of bone and histopathology including fungal stain. Treating fungal osteomyelitis involves a long course of antifungal treatment, along with surgical management and intensive wound care. In this report, the authors describe the case of a 78-year-old woman with peripheral arterial disease and diabetes who developed dry gangrene complicated by osteomyelitis due to the fungus Trichosporon asahii in the distal phalange of her right hallux. Initially, her pain and erythema around the gangrene improved with voriconazole; however, her gangrene worsened, likely because of nonadherence to wound care and offloading, and her comorbidities. Ultimately, she underwent a right foot guillotine transmetatarsal amputation. The authors also review the literature on fungal osteomyelitis, particularly in the context of diabetic foot infections and Trichosporon asahii infections.

Objective: To compare transepidermal water loss (TEWL) in preterm newborns treated with two different types of phototherapies.

Methods: In this experimental randomized controlled study, participants were 60 preterm infants aged 30 to 36 weeks' gestation who were admitted to the neonatal ICU of Duzce University Research and Application Center from December 2015 to May 2016. Researchers randomly assigned the newborns to two phototherapy groups: light-emitting diode (LED) and fluorescent phototherapy. Each group included 30 participants. Data were collected using a demographic information form and an evaporimeter to measure TEWL levels.

Results: Prior to phototherapy, the anterior region TEWL values were 11.99 ± 3.04 and 11.56 ± 3.99 g/m2 per hour in the fluorescent and LED groups, respectively, and the posterior region TEWL values were 12.82 ± 3.94 and 12.42 ± 4.24 g/m2 per hour in the fluorescent and LED groups, respectively. Prior to phototherapy, anterior and posterior TEWL measurements did not differ either within or between groups. However, in comparison with fluorescent group participants, participants in the LED group experienced significantly less water loss at 30 minutes and 1, 3, 6, 12, and 24 hours after the start of phototherapy (P < .001).

Conclusions: Fluorescent phototherapy causes more water loss than LED phototherapy in preterm infants, and TEWL values are similar in both anterior and posterior measurements.