Subepidermal moisture detection of pressure induced tissue damage on the trunk: The pressure ulcer detection study outcomes.

We examined the relationship between subepidermal moisture measured using surface electrical capacitance and visual skin assessment of pressure ulcers at the trunk location (sacral, ischial tuberosities) in 417 nursing home residents residing in 19 facilities. Participants were on average older (mean age of 77 years), 58% were female, over half were ethnic minorities (29% African American, 12% Asian American, and 21% Hispanic), and at risk for pressure ulcers (mean score for Braden Scale for Predicting Pressure Ulcer Risk of 15.6). Concurrent visual assessments and subepidermal moisture were obtained at the sacrum and right and left ischium weekly for 16 weeks. Visual assessment was categorized as normal, erythema, stage 1 pressure ulcer, Deep Tissue Injury or stage 2+ pressure ulcer using the National Pressure Ulcer Advisory Panel 2009 classification system. Incidence of any skin damage was 52%. Subepidermal moisture was measured with a dermal phase meter where higher readings indicate greater moisture (range: 0-70 tissue dielectric constant), with values increasing significantly with the presence of skin damage. Elevated subepidermal moisture values co-occurred with concurrent skin damage in generalized multinomial logistic models (to control for repeated observations) at the sacrum, adjusting for age and risk. Higher subepidermal moisture values were associated with visual damage 1 week later using similar models. Threshold values for subepidermal moisture were compared to visual ratings to predict skin damage 1 week later. Subepidermal moisture of 39 tissue dielectric constant units predicted 41% of future skin damage while visual ratings predicted 27%. Thus, this method of detecting early skin damage holds promise for clinicians, especially as it is objective and equally valid for all groups of patients.

Using a soft-silicone dressing to treat moist desquamation.

Skin reactions are a common side effect of radiotherapy. Radiotherapy damages basal cells and skin reactions occur when the basal layer is unable to produce enough new cells to compensate for the loss of damaged cells at the skin's surface. Skin reactions progress from erythema, through dry desquamation to moist desquamation. As yet, there are no nationally recognised guidelines for the management of radiotherapy-induced skin reactions. As a result, there is widespread variation in practice throughout the UK. Hydrocolloid and hydrogel dressings have been used to treat moist desquamation. However, this article describes the successful clinical experience with an alternative dressing, Mepilex Lite®. The clinical evidence presented also raises the question of whether Mepilex Lite can be used prophylactically as an alternative to aqueous cream on grade 1 (erythema) reactions. Further evidence on this indication for Mepilex Lite will be published in a BJN supplement in November 2014.

Radiotherapy-induced skin reactions: assessment and management.

Radiotherapy, the use of high-energy rays to either kill cancer cells or treat some benign tumours, is undoubtedly a positive intervention. However, as the primary mode of action in radiotherapy treatment is the killing of cells to prevent replication, other non-cancerous cells may be affected. For example, up to 85% of patients will experience some form of skin reaction, which will range from local erythema to moist desquamation. Such reactions are not only distressing and painful for the patient, if severe enough, they may warrant a halt in treatment. This article outlines the aims and nature of radiotherapy, and then discusses the aetiology of skin reactions, risk factors for reaction, and assessment tools. Management interventions will also be shown, with emphasis on silicone dressings.

Causes and strategies for moisture lesions.

Moisture lesions or incontinence-associated dermatitis are painful and distressing consequences of prolonged exposure to urine and faeces. They may adversely affect patients' physical and psychological wellbeing, so minimising damage is a vital part of the nurse's role. This article outlines their causes and strategies to prevent and treat them, as well as the causes of urinary and faecal incontinence and containment options.

Screening complications in the postoperative period of orthopedic surgeries by video arthroscopy

To analyze the prevalence and characteristics of late postoperative complications of orthopedic surgeries by video arthroscopy.This was a descriptive cross-sectional study that evaluated, through its own instrument, local and systemic postoperative complications of patients undergoing orthopedic surgeries by video arthroscopy. The study included 270 patients, who were evaluated on days 30(without prosthesis) and 90(with prosthesis placement) of the postoperative period, by telephone service. The selection of participants occurred sequentially and population-based, within the data collection period, from February to July 2020, in a large hospital for medium and high complexity surgeries. Of the 270 procedures performed in the period, 4.4% (n = 12) presented late postoperative infection. The most frequent complications were erythema (83%), edema (75%) and secretion (67%) in the surgical wound. Most used antibiotic therapy (92%) and anti-inflammatory drugs (67%). Hospital readmission was not necessary concerning the complications. Only 50% required medical evaluation before the scheduled time.The need for practices that ensure the quality of perioperative care and improve the active search to assess surgical outcomes is reinforced.

Lesiones cutáneas asociadas a la humedad en geriatría: a propósito de tres casos / Moisture associated skin damage in geriatrics: a three cases study

Las lesiones cutáneas asociadas a humedad son aquellas localizadas en la piel, presentadas como inflamación y/o erosión, causadas por exposición prolongada a fuentes de humedad con potencial irritativo. Los pacientes geriátricos, por cambios de estructura y resistencia de la piel, tienen más riesgo de padecerlas. Se presentan tres casos de pacientes geriátricos con estas lesiones. Exploración: Las pacientes presentan diversos tipos de lesiones: dermatitis intertriginosa, dermatitis asociada a la incontinencia y dermatitis asociada al exudado. Plan de actuación/tratamiento: Se realizó un abordaje global e interdisciplinar, además de local, incluyendo manejo de la humedad y uso de películas barrera siliconadas. RESULTADOS: La evolución fue satisfactoria, con disminución o eliminación del eritema y la sintomatología asociada. DISCUSIÓN: El abordaje global e interdisciplinar, y el uso de películas barrera siliconadas, ha mejorado el confort y la evolución de las lesiones y reducido el tiempo de cura. Es preciso dar, a las lesiones por humedad en pacientes geriátricos, la relevancia que precisan

Moisture associated skin damage are those located on the skin, presented as inflammation and/or erosion, caused by prolonged exposure to moisture sources with irritative potential. Geriatric patients, due to structural changes and resistance of the skin, have a higher risk of suffering from them. Three cases of geriatric patients with these lesions are presented. Exploration: The patients present diverse types of injuries: intertriginous dermatitis, dermatitis associated with incontinence and dermatitis associated with exudate. Action/treatment plan: A global and interdisciplinary approach was carried out, in addition to local, including humidity management and use of silicone barrier films. RESULTS: The evolution was satisfactory, diminishing or eliminating the erythema and the associated symptomatology. DISCUSSION: The global and interdisciplinary approach, and the use of silicone barrier films, has improved comfort, the evolution of injuries and reduced the time of healing. It is necessary to give the relevance these injuries require in geriatric patients

Acral erythema during bone marrow transplantation: a case study.

Six of 13 patients receiving high-dose cytosine arabinoside as preparation for bone marrow transplant experienced painful redness and blistering of the hands and feet. Literature reports described this syndrome in patients receiving high-dose chemotherapy but at lower rates of occurrence than in this series of patients. Nursing problems encountered in patients experiencing acral erythema included: pain, compromised self-care, decreased activity, and infection potential. Nursing measures for dealing with these problems are described.

Early and late radiation-induced skin alterations. Part II: Nursing care of irradiated skin.

Teaching patients how to care for irradiated skin during and after a course of radiation therapy is a major concern of oncology nurses. Part I of this two-part article (ONF 19(5):801-807) focused on the mechanisms of skin injury. Many topical preparations are available for skin care. When these substances are applied, both the active ingredient and the vehicle must be appropriate for the condition being treated. Preparations may be applied to the skin as liquids (e.g., lotions, solutions, tinctures used in wet dressings, soaks, baths) or solids (e.g., powders, creams, ointments). As skin reaction progresses during a course of radiation therapy, recommendations for skin care will change. Healing of injury occurs in three stages: inflammation, proliferation, and maturation. Wound healing proceeds more rapidly in a moist environment, and a variety of occlusive dressings can be used with moist desquamation.

Fifth disease: role for nurses in pediatric practice.

Parvovirus B19 infection is a common childhood disease. Infection is usually mild but may have serious consequences in pregnant women. Nurses in pediatric practice may be the only health professionals in a position to recognize and intervene in this potentially serious condition in certain high risk individuals.

The protective effects on wound edges of a new preparation.

Marked progress has been made in the management of chronic wounds in recent years. However, every attempt to protect the wound edges has been unsatisfactory and in many cases the products used were not developed for the purpose of skin protection.

Management of skin reactions during radiotherapy: a study of nursing practice.

The aim of this study was to investigate the consensus of skin care advice given by nurses during radiotherapy. Sixty-seven nurses, identified through nine Belgian radiotherapy departments, responded to a questionnaire survey consisting of 58 items regarding prevention and management of erythema, dry desquamation and moist desquamation. Consensus for a given advice was categorized as small if less than 50% of the nurses gave the same answer, as moderate if between 50% and 75% and as large when more than 75%. Overall, 33% of the items showed small consensus, 29% showed moderate consensus and 38% showed large consensus. The highest consensus was seen for advice in cases of moist and dry desquamation. There was less agreement in the case of erythema and it decreased further for preventive advice. Some skin care techniques that were frequently used by the nurses cannot be supported by the literature. Also, some techniques recommended by the literature are not frequently used. Further, few differences (P < 0.05) between nurses working in a university hospital and the ones working in a non-university hospital were found in terms of advice given to patients. To increase consensus on skin care issues more conclusive research is needed. Of equal importance is the translation of existing research results into daily clinical practice.

Paciente intervenido quirúrgicamente. Disminución de riesgos y aumento del confort mediante el uso del aerosol Nobecutan® / For Patients Undergoing Surgery, a reduction of risks and an increase in comfort by means using the Nobecutan® aerosol

Trabajo ganador del premio Nobecutan® de Enfermería 2010 en su segunda edición. Se trata de un estudio observacional sobre aquellos pacientes que han sido sometidos a una intervención quirúrgica de raquis aplicando el aerosol Nobecutan® en el momento del montaje del campo quirúrgico(AU)

This article summarizes the study which won the 2010 Nursing Nobecutan® Prize, Second Edition. This study is an observational study of patients who undergo spinal column surgery. At the beginning of their surgical procedure, Nobecutan aerosol was applied to the affetced area(AU)