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2.
Rev. bras. cir. plást ; 34(4): 582-583, oct.-dec. 2019.
Artículo en Inglés, Portugués | LILACS | ID: biblio-1047937

RESUMEN

As informações no leito, sobre a necessidade de manobras do paciente, em intervalos de 2 h, para evitar o aparecimento de lesões por pressão podem reduzir o tempo de permanência, diminuir o risco de lesões de pele e os custos de manutenção do paciente.


Bedside information on the need for repositioning the patient at 2 h intervals to avoid the appearance of pressure ulcers can reduce hospitalization time, risk of skin lesions, and maintenance costs.


Asunto(s)
Humanos , Cirugía Plástica , Heridas y Traumatismos , Úlcera por Presión , Tiempo de Internación , Cirugía Plástica/rehabilitación , Heridas y Traumatismos/terapia , Úlcera por Presión/cirugía , Úlcera por Presión/complicaciones , Úlcera por Presión/prevención & control , Úlcera por Presión/terapia
4.
Sensors (Basel) ; 19(20)2019 Oct 15.
Artículo en Inglés | MEDLINE | ID: mdl-31618875

RESUMEN

The ageing population has grown quickly in the last half century with increased longevity and declining birth rate. This presents challenges to health services and the wider society. This review paper considers different aspects (e.g., physical, mental, and social well-being) of healthy ageing and how health devices can help people to monitor health conditions, treat diseases and promote social interactions. Existing technologies for addressing non-physical (e.g., Alzheimer's, loneliness) and physical (e.g., stroke, bedsores, and fall) related challenges are presented together with the drivers and constraints of using e-textiles for these applications. E-textiles provide a platform that enables unobtrusive and ubiquitous deployment of sensors and actuators for healthy ageing applications. However, constraints remain on battery, integration, data accuracy, manufacturing, durability, ethics/privacy issues, and regulations. These challenges can only effectively be met by interdisciplinary teams sharing expertise and methods, and involving end users and other key stakeholders at an early stage in the research.


Asunto(s)
Envejecimiento Saludable/fisiología , Monitoreo Fisiológico , Dispositivos Electrónicos Vestibles , Accidentes por Caídas/prevención & control , Enfermedad de Alzheimer/prevención & control , Humanos , Soledad/psicología , Úlcera por Presión/prevención & control , Accidente Cerebrovascular/prevención & control , Textiles
5.
J Clin Nurs ; 28(23-24): 4595-4605, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31491054

RESUMEN

AIMS AND OBJECTIVES: To compare the reliability and predictive validity of the Braden and Jackson/Cubbin PI risk assessment scales in intensive care unit patients. BACKGROUND: Risk assessment with a standardised tool is the usual intervention for preventing pressure injury. Therefore, tools used to assess pressure injury risk should be valid and reliable for the designated patient population. DESIGN: A prospective and cross-sectional study adheres to the STARD guideline. METHODS: This study was conducted between November 2017-April 2018 in the intensive care units of a tertiary level university hospital in Turkey. The study sample consisted of 176 patients admitted to three intensive care units. Risk assessment was performed once daily with the Braden scale, followed immediately with the Jackson/Cubbin scale. Risk assessment was terminated on the day of pressure injury development or upon patient discharge from the intensive care unit. Each patient's final risk assessment was considered in the data analysis. RESULTS: The Cronbach's alpha coefficient of the Jackson/Cubbin and Braden scales was .78 and .85, respectively. The predictive validity of the Jackson/Cubbin scale was confirmed by a sensitivity of .87, specificity of .84, positive predictive value of .47 and negative predictive value of .97. These values for the Braden scale were .95, .75, .38 and .99, respectively. CONCLUSION: Both the Jackson/Cubbin and Braden scales are reliable and valid scales for pressure injury risk assessment in intensive care unit patients. However, the predictive ability to determine patients at risk and not at risk for pressure injury was better for the Jackson/Cubbin scale than for the Braden scale. RELEVANCE TO CLINICAL PRACTICE: Both scales are reliable and valid scales for pressure injury risk assessment. Jackson/Cubbin scale's discriminative ability (between the patients at pressure injury risk and not at pressure injury risk) was better.


Asunto(s)
Úlcera por Presión/prevención & control , Medición de Riesgo/métodos , Anciano , Estudios Transversales , Femenino , Humanos , Unidades de Cuidados Intensivos/organización & administración , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Estudios Prospectivos , Reproducibilidad de los Resultados , Turquia
6.
Enferm. intensiva (Ed. impr.) ; 30(3): 135-143, jul.-sept. 2019. ilus, graf, tab
Artículo en Español | IBECS | ID: ibc-182972

RESUMEN

Objetivos: Determinar la incidencia y categoría más incidente de úlceras por presión (UPP). Conocer las características clínicas de las UPP. Determinar si se realiza un registro adecuado de UPP y las medidas de prevención utilizadas. Método: Estudio observacional, descriptivo y retrospectivo realizado durante el año 2014 en la UCI del Hospital Universitario Araba (HUA)-Txagorritxu. La población de estudio fueron todos los pacientes ingresados con UPP, obtenidos mediante muestreo accidental. Los datos se recogieron a través de los registros informatizados del programa Metavisión de valoración del riesgo, valoración clínica y tratamiento de UPP, los cuales se analizaron con estadística descriptiva y se procesaron mediante el paquete estadístico SPSS, versión 22.0. El estudio fue aprobado por el Comité Ético de Investigaciones Clínicas del HUA. Resultados: La incidencia de pacientes con UPP durante el 2014 alcanzó el 6,78%. La localización de UPP más frecuente fue en la zona sacra y en los talones. La categoría de UPP más incidente fue la II, seguida de la I. De las 98 UPP tratadas en nuestros pacientes, 43 se produjeron fuera del servicio y 55 en la UCI del HUA. La ausencia de registro, en todas las variables descritas sobre las UPP, fue de un 19,01%. Conclusiones: La incidencia de UPP alcanzó un porcentaje inferior a lo existente en la literatura actual. La categoría, localización y características clínicas más frecuentes se asimilan a estudios previos. Existe una elevada tasa de no registro de las características de las UPP declaradas. Se efectuaron unas buenas medidas de prevención de UPP y registro de las mismas


Objectives: The aim of this paper is to determine the incidence and most incident pressure ulcers (PU) category. Establish the main clinical characteristics of these PU. Determine whether there is adequate documentation of PU and of the measures used to prevent them. Method: Observational descriptive and retrospective study during 2014 at Intensive Care Unit (ICU)-University Hospital of Araba. Study sample, all patients suffering from PU at the time of the study by accidental sampling. Computerised records regarding risk assessment, clinical assessment and pressure sore treatment, provided by the 'Metavision' computer programme and descriptive statistics using SPSS version 22.0. Approval from the Ethics Committee for Clinical Research of the University Hospital of Araba was obtained. Results: The incidence of patients suffering from PU during 2014 was 6.78%. The most common locations for PU were the sacral region and the heels: the most incident pressure ulcers category was grade II, followed by grade I. Out of the 98 PU treated in our patients, 43 occurred outside the ICU and 55 in the unit itself. The lack of records, in all the variables described about PU, was 19.10%. Conclusions: The incidence of pressure ulcers was lower than in the current literature. The most frequent category, location and clinical characteristics are comparable to previous studies. There is a high rate of failing to record the characteristics of the PU declared. Good PU prevention measures and recording were carried out


Asunto(s)
Humanos , Anciano , Úlcera por Presión/epidemiología , Úlcera por Presión/prevención & control , Registros de Enfermería , Control de Formularios y Registros , Unidades de Cuidados Intensivos , Estudios Retrospectivos , Análisis de Datos
7.
Crit Care Nurse ; 39(4): 13-19, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31371363

RESUMEN

BACKGROUND: Hospital-acquired pressure injuries are a serious problem among critical care patients. Although most hospital-acquired pressure injuries are stage 2 (partial-thickness skin loss with exposed dermis), no studies have examined outcomes of stage 2 pressure injuries among critical care patients. OBJECTIVES: To examine outcomes of stage 2 hospital-acquired pressure injuries among critical care patients and identify factors associated with nonhealing stage 2 hospital-acquired pressure injuries. METHODS: Electronic health record data were used to identify surgical critical care patients with stage 2 hospital-acquired pressure injuries at a level I trauma center. Univariate Cox regressions were used to identify factors associated with healed stage 2 hospital-acquired pressure injuries. RESULTS: Of 6376 surgical critical care patients, 298 (4.7%) developed stage 2 hospital-acquired pressure injuries; complete data were available for 253 patients. Of these 253 patients, 160 (63%) had unhealed pressure injuries at hospital discharge. Factors inversely related to the presence of a healed hospital-acquired pressure injury were older age (hazard ratio, 0.98; 95% CI, 0.97-0.99; P = .003), elevated serum lactate (hazard ratio, 0.85; 95% CI, 0.75-0.96; P = .01), elevated serum creatinine (hazard ratio, 0.87; 95% CI, 0.77-0.98; P = .02), and lower oxygenation (hazard ratio, 0.64; 95% CI, 0.41-1.00; P = .05). CONCLUSIONS: Stage 2 hospital-acquired pressure injuries were not healed at discharge in 63% of the patients in our sample. Nurses should be especially vigilant in treating pressure injury patients who are older, have altered oxygenation or perfusion (elevated serum lactate level or decreased oxygenation), or have evidence of renal compromise.


Asunto(s)
Enfermería de Cuidados Críticos/educación , Enfermería de Cuidados Críticos/normas , Enfermedad Iatrogénica/prevención & control , Guías de Práctica Clínica como Asunto , Úlcera por Presión/enfermería , Úlcera por Presión/prevención & control , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Curriculum , Educación Continua en Enfermería , Femenino , Humanos , Masculino , Persona de Mediana Edad , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Resultado del Tratamiento
8.
Adv Skin Wound Care ; 32(9): 394-408, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31436620

RESUMEN

GENERAL PURPOSE: To review what is known about pediatric pressure injuries (PIs) and the specific factors that make neonates and children vulnerable. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant should be better able to:1. Identify the scope of the problem and recall pediatric anatomy and physiology as it relates to PI formation.2. Differentiate currently available PI risk assessment instruments.3. Outline current recommendations for pediatric PI prevention and treatment. ABSTRACT: Pediatric patients, especially neonates and infants, are vulnerable to pressure injury formation. Clinicians are steadily realizing that, compared with adults and other specific populations, pediatric patients require special consideration, protocols, guidelines, and standardized approaches to pressure injury prevention. This National Pressure Advisory Panel white paper reviews this history and the science of why pediatric patients are vulnerable to pressure injury formation. Successful pediatric pressure injury prevention and treatment can be achieved through the standardized and concentrated efforts of interprofessional teams.


Asunto(s)
Úlcera por Presión/etiología , Úlcera por Presión/prevención & control , Factores de Edad , Niño , Preescolar , Humanos , Lactante , Recién Nacido , Guías de Práctica Clínica como Asunto , Medición de Riesgo , Cicatrización de Heridas
9.
Artículo en Inglés | MEDLINE | ID: mdl-31366078

RESUMEN

Background: Although the addition of patients in the process of shared decision-making can improve their recovery, there is a lack of knowledge about patients' and caregivers' perceptions on the management of pressure ulcers at home. Objectives: To explore the conceptualisations of patients with pressure ulcers and their caregivers on the barriers and facilitators for their involvement in home care and in the process of shared decision-making regarding the care provided. Methods: A qualitative study based on grounded theory in a theoretical sample of 10 patients with pressure ulcers and 15 main caregivers from the health district of Puertollano (Spain). The data were based on semi-structured interviews, analysed using a coding process and the constant comparative method. Results: According to the participants, personal motivation and the involvement of primary care professionals facilitated their participation in the process of shared decision-making and generated feelings of positivity. In contrast, older age, having disabling pathologies, a low educational level or health paternalism were perceived as barriers for their involvement. Conclusions: A non-paternalistic care model and personal motivation facilitate the process of shared decision-making in the care of people with pressure ulcers. Further studies are required to deepen the understanding of this phenomenon and examine the barriers and facilitators for the involvement of patients and caregivers in the management of these injuries in other contexts.


Asunto(s)
Cuidadores , Toma de Decisiones , Servicios de Atención de Salud a Domicilio , Úlcera por Presión/patología , Úlcera por Presión/prevención & control , Adulto , Anciano , Envejecimiento , Resina de Colestiramina , Formación de Concepto , Recolección de Datos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Atención Primaria de Salud , Investigación Cualitativa , España
10.
Niger J Clin Pract ; 22(7): 1014-1021, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31293270

RESUMEN

Introduction: Globally, nurses are known to care for hospitalized patients and the presence or absence of pressure ulcers is being regarded as a performance measure of quality nursing care. The study aims to determine the knowledge and practice of caregivers towards pressure ulcer prevention for hospitalized patients in National Orthopaedic Hospital, Enugu. Method: A cross sectional descriptive survey design was adopted among eighty-five (85) caregivers who met the inclusion criteria and participated in the study. Ethical approval and informed consent of participants was obtained before data collection using a pre-tested semi-structured questionnaire and checklist. Descriptive analysis and Chi-square statistical test was used to test for association between variables. Result: Results revealed poor knowledge 67.3% of pressure ulcer prevention among caregivers. Inadequate staffing 93.5%, heavy workload 92.9%, were highest perceived barriers to pressure ulcer prevention. The test of hypothesis showed that there is a significant relationship between years of service of caregivers and knowledge of pressure ulcer P = 0.000. Conclusion: It was concluded that in-service training, recruitment of more staff and ensuring availability of the necessary equipment are some of the important steps to improve nurses' knowledge and practice regarding prevention of pressure ulcer.


Asunto(s)
Cuidadores/psicología , Conocimientos, Actitudes y Práctica en Salud , Enfermería Ortopédica/métodos , Enfermería Ortopédica/estadística & datos numéricos , Úlcera por Presión/prevención & control , Adulto , Estudios Transversales , Femenino , Humanos , Persona de Mediana Edad , Nigeria , Personal de Enfermería en Hospital , Ortopedia , Encuestas y Cuestionarios
11.
Br J Community Nurs ; 24(Sup7): S29-S31, 2019 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-31264458

RESUMEN

This article provides an outline of an educational programme designed to inform and guide registered nurses and healthcare support workers on understanding the connection between nutrition and wound healing, with the aim of helping them recognise malnutrition in older community-dwelling adults with wounds. The Agents for Nutrition and Tissue Viability programme was set up 9 years ago, The Agents for Nutrition and Tissue Viability Programme was set up 9 years ago within an acute trust and has since then has been rolled out to a local community trust. Benefits have included greater networking between acute and community trusts and quality improvements for patients.


Asunto(s)
Técnicos Medios en Salud , Capacitación en Servicio , Enfermeras y Enfermeros , Estado Nutricional , Cicatrización de Heridas , Anciano , Enfermería en Salud Comunitaria , Servicios de Salud para Ancianos , Humanos , Úlcera por Presión/enfermería , Úlcera por Presión/prevención & control , Medicina Estatal , Supervivencia Tisular , Reino Unido
12.
Adv Neonatal Care ; 19(4): 262-274, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31335377

RESUMEN

BACKGROUND: Neonates are at a high risk for pressure ulcers (PU) due to skin immaturity and exposure to various medical devices. The prevalence of PU in the neonatal intensive care unit is estimated to be 23%, with 80% of those being related to medical devices, including electroencephalographic (EEG) electrodes. Proposed mechanisms involve prolonged pressure to the electrodes and chemical reactions to conductive agents. PURPOSE: The object of this quality improvement project was to reduce PU in neonates during continuous EEG (cEEG) monitoring by 50% within 12 months and 75% within 18 months. A secondary objective was to eliminate electrode-related infections by 12 months. Balancing measures included gestational age at the time of monitoring, integrity of the EEG setup, and cost effectiveness. The process measure was adherence to the skin-monitoring tool kit. METHODS: A multiple Plan-Do-Study-Act cycle method was used. All neonates monitored with cEEG were included. The monitoring tool kit was used to document the condition of scalp and EEG electrodes before, during, and after cEEG. RESULTS: In the preproject period, 8.5% (9/106) of monitored patients developed PU, and 22.2% (2/9) of those developed infections. During the project period, 3.5% (7/198) of monitored patients developed PU and no infections were observed. During monitoring, 21 patients showed skin irritation, and timely intervention resulted in resolution in more than 90% of the cases and prevented progression into PU. Silver/silver chloride-plated electrodes, when exposed to external heat sources, can cause burns, resembling PU. IMPLICATIONS FOR PRACTICE: Intervention at the electrode level together with skin inspection successfully reduces PU in neonates. Silver/silver chloride-plated electrodes should be avoided in neonates. IMPLICATIONS FOR RESEARCH: Further research is needed to identify the optimal electrode for neonatal EEG.


Asunto(s)
Úlcera por Presión/prevención & control , Mejoramiento de la Calidad , Enfermedades de la Piel/prevención & control , Enfermedad Crítica , Electrodos , Electroencefalografía , Femenino , Edad Gestacional , Humanos , Indiana/epidemiología , Recién Nacido , Unidades de Cuidado Intensivo Neonatal , Comunicación Interdisciplinaria , Masculino , Monitoreo Fisiológico , Úlcera por Presión/epidemiología , Enfermedades de la Piel/epidemiología
14.
Trials ; 20(1): 449, 2019 Jul 22.
Artículo en Inglés | MEDLINE | ID: mdl-31331366

RESUMEN

BACKGROUND: Core outcome sets (COS) are being developed in many clinical areas to increase the quality and comparability of clinical trial results as well as to ensure their relevance for patients. A COS represents an agreed standardized set of outcomes that describes the minimum that should be consistently reported in all clinical trials of a defined area. It comprises a core domain set (defining what core outcomes should be measured) and a core measurement set (defining measurement/assessment instruments for each core domain). For pressure ulcer prevention trials a COS is lacking. The great heterogeneity of reported outcomes in this field indicates the need for a COS. METHODS/DESIGN: The first part of this project aims to develop a core domain set by following established methods, which incorporates four steps: (1) definition of the scope, (2) conducting a scoping review, (3) organizing facilitated workshops with service users, (4) performing Delphi surveys and establishing consensus in a face-to-face meeting with different stakeholders. DISCUSSION: After achieving consensus on the core domain set, further work will be undertaken to determine a corresponding core measurement set. This will lead to better pressure ulcer prevention research in the future. There are a number of methodological challenges in the field of COS development. To meet these challenges and to ensure a high-quality COS, the OUTPUTS project affiliates to current standards and works in close collaboration with international experts and with existing international service user groups. TRIAL REGISTRATION: The OUTPUTs project is registered in the COMET database: ( http://www.comet-initiative.org/studies/details/283 ). Registered on 2015.


Asunto(s)
Ensayos Clínicos como Asunto/normas , Determinación de Punto Final/normas , Úlcera por Presión/prevención & control , Úlcera por Presión/terapia , Proyectos de Investigación/normas , Consenso , Técnica Delfos , Humanos , Resultado del Tratamiento
15.
Emerg Med J ; 36(10): 631-634, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31311786
16.
Rev. pesqui. cuid. fundam. (Online) ; 11(4): 992-997, jul.-set. 2019. tab
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1005821

RESUMEN

Objetivo: Identificar o conhecimento dos enfermeiros assistenciais quanto à prevenção e aos cuidados com lesões por pressão (LPP) em unidades de clínica médica e cirúrgica de um hospital universitário de Brasília. Métodos: Trata-se de estudo descritivo, transversal com análise quantitativa. Os dados foram coletados por meio da aplicação de um instrumento com informações acerca da formação e conhecimento do enfermeiro acerca da LPP. Resultados: A amostra foi de 38 enfermeiros, na qual 78.9%, acertaram entre 70 a 89% do instrumento, e somente dois enfermeiros (5,2%) obtiveram nota igual ou maior a 90% de acerto. Os itens de menor acerto estão relacionados ao uso de dispositivos, como luva d'água (23,6%), almofadas (23,6%), e em relação a posicionamento e reposicionamento, além da massagem em proeminências ósseas. Conclusão: Conclui-se que há um déficit do conhecimento da equipe de enfermagem deste hospital, o que pode comprometer diretamente na assistência principalmente do paciente em risco para LPP


Objective: To identify the knowledge of nursing assistants regarding the prevention and care of pressure lesions (LPP) in medical and surgical clinic units of a university hospital in Brasília. Methods: This is a descriptive, cross-sectional study with quantitative analysis. Data were collected through the application of an instrument with information about nurses' training and knowledge about LPP. Results: The sample consisted of 38 nurses, where 78.9% scored between 70 and 89% of the instrument, and only 2 nurses (5.2%) scored 90% or better. The items with the lowest accuracy are related to the use of devices such as water glove (23.6%), cushions (23.6%), and in relation to positioning and repositioning, in addition to bony prominence massage. Conclusion: It is concluded that there is a lack of knowledge of the nursing team of this hospital, which may directly compromise the care of the patient at risk for LPP


Objetivo: Identificar el conocimiento de los enfermeros asistenciales en cuanto a la prevención y cuidados con lesiones por presión (LPP) en unidades de clínica médica y quirúrgica de un hospital universitario de Brasilia. Métodos: Se trata de un estudio descriptivo, transversal con análisis cuantitativo. Los datos fueron recolectados por medio de la aplicación de un instrumento con informaciones acerca de la formación y conocimiento del enfermero acerca de la LPP. Resultados: La muestra fue de 38 enfermeros, donde 78.9%, acertaron entre 70 a 89% del instrumento, y solamente 2 enfermeros (5,2%) obtuvieron nota igual o mayor al 90% de acierto. Los elementos de menor acierto están relacionados al uso de dispositivos, como guante de agua (23,6%), cojines (23,6%), y en relación al posicionamiento y reposicionamiento, además del masaje en prominencia ósea. Conclusión: Se concluye que hay un déficit del conocimiento del equipo de enfermería de este hospital, lo que puede comprometer directamente en la asistencia principalmente del paciente en riesgo para LPP


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Úlcera por Presión/enfermería , Úlcera por Presión/prevención & control , Úlcera por Presión/terapia , Educación en Enfermería , Capacitación Profesional , Hospitales Universitarios
18.
Adv Skin Wound Care ; 32(7S Suppl 1): S4-S13, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31219896

RESUMEN

This article is a review of the work conducted and published to date in employing computer finite element (FE) modeling for efficacy research of prophylactic dressings in the context of preventing pressure injuries. The authors strive to explain why FE modeling is essential in establishing the efficacy of prophylactic dressings, as it is in the development and evaluation of any other preventive intervention. In particular, FE modeling provides insights into the interactions between dressing structures and weight-bearing body tissues (including susceptible anatomical locations such as the sacrum and heels of supine patients). Modeling further facilitates reliable visualization and quantification of the mechanical loads that develop in superficial and deep tissues as a result of body weight or external forces based on known physical principles. The modeling then helps to determine how these tissue loads are mitigated using prophylactic dressings of different designs, structures, and material compositions and rate performances of existing or new products.All of the work published so far on modeling the modes of action of prophylactic dressings has focused on the Mepilex Border dressing (Mölnlycke Health Care AB, Gothenburg, Sweden). Published work has revealed several key design features that are pivotal for obtaining successful clinical outcomes, namely, (1) a multilayered alternating-stiffness structure with embedded anisotropy; (2) a minimal friction coefficient at the external surface of the dressing; and (3) low impact of fluid retention on the mechanical behavior of the dressing. These features, their importance, and the methods of identifying their roles in the modes of action of effective prophylactic dressings are detailed here.Computer models clearly inform the process of engineering prophylactic dressings, but they may also provide guidance in clinical use, contribute to assessing technologies and products, support purchasing, and describe product endurance. As the methods of FE modeling of dressings improve, simulations may soon incorporate the simultaneous complex interactions among tissue distortion, heat transfer in tissue, and prophylactic dressings to inform patient care.


Asunto(s)
Vendajes , Diseño de Equipo , Análisis de Elementos Finitos , Úlcera por Presión/prevención & control , Simulación por Computador , Humanos
19.
Adv Skin Wound Care ; 32(7S Suppl 1): S14-S20, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31219897

RESUMEN

It has been demonstrated that wound dressings provide a protective effect against pressure injuries. However, no method exists to measure either the life or performance of dressings used in prevention; testing dressings in a clinical setting or a research environment has typically been based on measuring its moisture absorption capacity. This article examines the changes that occur in the structural and mechanical properties of a prophylactic dressing based on conditions of use when wound exudate is not present.A clinically relevant method was developed to simulate the loading, friction-inducing shear, and moisture transpiration present in a typical hospitalization where a dressing is applied for prevention. Single-use dressings were tested using this method to evaluate their ability to protect patients from pressure injuries throughout the typical 5 to 7 days of use. Following this aging process, researchers measured the physical, structural, and mechanical changes in prophylactic dressings over time.This innovative method provides guidance for clinicians on dressing use and replacement intervals. For bioengineers, the method generates important empirical data for computer modeling of dressing performance, which can then reveal the consequences of changes in dressing structure and function on sustained tissue loads. It is the authors' hope to generate discussion about the creation of industry-wide standards for testing dressings to improve patient care.


Asunto(s)
Vendajes , Ensayo de Materiales , Úlcera por Presión/prevención & control , Sacro , Diseño de Equipo , Humanos
20.
Adv Skin Wound Care ; 32(7S Suppl 1): S21-S27, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31219898

RESUMEN

Results from large-scale randomized clinical trials support the application of prophylactic dressings to provide protection from body-weight force-induced deformations known to damage skin and underlying tissues, which often result in pressure injuries (pressure ulcers). This laboratory study using a new method for aging dressings in simulated use followed by tensile testing was conducted to further understand the protective effect of sacral prophylactic dressings (SPDs) in alleviating tissue deformations in the sacral region through the course of typical application. Specifically, four SPDs were exposed to a simulation of the clinical environment incorporating saline solution absorption, mechanical loading, and repetitive sliding-induced shear. After aging, the protective endurance of the SPDs was measured through tensile testing to determine their effectiveness against tissue-damaging forces over time.This study uses the concepts of axial stiffness, protective endurance, and elastic limit to describe more accurately the protective aspects of SPDs under dry and moist conditions and how they interact with the skin and underlying tissues over the life of the dressing. The authors propose two primary features in SPD effectiveness in preventing pressure injuries: high conformability (ie, low flexural stiffness) and protective endurance (the dressing's capacity to maintain biomechanical performance when moist).


Asunto(s)
Vendajes , Ensayo de Materiales , Úlcera por Presión/prevención & control , Sacro , Resistencia a la Tracción , Diseño de Equipo , Humanos , Factores de Tiempo , Soporte de Peso
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