Journal of Wound Ostomy and Continence Nursing最新文献

{"title":"Effects of Skin Microclimate Changes on Skin Condition in Healthy Adults.","authors":"Caroline Borzdynski, Charne Miller, William McGuinness","doi":"10.1097/WON.0000000000001126","DOIUrl":"https://doi.org/10.1097/WON.0000000000001126","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to examine the effects of moisture, as a skin microclimate variable, at the skin-support surface interface on repeated measures of skin erythema, stratum corneum hydration and skin temperature at pressure-prone areas of healthy adults.</p><p><strong>Design: </strong>Quasi-experimental repeated measures study.</p><p><strong>Subjects and setting: </strong>Forty-eight healthy adults participated in a single center-controlled study conducted in a simulated hospital setting in an urban setting (Melbourne, Australia). This research project was conducted from November 2021 to June 2022.</p><p><strong>Methods: </strong>The effects of moisture and intermittent pressure-loading on skin overlying the sacrum, heels, and elbows were investigated. Participants followed a standardized immobilization protocol of 60 minutes, with 10-minute brief pressure off-loading, in the semi-recumbent position on a standard hospital bed/mattress. The intervention comprised laying with the sacrum in contact with an absorbent pad saturated with normal saline; control skin sites (elbows and heels) were not exposed to the moistened absorbent pad. Skin measures were obtained consecutively at each anatomical testing site upon brief off-loading. Linear mixed models (LMMs) were used to compare skin parameters over time and between conditions.</p><p><strong>Results: </strong>Differences in stratum corneum hydration scores between control and intervention conditions at the sacrum were significant (P = .001). Differences in erythema and skin temperature scores between control and intervention conditions at the sacrum did not significantly differ; however, significant changes in skin temperature (P = .025) at the sacrum were observed at the 10-minute measurement intervals over 1 hour in the sample, suggesting change in skin temperature over time. No participant displayed non-blanching erythema as a subjective indicator of skin injury in any of the testing conditions.</p><p><strong>Conclusions: </strong>Skin moisture/wetness, over a period of 1 hour, does not appear to impact erythema and skin temperature at the sacrum. In contrast, the introduction of moisture at the sacrum significantly increases sacral stratum corneum hydration. Study findings suggest that more frequent monitoring cycles of wet sacral skin may be required to identify moisture-associated skin changes.</p>","PeriodicalId":49950,"journal":{"name":"Journal of Wound Ostomy and Continence Nursing","volume":"51 6","pages":"454-462"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Filling the Gap: Establishing the Standard for the Topical Management of Malignant Cutaneous Wounds.","authors":"Debra Johnston, Marilyn Kerr, Jordan Smart, Valerie Chaplain, Jennifer Malley, Dawn Ross","doi":"10.1097/WON.0000000000001135","DOIUrl":"https://doi.org/10.1097/WON.0000000000001135","url":null,"abstract":"","PeriodicalId":49950,"journal":{"name":"Journal of Wound Ostomy and Continence Nursing","volume":"51 6","pages":"507-509"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparative Randomized Cross-Over Trial to Examine Efficacy of Urine Capture and Comfort of Two Male External Urine Collection Devices in Healthy Male Volunteers.","authors":"Adrian Wagg, Danielle R Redmond","doi":"10.1097/WON.0000000000001131","DOIUrl":"10.1097/WON.0000000000001131","url":null,"abstract":"<p><strong>Purpose: </strong>This study assessed the efficiency of urine collection using external urine collection devices over two voids in a group of morbidly obese and non-obese men.</p><p><strong>Design: </strong>Prospective single-blind comparative crossover study.</p><p><strong>Materials and method: </strong>We assessed the comparative urine capture efficiency of two commercially available male external urine management systems. Continent consenting men were randomized to use each device for a single void. The proportion of urine captured by each device expressed as a percentage of the total volume voided in grams was calculated and compared. Results were compared between morbidly obese (BMI ≥ 40 kg/m2) and non-morbidity (BMI ≤ 40 kg/m2) men.</p><p><strong>Results: </strong>Fifty-nine men completed the study; their mean (standard deviation, SD) age was 40.8 (SD 12.4) years. For void 1, the mean proportion of urine capture for Device A was 97.8% (SD 10.0); for Device B it was 90.7% (SD 20.7). For void 2, the mean proportion of urine capture for Device A was 91.1% (SD 25.8); for Device B it was 85.2% (SD 21.7). The mean difference between devices was 6.6% (95% CI 0.18, 13.0), P = .044. Stratified by weight, in the morbidly obese men, Device A captured 99.7% (SD 0.88) of the first void versus 83.5% (SD 32.2) for Device B. Analysis of the second voids found that Device A captured 80.8% (SD 36.9) versus 79.3% (SD 23.3) for Device B.</p><p><strong>Conclusion: </strong>Device A (the investigational device) performed significantly better than Device B in capture rates when compared based on voided volume, order of void, or BMI category. Device A male external catheter system is an effective option for urine management in both obese and non-obese men.</p>","PeriodicalId":49950,"journal":{"name":"Journal of Wound Ostomy and Continence Nursing","volume":"51 6","pages":"486-490"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Executive Summary: Topical Management of Malignant Cutaneous Wounds: Canadian Best Practice Recommendations for Health Care Professionals Developed by Nurses Specialized in Wound, Ostomy and Continence Canada (in collaboration with the Canadian Palliative Care Nursing Association).","authors":"Debra Johnston, Valerie Chaplain, Marilyn Kerr, Jennifer Malley, Valentina Popov, Dawn Ross, Jordan Smart","doi":"10.1097/WON.0000000000001130","DOIUrl":"https://doi.org/10.1097/WON.0000000000001130","url":null,"abstract":"<p><p>Malignant cutaneous wounds pose unique challenges in patient care, requiring specialized attention to alleviate local symptoms and enhance health-related quality of life. As the prevalence of these wounds continues to rise with improving cancer survival rates, it is essential to establish comprehensive best practice recommendations for their topical management. To address this need, a task force was assembled from across Canada, consisting of members from Nurses Specialized in Wound, Ostomy, and Continence Canada and the Canadian Palliative Care Nursing Association. The purpose of these recommendations is to provide a framework for the topical management of malignant cutaneous wounds for health care professionals, emphasizing the substantial role of their support persons. Recognizing the impact of cultural humility and the need to deliver care that respects individual beliefs and practices is crucial in providing effective and equitable care. The 23 presented recommendations aim to guide nurses, the interdisciplinary team, and the health system to enhance the overall quality of malignant cutaneous wound care management.</p>","PeriodicalId":49950,"journal":{"name":"Journal of Wound Ostomy and Continence Nursing","volume":"51 6","pages":"463-469"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of Diaper Dermatitis in Patients Aged 0-24 Months After Congenital Heart Disease and the Effects of a Diaper Dermatitis Care Bundle: A Comparison of 2 Groups.","authors":"Pei-Ju Chin, Li-Na Liao, Li-Chi Huang","doi":"10.1097/WON.0000000000001132","DOIUrl":"https://doi.org/10.1097/WON.0000000000001132","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to examine characteristics of diaper dermatitis (DD) in critically ill patients aged 0 to 24 months following surgery for congenital heart disease (CHD), the effects of a diaper dermatitis care bundle (DDCB), and factors associated with the development of DD in this population.</p><p><strong>Design: </strong>Nonrandomized comparison cohort study with a historical comparison group.</p><p><strong>Subjects and setting: </strong>Convenience sampling was used to identify children aged 0 to 24 months undergoing CHD and cared for in a pediatric intensive care unit in central Taiwan (Taichung). The sample comprised 54 participants; 24 were in the historical comparison group and 30 received the DDCB.</p><p><strong>Methods: </strong>The rate of DD from the historical comparison group was compared to that in an intervention group managed with a bundle of interventions used to prevent and manage DD, which includes the routine use of a topical skin protectant. The participants in the historical comparison group received usual care to prevent and manage DD including routine cleansing with a moistened, disposable cloth every 3 hours and following defecation or urination. The DDCB comprised diaper changes at least every 3 hours and as needed after soiling, along with the routine application of a dimethicone and sodium hyaluronate-based skin protectant before diaper changes. Both groups were evaluated for use of an antifungal cream when candidiasis was present.</p><p><strong>Results: </strong>Participants managed with the DDCB have a significantly lower rate of DD than the historical comparison group who received routine care (41.65% vs 6.67%, P = .002). Univariate logistic regression showed an odds ratio of 0.10 (95% confidence interval of 0.019-0.520, P = .006), suggesting that the DDCB acted as a protective factor against the development of DD. Multivariate analysis of the historical comparison group indicated that non-cyanotic heart disease was associated with a lower likelihood of postoperative DD compared to those with cyanotic heart disease (odds ratio = 0.01, 95% confidence interval of 0.000-0.946, P = .047).</p><p><strong>Conclusions: </strong>Managing critically ill patients with a DDCB recovering from cardiac surgery significantly decreased the incidence of DD. We recommend routine use of this type of care bundle for preventing DD in this vulnerable population in all children with CHD, with particular attention being paid to this with cyanotic CHD.</p>","PeriodicalId":49950,"journal":{"name":"Journal of Wound Ostomy and Continence Nursing","volume":"51 6","pages":"491-498"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of Patients Admitted to Vascular Surgery Service for a Major Lower Limb Amputation From 2017 to 2021 With Present on Admission Pressure Injuries.","authors":"Catherine R Ratliff, Virginia Rovnyak","doi":"10.1097/WON.0000000000001121","DOIUrl":"10.1097/WON.0000000000001121","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to describe characteristics of patients admitted from 2017 to 2021 with peripheral arterial disease (PAD) who required a below knee amputation (BKA) or above knee amputation (AKA), including present on admission pressure injuries (POA-PIs).</p><p><strong>Design: </strong>Descriptive, cross-sectional retrospective research design.</p><p><strong>Subjects and setting: </strong>The sample comprised 196 patients who underwent 258 major lower limb amputations. A majority (65.9 %n = 170) underwent BKAs and 88 (34.1 %) underwent AKAs. Coronary artery disease was present in 107 (54.6 %) and 143 (73.0%) had diabetes mellitus. The study site was a 670-bed level 1 trauma center in the Mid-Atlantic region of the United States.</p><p><strong>Methods: </strong>A retrospective chart review of patients undergoing major lower limb amputations using CPT codes 27880 BKA, and 27590 AKA was completed. Variables extracted included age, sex, race, and comorbid conditions such as smoking, cardiovascular disease, diabetes mellitus, end stage renal disease requiring dialysis, and POA-PI. Descriptive statistics (frequencies, percentages, and means) were used to describe the sample.</p><p><strong>Results: </strong>There were 25 (12.8%) individuals with POA-PI compared with 171 (87.2%) who did not have POA-PI. None of the characteristics reviewed significantly differed when patients with or without POA-PI were compared. Age was closest to statistical significance ( P = .052). In addition, analysis revealed that 73% (n = 143) of individuals had diabetes mellitus in addition to having PAD.</p><p><strong>Conclusion: </strong>Approximately 13% of a group of patients with PAD had POA-PI when admitted to hospital for major limb amputation. Analysis of multiple factors found that none significantly differed between patients with or without POA-PI. Age came nearest to statistical significance and we hypothesize that older age may increase the risk for POA-PI; additional research in samples with greater power to detect this effect are needed. Findings also indicate that diabetes mellitus is a common risk factor for major lower limb amputation. It is important to educate staff/patients/caregivers on the importance of PI prevention especially in the elderly vascular population who are at risk for undergoing major lower limb amputations.</p>","PeriodicalId":49950,"journal":{"name":"Journal of Wound Ostomy and Continence Nursing","volume":" ","pages":"441-444"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Context for Practice: Present on Admission Pressure Injuries, Cutaneous Microclimate, Online Ostomy Resources, Diaper Dermatitis.","authors":"Mikel Gray","doi":"10.1097/WON.0000000000001133","DOIUrl":"https://doi.org/10.1097/WON.0000000000001133","url":null,"abstract":"","PeriodicalId":49950,"journal":{"name":"Journal of Wound Ostomy and Continence Nursing","volume":"51 6","pages":"435-436"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Executive Summary: Topical Management of Malignant Cutaneous Wounds: Canadian Best Practice Recommendations for Health Care Professionals Developed by Nurses Specialized in Wound, Ostomy and Continence Canada (in collaboration with the Canadian Palliative Care Nursing Association).","authors":"","doi":"10.1097/WON.0000000000001142","DOIUrl":"https://doi.org/10.1097/WON.0000000000001142","url":null,"abstract":"","PeriodicalId":49950,"journal":{"name":"Journal of Wound Ostomy and Continence Nursing","volume":"51 6","pages":"E7-E8"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence: The Role in Wound Care.","authors":"Vittoria Vicky Pontieri-Lewis","doi":"10.1097/WON.0000000000001134","DOIUrl":"https://doi.org/10.1097/WON.0000000000001134","url":null,"abstract":"","PeriodicalId":49950,"journal":{"name":"Journal of Wound Ostomy and Continence Nursing","volume":"51 6","pages":"437"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of Pressure Injuries in Patients at Risk Using a Powered Alternating Pressure Air Mattress: A Noninterventional Study in a Real-World Setting.","authors":"Sylvie Meaume, Renaud Urbinelli, Marc Marty","doi":"10.1097/WON.0000000000001104","DOIUrl":"10.1097/WON.0000000000001104","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the study was to determine the clinical value of using a powered alternating pressure air mattress (P-APAM) in the prevention of pressure injury (PI) in patients at medium to high risk.</p><p><strong>Design: </strong>Noncomparative, observational study.</p><p><strong>Subjects and setting: </strong>The sample comprised 86 patients who were >18 years old, were classified as having medium to high risk of PI, had no PI at baseline, and were lying more than 15 hours a day on a specific P-APAM. Data were collected between September 2018 and July 2019, in 4 nursing homes, and 1 long-term care geriatrics hospital department in France.</p><p><strong>Methods: </strong>In addition to guideline-based care for PI prevention, patients were followed up for 35 days following placement on the P-APAM. The main outcome was the percentage of patients who developed between day 0 and day 35 at least 1 PI of at least stage 2 on the sacrum, spine, or heel. Secondary outcomes were patient assessments of comfort, caregiver satisfaction, mattress noise level, and mattress safety.</p><p><strong>Results: </strong>No patients experienced a PI (incidence = 0%; 95% confidence interval, 0.00%-4.28%). Patients were satisfied or very satisfied with the mattress in most cases in terms of comfort (77.9%) and stability (73.0%). Patients also rated the noise level of the mattress as satisfactory or very satisfactory in all cases (100%).</p><p><strong>Conclusion: </strong>When combined with guideline-based PI prevention measures, use of the P-APAM was associated with a low incidence of PI.</p>","PeriodicalId":49950,"journal":{"name":"Journal of Wound Ostomy and Continence Nursing","volume":"51 5","pages":"382-388"},"PeriodicalIF":1.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}