Tsao Wen-Yi, Lo Shu-Fen, Harmod Tomor, Lee Ru-Ping
Department of Nursing, Tzu Chi University, Taiwan, ROC.
Hu Li Za Zhi. 2013 Aug;60(4):65-75. doi: 10.6224/JN.60.3.65.
Although high-technology wound dressings are widely used in clinical care worldwide, no evidence or discussions have been published regarding the efficacy of these dressings in preventing pressure ulcers.
This study presents a repositioning of routine management combined with hydrocolloid dressing or foam dressing for pressure ulcer prevention.
We used a quasi-experimental design and recruited a convenience sample of 90 from a surgical intensive care unit (SICU) at a medical center in Hualien County, Taiwan. Participants were allocated randomly to one of three groups: repositioning of routine management, hydrocolloid dressing, and foam dressing. Study instruments included a pressure ulcer risk table (Braden scale) and the pressure ulcer classification system of the European Pressure Ulcer Advisory Panel. An independent sample t-test, ANOVA, and Mann-Whitney U test were used to verify research hypotheses.
The repositioning of routine management group had the highest pressure ulcer incidence rate, followed by the hydrocolloid-dressing group. The foam-dressing group recorded no pressure ulcers. Pressure ulcer occurrence grades were primarily level 1 and 2. There was no significance difference in pressure ulcer occurrence time between the repositioning of routine-management group and the hydrocolloid-dressing group. Finally, there were significant differences (p < .05) among gender, hypertension history, and BMI regardless of pressure ulcer incidences.
It is recommended that patients in high-risk groups in clinical settings adopt strategies including repositioning and regular visual skin examinations. Also, hydrocolloid or foam dressings may be used as appropriate to prevent sacral pressure ulcers.
尽管高科技伤口敷料在全球临床护理中被广泛使用,但关于这些敷料在预防压疮方面的疗效,尚无证据或相关讨论发表。
本研究提出将常规管理与水胶体敷料或泡沫敷料相结合用于预防压疮的重新定位。
我们采用了准实验设计,从台湾花莲县一家医疗中心的外科重症监护病房(SICU)方便抽样招募了90名患者。参与者被随机分配到三组中的一组:常规管理重新定位组、水胶体敷料组和泡沫敷料组。研究工具包括压疮风险表(Braden量表)和欧洲压疮咨询小组的压疮分类系统。使用独立样本t检验、方差分析和曼-惠特尼U检验来验证研究假设。
常规管理重新定位组的压疮发生率最高,其次是水胶体敷料组。泡沫敷料组未出现压疮。压疮发生等级主要为1级和2级。常规管理重新定位组和水胶体敷料组在压疮发生时间上无显著差异。最后,无论压疮发生率如何,性别、高血压病史和体重指数之间均存在显著差异(p <.05)。
建议临床环境中的高危患者群体采取包括重新定位和定期目视皮肤检查在内的策略。此外,可根据情况使用水胶体或泡沫敷料预防骶骨压疮。