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一项多层面硅酮泡沫敷料预防高危老年护理居民压力性损伤的临床效果的随机对照试验:Border III 试验。

A randomised controlled trial of the clinical effectiveness of multi-layer silicone foam dressings for the prevention of pressure injuries in high-risk aged care residents: The Border III Trial.

机构信息

Department of Nursing, University of Melbourne, Melbourne, Australia.

Department of Biomedical Engineering, Tel Aviv University, Tel Aviv, Israel.

出版信息

Int Wound J. 2018 Jun;15(3):482-490. doi: 10.1111/iwj.12891. Epub 2018 Apr 10.

Abstract

Pressure injuries are prevalent in highly dependent aged care residents. This study investigated the clinical effectiveness of the application of the Mepilex Border Sacrum and Mepilex Heel dressings to prevent the development of facility-acquired pressure injuries. A total of 288 recently admitted residents were enrolled from 40 Australian nursing homes into a randomised controlled trial. Residents randomised to standard care (n = 150) received pressure injury prevention as recommended by international guidelines. Residents randomised to the intervention (n = 138) received standard pressure injury prevention care and had dressings applied to their sacrum and heels. Participants were comparable on demographic and physiological parameters. More residents in the control group developed pressure injuries than in the intervention group (16 vs 3, P = 0.004), and they developed more pressure injuries in total than residents in the intervention group. The results represent a relative risk reduction of 80% for residents treated with the dressings and for every 12 patients that we treated we prevented one pressure injury. Based on our findings, we conclude that the use of the Mölnlycke Mepilex Border Sacrum and Mepilex Heel dressings confers a significant additional protective benefit to nursing home residents with a high risk of developing a facility-acquired pressure injury.

摘要

压力性损伤在高度依赖的老年护理居民中很常见。本研究调查了应用 Mepilex Border Sacrum 和 Mepilex Heel 敷料预防机构获得性压力性损伤的临床效果。共有 288 名最近入住的居民从澳大利亚 40 家养老院被随机分配到一项随机对照试验中。随机分配到标准护理组(n = 150)的居民接受了国际指南推荐的压力性损伤预防措施。随机分配到干预组(n = 138)的居民接受了标准的压力性损伤预防护理,并在骶骨和脚跟处使用了敷料。参与者在人口统计学和生理参数方面具有可比性。对照组发生压力性损伤的患者多于干预组(16 例比 3 例,P = 0.004),且发生的压力性损伤总数多于干预组。这表明使用敷料治疗的患者的相对风险降低了 80%,每治疗 12 名患者,我们就能预防 1 例压力性损伤。基于我们的发现,我们得出结论,使用 Mölnlycke Mepilex Border Sacrum 和 Mepilex Heel 敷料为有发生机构获得性压力性损伤高风险的养老院居民提供了显著的额外保护益处。

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本文引用的文献

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Why is the heel particularly vulnerable to pressure ulcers?为什么足跟特别容易发生压疮?
Br J Nurs. 2017 Nov 8;26(Sup20):S62-S74. doi: 10.12968/bjon.2017.26.Sup20.S62.
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The biomechanical efficacy of dressings in preventing heel ulcers.敷料预防足跟溃疡的生物力学功效。
J Tissue Viability. 2015 Feb;24(1):1-11. doi: 10.1016/j.jtv.2015.01.001. Epub 2015 Jan 19.
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