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用于预防心脏手术患者骶骨深部组织损伤的硅胶泡沫敷料

Silicone Foam Dressing for Prevention of Sacral Deep Tissue Injuries Among Cardiac Surgery Patients.

作者信息

Strauss Robyn, Preston Ave, Zalman Demetra C, Rao Aditi D

机构信息

At the Hospital of the University of Pennsylvania, in Philadelphia, Pennsylvania, Robyn Strauss, ACNS-BC, MSN, RN, WCC, is Clinical Nurse Specialist, Level VI; Ave Preston, ACNS-BC, MSN, RN, CWOCN, is an Ostomy & Wound Clinical Nurse Specialist; Demetra C. Zalman, MSN, CRNP, WCC, is an Acute Care Nurse Practitioner, Cardiac Surgery; and Aditi D. Rao, PhD, RN, is Director of Nursing Practice. The authors have disclosed no financial relationships related to this article. Submitted September 25, 2018; accepted in revised form November 13, 2018.

出版信息

Adv Skin Wound Care. 2019 Mar;32(3):139-142. doi: 10.1097/01.ASW.0000553111.55505.84.

Abstract

OBJECTIVE

To evaluate the effect of silicone foam dressings, placed preoperatively, on the incidence of postoperative sacral deep-tissue pressure injuries.

DESIGN, SETTING, AND PATIENTS: An uncontrolled before-and-after quality improvement method was used. Within a single, urban academic medical center, consecutively admitted adult cardiac surgery patients were included in the pre- and postintervention groups; only those receiving elective procedures were included.

INTERVENTION

Nurses applied a sacral silicone foam dressing preoperatively. This dressing was maintained on the patient's sacrum intraoperatively and postoperatively for up to 5 days in the intensive care and step-down units.

MAIN RESULTS

This project demonstrated a clinically significant decrease (P < .02) in the incidence of postoperative sacral deep-tissue pressure injuries from 2.3% (preintervention, n = 300) to 0% (postintervention, n = 224). These results were sustained for 24 months after the trial was completed.

CONCLUSIONS

The use of silicone foam dressings may be an effective prophylactic intervention to reduce the incidence of perioperative deep-tissue pressure injuries among cardiac surgery patients, a high-risk population.

摘要

目的

评估术前使用硅胶泡沫敷料对术后骶骨深部组织压力性损伤发生率的影响。

设计、设置和患者:采用非对照的前后质量改进方法。在一家城市学术医疗中心内,连续收治的成年心脏手术患者被纳入干预前和干预后组;仅纳入接受择期手术的患者。

干预措施

护士在术前应用骶骨硅胶泡沫敷料。该敷料在患者骶骨部位术中及术后在重症监护病房和逐步降级病房维持使用长达5天。

主要结果

该项目表明,术后骶骨深部组织压力性损伤的发生率从2.3%(干预前,n = 300)显著降至0%(干预后,n = 224)(P <.02)。这些结果在试验完成后持续了24个月。

结论

对于心脏手术患者这一高危人群,使用硅胶泡沫敷料可能是一种有效的预防性干预措施,可降低围手术期深部组织压力性损伤的发生率。

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