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两种颈椎固定器的压痕标记、皮肤温度和舒适度:一项健康志愿者单盲随机对照试验。

Indentation marks, skin temperature and comfort of two cervical collars: A single-blinded randomized controlled trial in healthy volunteers.

机构信息

Department of Surgery, Isala, Dr. van Heesweg 2, 8025 AB Zwolle, The Netherlands.

Emergency Department, University Medical Center Utrecht, University of Applied Science, Institute of Nursing Studies, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.

出版信息

Int Emerg Nurs. 2020 Jul;51:100878. doi: 10.1016/j.ienj.2020.100878. Epub 2020 Jun 5.

Abstract

BACKGROUND

Collar-related pressure ulcers (CRPU) are a problem in trauma patients with a suspicion of cervical cord injury patients. Indentation marks (IM), skin temperature (T) and comfort could play a role in the development of CRPU. Two comparable cervical collars are the Stifneck® and Philadelphia®. However, the differences between them remain unclear.

AIM

To determine and compare occurrence and severity of IM, T and comfort of the Stifneck® and Philadelphia® in immobilized healthy adults.

METHODS

This single-blinded randomized controlled trial compared two groups of immobilized participants in supine position for 20 min.

RESULTS

All participants (n = 60) generated IM in at least one location in the observed area. Total occurrence was higher in the Stifneck®-group (n = 95 versus n = 69; p = .002). T increased significantly with 1.0  °C in the Stifneck®-group and 1.3 °C in the Philadelphia®-group (p = .024). Comfort was rated 3 on a scale of 5 (p = .506).

CONCLUSION

The occurrence of IM in both groups was high. In comparison to the Stifneck®, fewer and less severe IM were observed from the Philadelphia®. The T increased significantly with both collars; however, no clinical difference in increase of T between them was found. The results emphasize the need for a better design of cervical collars regarding CRPU.

摘要

背景

颈托相关压疮(CRPU)是疑似颈脊髓损伤创伤患者的一个问题。压痕(IM)、皮肤温度(T)和舒适度可能与 CRPU 的发展有关。两种可比的颈托是 Stifneck®和 Philadelphia®。然而,它们之间的差异尚不清楚。

目的

确定并比较 Stifneck®和 Philadelphia®在固定健康成年人中的 IM、T 和舒适度的发生和严重程度。

方法

这项单盲随机对照试验比较了两组仰卧位固定 20 分钟的参与者。

结果

所有参与者(n=60)在观察区域的至少一个部位都产生了 IM。在 Stifneck®组(n=95)总发生率高于 Philadelphia®组(n=69;p=0.002)。Stifneck®组 T 值升高 1.0°C,Philadelphia®组 T 值升高 1.3°C(p=0.024)。舒适度评分为 5 分(p=0.506)。

结论

两组的 IM 发生率均较高。与 Stifneck®相比,Philadelphia®观察到的 IM 更少且程度更轻。两种颈托都会使 T 值显著升高;然而,两者之间 T 值升高的临床差异并不明显。研究结果强调需要更好地设计颈托以预防 CRPU。

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