Advanced Health Care Science Research Unit, Innovative Integrated Bio-Research Core, Institute for Frontier Science Initiative, 12858Kanazawa University, Kanazawa, Japan.
Department of Clinical Nursing, Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, 12858Kanazawa University, Kanazawa, Japan.
Biol Res Nurs. 2021 Jan;23(1):75-81. doi: 10.1177/1099800420941100. Epub 2020 Jul 10.
Preventing recurrent pressure injuries (RPIs) is one of the important challenges faced in healthcare, but the risk factors of RPIs have not been fully revealed. This study aims to explore factors associated with RPIs, by focusing on skin physiology and its microbiome as local factors crucial for the health of healed tissue after pressure injury healing.
This prospective observational study was conducted in a long-term care facility in Japan with patients whose PIs had healed within 1 month. Skin physiology was evaluated by stratum corneum (SC) hydration, pH, and transepidermal water loss. Skin bacteria was collected by tape stripping, followed by 16S ribosomal RNA-based metagenomics analysis. These parameters were evaluated every two weeks over a period of six weeks.
A total of 30 patients were included in this study, and 8 patients (26.7%) had an RPI within 6 weeks. In this study, significantly lower SC hydration and a higher rate of species on the healed site were found in the RPI group.
A high rate of RPIs (about one in four) points out the necessity of a further care strategy on the healed PIs. Lower skin hydration and/or the increase in bacteria may have a potential to be used as a biomarker for the prediction of RPIs, or may be an intervention point for the prevention of RPIs by, for example, skin cleansing with moisturizing care.
预防复发性压疮（RPIs）是医疗保健面临的重要挑战之一，但 RPIs 的风险因素尚未完全揭示。本研究旨在通过关注皮肤生理学及其微生物组，探索与 RPIs 相关的因素，因为皮肤生理学及其微生物组是愈合的压力损伤组织健康的关键局部因素。
本前瞻性观察性研究在日本的一家长期护理机构进行，纳入了在 1 个月内愈合的压疮患者。通过角质层（SC）水合作用、pH 值和经皮水分流失来评估皮肤生理学。通过胶带剥离收集皮肤细菌，然后进行 16S 核糖体 RNA 基于宏基因组学分析。在六周的时间内，每两周评估一次这些参数。
本研究共纳入 30 例患者，其中 8 例（26.7%）在 6 周内发生 RPI。在这项研究中，RPI 组的 SC 水合作用明显较低，愈合部位的 物种比例较高。
较高的 RPI 发生率（约四分之一）表明需要对愈合的 PIs 采取进一步的护理策略。较低的皮肤水合作用和/或 细菌的增加可能有潜力作为 RPI 预测的生物标志物，或者可以通过例如用保湿护理进行皮肤清洁来预防 RPI 的干预点。
