Gazineo Domenica, Chiarabelli Matteo, Cirone Rosanna, Chiari Paolo, Ambrosi Elisa
Domenica Gazineo, MSN, Evidence-Based Nursing Centre, Azienda Ospedaliero-Universitaria, Bologna, Italy.
Matteo Chiarabelli, MSN, Cardio-Thoracic Vascular Department, Azienda Ospedaliero-Universitaria, Bologna, Italy.
J Wound Ostomy Continence Nurs. 2020 Nov/Dec;47(6):582-587. doi: 10.1097/WON.0000000000000715.
The purpose of this study was to determine the effectiveness of a multilayered polyurethane foam dressing applied within 24 hours of hospital admission compared with standard preventive pressure injury (PI) care in reducing sacral PI occurrence in older patients with hip fractures.
Open-label, parallel-group, 2-arm, superiority trial.
The sample comprised older patients aged 69 to 97 years admitted to a 1500-bed university hospital in Bologna, Italy, for hip fracture surgery.
Patients were randomly allocated to an intervention or control group. Both groups received standard evidence-based PI preventive care in accordance with National Pressure Ulcer Advisory Panel guidelines. In addition, patients in the intervention group received a single 12.9 × 12.9-cm multilayered polyurethane foam dressing shaped for the sacrum area applied within 24 hours of hospital admission. Bivariate analysis on primary and secondary outcomes and baseline characteristics was performed to compare group differences, and a survival analysis was used to determine the difference in PI incidence rates per group.
Sixty-eight patients completed the trial; 34 patients were allocated to the intervention group and 34 patients to the control group. A trend toward significance was observed for sacral PI occurrence in the intervention group (intervention: 20.6%; control: 2.9%; P = .054). The foam dressing allowed significantly longer time (days) to PI occurrence (intervention: 5.9 ± 1.60; control: 2.7 ± 0.96; P = .003).
These findings suggest that multilayered polyurethane foam dressings are not superior to the standard preventive PI care alone and should be used with caution, especially when multiple dressing changes may occur. Further exploration of the role of multilayered polyurethane foam dressings in preventing PI development is warranted.
本研究旨在确定与标准预防性压力性损伤（PI）护理相比，在髋部骨折老年患者入院24小时内应用多层聚氨酯泡沫敷料在降低骶部PI发生率方面的有效性。
开放标签、平行组、双臂、优效性试验。
样本包括69至97岁因髋部骨折手术入住意大利博洛尼亚一家拥有1500张床位的大学医院的老年患者。
患者被随机分配至干预组或对照组。两组均按照国家压力性溃疡咨询小组的指南接受标准的循证PI预防护理。此外，干预组患者在入院24小时内接受一片为骶骨区域定制的12.9×12.9厘米多层聚氨酯泡沫敷料。对主要和次要结局以及基线特征进行双变量分析以比较组间差异，并采用生存分析来确定每组PI发生率的差异。
68名患者完成了试验；34名患者被分配至干预组，34名患者被分配至对照组。干预组骶部PI发生情况观察到有显著趋势（干预组：20.6%；对照组：2.9%；P = 0.054）。泡沫敷料使PI发生的时间（天数）显著延长（干预组：5.9±1.60；对照组：2.7±0.96；P = 0.003）。
这些发现表明，多层聚氨酯泡沫敷料并不优于单独的标准预防性PI护理，应谨慎使用，尤其是在可能需要多次更换敷料的情况下。有必要进一步探索多层聚氨酯泡沫敷料在预防PI发生中的作用。
