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预防性敷料对普通外科非危重症患者骶尾部压疮的影响:一项随机对照试验。

Effect of a prophylactic dressing for sacral pressure injuries in non-critically ill patients after general surgery: A randomized controlled trial.

机构信息

Department of Nursing, Asan Medical Center, Seoul, South Korea.

Department of Nursing, Chung-Ang University, Seoul, South Korea.

出版信息

Worldviews Evid Based Nurs. 2023 Jun;20(3):259-268. doi: 10.1111/wvn.12651. Epub 2023 May 14.

Abstract

BACKGROUND

Hospital-acquired pressure injuries are strongly associated with surgeries performed under general anesthesia.

AIMS

The aim of this study was to evaluate the effects of using a prophylactic multi-layer soft silicone foam dressing in non-critically ill patients with a Braden Scale score of ≤18 after undergoing routine surgery without sacral pressure injuries.

METHODS

This randomized controlled trial included 156 patients who were admitted for surgery under general anesthesia in a tertiary general hospital. The patients were divided into a control group and an intervention group. A 5-layer soft silicone foam dressing was applied to the sacrum of patients in the intervention group immediately after surgery. For the control group, standard pressure injury prevention activities were performed alongside standard care without preventive dressings.

RESULTS

There were no significant differences in general and clinical characteristics between the two groups; however, the incidence of pressure injury and blanching erythema was higher in the control group, showing a significant difference from the experimental group. Factors influencing the development of pressure injuries and blanching erythema through multivariate regression analysis were prophylactic dressing application and Braden Scale score at the time of admission. A statistically significant difference was noted in survival time from pressure injury between both groups.

LINKING EVIDENCE TO ACTION

The incidence of pressure injuries and blanching erythema was lower when the prophylactic dressing was applied with standard protocol for general ward patients after surgery. Accurate evaluation of the patient's skin condition and pressure injury risk assessment before surgery are important. Progressive prophylactic dressings to prevent pressure injuries are effective, and tailored nursing interventions based on accurate assessment of patient's skin condition and risk factors are essential for maintaining skin integrity.

摘要

背景

医院获得性压力损伤与全身麻醉下进行的手术密切相关。

目的

本研究旨在评估在常规手术且无骶尾部压力损伤的情况下,对 Braden 量表评分为≤18 的非危重症全麻术后患者使用预防性多层软硅胶泡沫敷料的效果。

方法

这是一项随机对照试验,纳入了 156 名在三级综合医院接受全身麻醉下手术的患者。患者分为对照组和干预组。干预组患者术后立即在骶骨上使用 5 层软硅胶泡沫敷料。对照组则在标准护理的基础上进行标准压疮预防活动,不使用预防性敷料。

结果

两组患者的一般和临床特征无显著差异,但对照组的压疮和苍白红斑发生率较高,与实验组有显著差异。通过多变量回归分析,影响压疮和苍白红斑发生的因素为预防性敷料的应用和入院时的 Braden 量表评分。两组患者的压力性损伤生存时间有统计学差异。

实践转化

术后对普通病房患者按标准方案应用预防性敷料可降低压疮和苍白红斑的发生率。术前准确评估患者的皮肤状况和压疮风险评估非常重要。预防性使用渐进性敷料来预防压疮是有效的,根据患者皮肤状况和风险因素的准确评估制定个性化护理干预措施对于维持皮肤完整性至关重要。

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