Ping Hou, MM, RN, Division of Basic & Clinical Medicine, Faculty of Nursing, Nagano College of Nursing, Komagane, Japan; and School of Nursing and School of Public Health, Yangzhou University, Yangzhou, China.
Lu Chen, MM, RN, Division of Basic & Clinical Medicine, Faculty of Nursing, Nagano College of Nursing, Komagane, Japan; and Department of Anesthesiology, the Affiliated Hospital of Yangzhou University, Yangzhou, China.
J Wound Ostomy Continence Nurs. 2024;51(1):32-38. doi: 10.1097/WON.0000000000001043.
The aim of this study was to identify the most meaningful diagnostic indicator for distinguishing blanchable erythema (BE) and stage 1 pressure injury (early PI) in an in vivo (rat) model.
A prospective case-control design was used to complete a horizontal and vertical comparison of detection indicators during the process of fading of BE or the deterioration of early PI into ulcer in rat models.
The sample comprised 5 hairless rats with 20 injuries, of which 10 were BE and the other 10 were early PI. Data were collected at Nagano College of Nursing in 2020 in Nagano, Japan.
The BE and PI rat models were established by subjecting the dorsal skin of a hairless rat to compression between 2 neodymium magnets for 45 minutes and 3.45 hours, respectively. The affected skin was observed based on the following: (1) photography, (2) hardness, (3) temperature, (4) moisture, and (5) spectrophotometric (a* value and ultraviolet [UV] reflectance) measurements. All measurements of BE were performed at the beginning to 60 minutes after decompression, and those for early PI were performed until 48 hours after decompression.
Multiple BE factors, such as the degree of erythema (macroscopy and a* value), hardness, temperature, and moisture, were found to have unstable fluctuations. Only UV reflectance gradually decreased from 6 hours and decreased significantly at 48 hours after decompression (P = .001 vs 1 hour). In contrast to early PI, erythema in BE obviously faded within 10 minutes.
Study findings indicate that a continuous decrease in UV reflectance can reflect the worsening of hemorrhage in early (stage 1) PI. In contrast, other indicators including photography, skin hardness, temperature, and moisture fluctuated and did not prove predictive for PI progression. The obvious fading of erythema in BE a short time after decompression can be used for clinical observations.
本研究旨在确定一种最有意义的诊断指标，用于区分活体（大鼠）模型中的可褪色红斑（BE）和 1 期压力性损伤（早期 PI）。
采用前瞻性病例对照设计，对 BE 褪色或早期 PI 恶化成溃疡过程中的检测指标进行横向和纵向比较。
样本包括 5 只无毛大鼠，共 20 处损伤，其中 10 处为 BE，10 处为早期 PI。数据于 2020 年在日本长野县长野市的长野护理学院收集。
通过将 2 块钕磁铁分别置于无毛大鼠背部皮肤 45 分钟和 3.45 小时，分别建立 BE 和 PI 大鼠模型。根据以下指标观察受影响的皮肤：（1）摄影，（2）硬度，（3）温度，（4）湿度，和（5）分光光度法（a*值和紫外线[UV]反射率）测量。所有 BE 的测量均在减压后 60 分钟内进行，而早期 PI 的测量则在减压后 48 小时内进行。
多项 BE 因素，如红斑程度（肉眼观察和 a*值）、硬度、温度和湿度，均发现存在不稳定波动。只有 UV 反射率从 6 小时开始逐渐下降，减压后 48 小时明显下降（P=0.001 与 1 小时）。与早期 PI 不同，BE 中的红斑在 10 分钟内明显褪色。
研究结果表明，UV 反射率的持续下降可以反映早期（1 期）PI 中出血的恶化。相比之下，其他指标，包括摄影、皮肤硬度、温度和湿度波动，并未证明对 PI 进展具有预测性。BE 中红斑在减压后短时间内明显褪色可用于临床观察。
