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旋转腿部预处理仪对降低心脏手术患者压力性损伤及预防手术部位感染的有效性:配对匹配随机对照试验

Effectiveness of a Rotating-Leg Prepper for Reducing Pressure Injury and Preventing Surgical Site Infection in Patients Undergoing Heart Surgery: Paired Matching Randomised Controlled Trial.

作者信息

Chiannilkulchai Natthacha, Pichaiphanupatt Pimnada

机构信息

Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Division of Perioperative Nursing, Department of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

出版信息

Int Wound J. 2025 Apr;22(4):e70371. doi: 10.1111/iwj.70371.

DOI:10.1111/iwj.70371
PMID:40240308
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12003049/
Abstract

This study aims to evaluate the effectiveness of a rotating-leg prepper (intervention) compared with a rolled gauze bandage (control) in reducing pressure injury and preventing surgical site infection in the legs of patients undergoing heart surgery. The paired-matched, open, randomised controlled trial was conducted from September 2022 to July 2024. The participants were composed of the patient and the staff groups. Sixty patients were paired-matched to the intervention and control groups. Before painting the resting area with an antiseptic, the ankle presented non-blanchable erythema, which was recorded as a pressure injury. The intervention group showed significantly lower pressure injury (0% vs. 76.6%, p = 0.001) than the control group, with a relative risk of 5.29 (95% CI: 2.71-10.30). Both groups exhibited no significant difference in surgical site infection. However, the relative risk of surgical site infection in the control group was 2.03 (95% CI: 1.57-2.64). Thirty staff participants were purposively sampled to evaluate the effects of both leg lifting methods and assess their satisfaction with the leg prepper. The overall satisfaction with the rotating-leg prepper was 4.87 ± 0.22. Rotating-leg preppers can reduce pressure injury and prevent surgical site infections in patients' legs during heart surgery.

摘要

本研究旨在评估旋转腿部准备器(干预措施)与卷状纱布绷带(对照)相比,在降低心脏手术患者腿部压力性损伤及预防手术部位感染方面的有效性。配对匹配、开放性随机对照试验于2022年9月至2024年7月进行。参与者包括患者组和工作人员组。60名患者被配对匹配到干预组和对照组。在用消毒剂涂抹休息区域之前,脚踝出现了非压之褪色红斑,被记录为压力性损伤。干预组的压力性损伤显著低于对照组(0%对76.6%,p = 0.001),相对风险为5.29(95%CI:2.71 - 10.30)。两组在手术部位感染方面无显著差异。然而,对照组手术部位感染的相对风险为2.03(95%CI:1.57 - 2.64)。有目的地抽取了30名工作人员参与者,以评估两种腿部抬起方法的效果并评估他们对腿部准备器的满意度。对旋转腿部准备器的总体满意度为4.87±0.22。旋转腿部准备器可降低心脏手术期间患者腿部的压力性损伤并预防手术部位感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0102/12003049/04b4537b5c48/IWJ-22-e70371-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0102/12003049/9076fe59a714/IWJ-22-e70371-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0102/12003049/bb92cd06d7eb/IWJ-22-e70371-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0102/12003049/04b4537b5c48/IWJ-22-e70371-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0102/12003049/9076fe59a714/IWJ-22-e70371-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0102/12003049/bb92cd06d7eb/IWJ-22-e70371-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0102/12003049/04b4537b5c48/IWJ-22-e70371-g001.jpg

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Int Wound J. 2024 Dec;21(12):e70074. doi: 10.1111/iwj.70074.
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Clinical nurses' attitudes towards medical device-related pressure injuries and an analysis of relevant influencing factors: A cross-sectional study in China.临床护士对医疗器械相关压力性损伤的态度及相关影响因素分析:中国的一项横断面研究。
Int Wound J. 2024 Nov;21(11):e70093. doi: 10.1111/iwj.70093.
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The pressure injury prevalence and practice improvements (PIPPI) study: A multiple methods evaluation of pressure injury prevention practices in an acute-care hospital.
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Int Wound J. 2024 Oct;21(10):e70050. doi: 10.1111/iwj.70050.
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A randomised controlled phase II trial to examine the feasibility of using hyper-oxygenated fatty acids (HOFA) to prevent facial pressure injuries from medical devices among adults admitted to intensive care-A research protocol.一项随机对照二期临床试验,旨在检验使用高氧脂肪酸(HOFA)预防重症监护病房成人因医疗设备导致面部压疮的可行性:研究方案。
Int Wound J. 2024 Oct;21(10):e70069. doi: 10.1111/iwj.70069.
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Risk factors for infection at the saphenous vein harvest site after coronary artery bypass grafting surgery: a retrospective cohort study.冠状动脉旁路移植术后隐静脉采集部位感染的危险因素:一项回顾性队列研究。
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