Defa Arisandi1,2, Kazuhiro Ogai3, Tamae Urai4, Miku Aoki1, Takeo Minematsu4,5, Shigefumi Okamoto3,6, Hiromi Sanada4,7, Toshio Nakatani1, Junko Sugama8. 1. Department of Clinical Nursing, Division of Health Sciences, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan. 2. Kitamura Wound Care Clinic Pontianak, West Borneo, Indonesia. 3. Wellness Promotion Science Center, College of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan. 4. Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. 5. Department of Skincare Science, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. 6. Department of Laboratory Sciences, Division of Health Sciences, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan. 7. Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. 8. Advanced Health Care Science Research Unit, Innovative Integrated Bio-Research Core, Institute for Frontier Science Initiative, Kanazawa University, Kanazawa, Japan.
Abstract
OBJECTIVE: Prevention of recurrent pressure ulcers (PU) is one of the most important challenges in wound care, furthermore, the risk factors for recurrent PUs are still not fully understood. This study aimed to explore the risk factors for recurrent PU development within two weeks, including biophysical skin properties, pro-inflammatory cytokine (tumour necrosis factor [TNF]-α) levels and bacterial species, in older patients. METHOD: This prospective study was conducted in a long-term care facility with patients whose PU had healed within two months. Biophysical skin properties were evaluated by stratum corneum hydration, pH, sebum content and transepidermal water loss. TNF-α level was measured using skin blotting. Skin bacteria were collected using tape stripping and determined by species-specific gene amplification. These parameters, along with Braden scale and interface pressure, were evaluated every two weeks for a total period of eight weeks. A penalised generalised estimating equation analysis was used to determine the risk factors for recurrent PUs. RESULTS: In total, 20 patients were included in this study, with 57 observations. Of these, recurrent PU was seen in eight observations. Elevation of pH (p=0.049; odds ratio [OR] per 1 unit=3.91, 95% confidence interval [CI]:1.01-15.15), presence of Acinetobacter spp. (p=0.039; OR versus culture-negative=6.28, 95%CI:1.10-35.86) and higher interface pressure (p=0.008; OR per 1 mmHg=1.06, 95%CI:1.01-1.10) on the healed PU were significantly related to the development of recurrent PU. CONCLUSION: Higher pH, existence of Acinetobacter spp. and higher interface pressure on the site of the healed PU were associated with the development of recurrent PUs in older patients undergoing conservative treatments.
OBJECTIVE: Prevention of recurrent pressure ulcers (PU) is one of the most important challenges in wound care, furthermore, the risk factors for recurrent PUs are still not fully understood. This study aimed to explore the risk factors for recurrent PU development within two weeks, including biophysical skin properties, pro-inflammatory cytokine (tumour necrosis factor [TNF]-α) levels and bacterial species, in older patients. METHOD: This prospective study was conducted in a long-term care facility with patients whose PU had healed within two months. Biophysical skin properties were evaluated by stratum corneum hydration, pH, sebum content and transepidermal water loss. TNF-α level was measured using skin blotting. Skin bacteria were collected using tape stripping and determined by species-specific gene amplification. These parameters, along with Braden scale and interface pressure, were evaluated every two weeks for a total period of eight weeks. A penalised generalised estimating equation analysis was used to determine the risk factors for recurrent PUs. RESULTS: In total, 20 patients were included in this study, with 57 observations. Of these, recurrent PU was seen in eight observations. Elevation of pH (p=0.049; odds ratio [OR] per 1 unit=3.91, 95% confidence interval [CI]:1.01-15.15), presence of Acinetobacter spp. (p=0.039; OR versus culture-negative=6.28, 95%CI:1.10-35.86) and higher interface pressure (p=0.008; OR per 1 mmHg=1.06, 95%CI:1.01-1.10) on the healed PU were significantly related to the development of recurrent PU. CONCLUSION: Higher pH, existence of Acinetobacter spp. and higher interface pressure on the site of the healed PU were associated with the development of recurrent PUs in older patients undergoing conservative treatments.
Authors: N Jannah M Nasir; Alberto Corrias; Hans Heemskerk; Eng Tat Ang; Julia H Jenkins; S J Sebastin; Lisa Tucker-Kellogg Journal: J R Soc Interface Date: 2022-02-23 Impact factor: 4.118
Authors: Guy H M Stanley; Katie Wang; Patrick Daly; Christopher Lau; Aoife M O'Brien; Cheryl Hamill; Mark Fear; Fiona M Wood Journal: Wound Repair Regen Date: 2022-06-17 Impact factor: 3.401