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Journal of Tissue Viability May 2022This systematic review was carried out to examine pressure ulcers in healthcare staff due to the use of protective equipment during COVID-19 pandemic and the precautions... (Review)
Review
AIM
This systematic review was carried out to examine pressure ulcers in healthcare staff due to the use of protective equipment during COVID-19 pandemic and the precautions taken to prevent these injuries.
METHOD
Relevant studies were retrospectively searched. Seven English keywords identified from MESH were used while searching. The search was carried out in five international databases by trying various combinations of these words during February 15-25, 2021. This systematic review was updated by rescanning databases on December 20, 2021 and a total of 611 studies were attained.
RESULTS
17 studies which met the study inclusion criteria, which were conducted mostly through online survey method in different study designs and which included a total of 24,889 healthcare professionals were examined. The incidence of PPE-related pressure ulcers was found to be between 30% and 92.8%. Grade I pressure ulcers were the most common (44.1%-82%). The incidence of skin problems except PPE-related pressure ulcers such as itching, redness and dry skin was found to be between 42.8-88.1%. Risk factors that frequently played a role in the development of PPE-related pressure ulcers and other skin problems were longer use of PPE and sweating. PPE-related pressure ulcers and other skin problems were more frequent over the nose (nasal bone/nasal bridge), ears, forehead and cheeks. PPE-related itching, redness and dry skin mostly occurred. Several dressing applications were found to be effective in the prevention of PPE-related pressure ulcers and other skin problems that might develop especially on the facial region.
CONCLUSION
PPE-related pressure ulcers and other skin problems were found to be higher among healthcare professionals. Data regarding the sealing of dressing applications against viral transmission in the prevention of PPE-related pressure ulcers and other skin problems are limited. It is estimated that future studies will be performed to prevent device-related pressure ulcers in healthcare workers. It is suggested that there is a need to conduct studies with larger samples where expert researchers make observations for pressure ulcers in order to determine the prevalence and incidence of PPE-related pressure ulcers.
Topics: COVID-19; Health Personnel; Humans; Pandemics; Personal Protective Equipment; Pressure Ulcer; Pruritus; Retrospective Studies
PubMed: 35210162
DOI: 10.1016/j.jtv.2022.02.004 -
Nagoya Journal of Medical Science Feb 2023We conducted this systematic review to clarify the clinical characteristics, complications, and outcomes of surgical and non-surgical patients with fragility fracture of... (Review)
Review
We conducted this systematic review to clarify the clinical characteristics, complications, and outcomes of surgical and non-surgical patients with fragility fracture of the pelvis (FFP). We searched PubMed, Google Scholar, Cochrane Library, Web of Science, and MEDLINE for English language articles on FFP. We calculated pooled odds ratios (ORs) or mean differences (MDs) of surgical patients in comparison to non-surgical patients for clinical characteristics (Rommens FFP classification, age, sex, dementia, osteoporosis, diabetes mellitus, pulmonary disease, cardiovascular disease, and malignancy), complications (pneumonia, urinary tract infection, cardiac event, thrombosis, pulmonary embolism, pressure ulcer, multiple organ failure, anemia caused by surgical bleeding, and surgical site infection), and outcomes (hospital mortality and one-year mortality). Five studies involving 1,090 patients with FFP (surgical patients, 432; non-surgical patients, 658) were included. FFP type III and IV (OR = 8.44; 95% confidence interval [CI] 5.99 to 11.88; <0.00001), a younger age (MD = -3.29; 95% CI -3.83 to -2.75; 0.00001), the absence of dementia (OR = 0.36; 95% CI 0.23 to 0.57; <0.0001), and the presence of osteoporosis (OR = 1.74; 95% CI 1.29 to 2.35; = 0.0003) were significantly associated with the surgical patients. Urinary tract infection (OR = 2.06; 95% CI 1.37 to 3.10; = 0.0005), anemia caused by surgical bleeding (OR = 4.55; 95% CI 1.95 to 10.62; = 0.0005), and surgical site infection (OR = 16.74; 95% CI 3.05 to 91.87; = 0.001) were significantly associated with the surgical patients. There were no significant differences in the outcomes between the surgical and non-surgical patients. Our findings may help to further understand the treatment strategy for FFP and improve clinical outcomes.
Topics: Humans; Surgical Wound Infection; Fractures, Bone; Blood Loss, Surgical; Urinary Tract Infections; Osteoporosis; Dementia; Pelvis
PubMed: 36923634
DOI: 10.18999/nagjms.85.1.35 -
Journal of Clinical Medicine Nov 2020We aimed to comprehensively and systematically review studies associating key foot-loading factors (i.e., plantar pressure, weight-bearing activity, adherence or a... (Review)
Review
We aimed to comprehensively and systematically review studies associating key foot-loading factors (i.e., plantar pressure, weight-bearing activity, adherence or a combination thereof) with ulcer development and ulcer healing in people with diabetes. A systematic literature search was performed in PubMed and EMBASE. We included studies if barefoot or in-shoe plantar pressure, weight-bearing activity or footwear or device adherence was measured and associated with either ulcer development or ulcer healing in people with diabetes. Out of 1954 records, 36 studies were included and qualitatively analyzed. We found low to moderate quality evidence that lower barefoot plantar pressure and higher footwear and device adherence associate with lower risk of ulcer development and shorter healing times. For the other foot-loading factors, we found low quality evidence with limited or contradictory results. For combined measures of foot-loading factors, we found low quality evidence suggesting that lower cumulative plantar tissue stress is associated with lower risk of ulcer development and higher ulcer healing incidence. We conclude that evidence for barefoot plantar pressure and adherence in association with ulcer outcome is present, but is limited for the other foot-loading factors. More comprehensive investigation in particularly the combination of foot-loading factors may improve the evidence and targeting preventative treatment.
PubMed: 33171726
DOI: 10.3390/jcm9113591 -
Iranian Journal of Public Health Nov 2019We aimed to systematically evaluate the efficacy of high-voltage pulsed current (HVPC) in the treatment of pressure ulcer. (Review)
Review
BACKGROUND
We aimed to systematically evaluate the efficacy of high-voltage pulsed current (HVPC) in the treatment of pressure ulcer.
METHODS
We searched the databases of PubMed, Cochrane Library, Elsevier and EMBASE to identify randomized controlled studies on the application of HVPC in pressure ulcer treatment, up to January 2019. Two authors independently screened the literature according to the inclusion and exclusion criteria, extracted the data and evaluated the quality. RevMan 5.3 software was used for statistical analysis. Four randomized controlled trials involving a total of 176 patients were included in the study.
RESULTS
Meta-analysis showed that the percentage of wound area reduction in the HVPC treatment group was higher than that in the control group (95%CI 24.59, 47.76, <0.001). Descriptive analysis showed that there was no significant difference in wound healing between the HVPC treatment group and the control group. One study reported that there was contact dermatitis, and the rest of the studies reported no adverse events.
CONCLUSION
Compared with the conventional therapy, the combination with HVPC therapy can reduce the area of pressure ulcers more effectively. However, due to the small number of the studies included in this evaluation, the conclusions need to be verified by more high-quality studies.
PubMed: 31970093
DOI: No ID Found -
Heliyon Jul 2021Pressure ulcers (PU) are injuries to the skin and underlying tissue because of prolonged pressure. It affects millions of people in the world. One of the major nursing...
OBJECTIVE
Pressure ulcers (PU) are injuries to the skin and underlying tissue because of prolonged pressure. It affects millions of people in the world. One of the major nursing roles is to prevent patients from developing PU. Inadequate knowledge of nurses' toward PU can have a significant effect on preventive care strategies. Therefore, the aim of this meta-analysis study was to assess the overall level of nurses' knowledge about the prevention of pressure ulcers.
METHODS
A systemic review of primary research was undertaken and nurses' knowledge on pressure ulcer prevention was evaluated. All original cross-sectional studies conducted only in Ethiopia in the English language were included in this meta-analysis. After extraction, the data analysis was done using STATA version 11 statistical software. Based on heterogeneity between the studies, the data were analyzed using a random effects model.
RESULTS
In this systematic review and meta-analysis, all the studies on nurses' knowledge on the prevention of PU were reviewed based on the PRISMA statement. The overall knowledge of nurses' on pressure ulcer prevention was 46.24 % (95 % CI: 26.63-65.85).
CONCLUSION
The overall knowledge of nurses' on pressure ulcer prevention was low in this meta-analysis study. Sustainable training about the prevention of PU is very important for all nurses.
PubMed: 34381901
DOI: 10.1016/j.heliyon.2021.e07648 -
International Journal of Nursing... Apr 2023To evaluate the incidence of facial pressure injuries in health-care professionals during the COVID-19 pandemic in a meta-analysis. (Meta-Analysis)
Meta-Analysis Review
AIM
To evaluate the incidence of facial pressure injuries in health-care professionals during the COVID-19 pandemic in a meta-analysis.
METHODS
Related studies were obtained through electronic databases, including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI) Chinese Scientific Journal (VIP) China Biomedical Literature service systems (CBM) and Wanfang Data (from inception to 27 November 2021). The pooled incidence and the 95% confidence interval of facial pressure injuries were calculated with Review Manager v5.4 software.
RESULTS
Overall, 16 studies with 14 430 health-care professionals were included. Pooled results showed that the pooled incidence of facial pressure injury in health-care professionals was 58.8% (95% CI: 49.0%-68.7%; p < 0.01). The results of the subgroup analysis showed that the incidence of facial pressure injury in these staff was high, and predominantly stage I pressure injury, in the following cases: in health-care professionals who wore personal protective equipment for longer than 4 h, in those without any training experience, and on the nose.
CONCLUSION
Administrators and researchers should pay attention to preventing facial pressure injury related to the wearing of personal protective equipment (PPE) by ensuring all health-care professionals receive training and by limiting prolonged periods of use.
Topics: Humans; COVID-19; Pressure Ulcer; Pandemics; Incidence; Health Personnel
PubMed: 36535903
DOI: 10.1111/ijn.13125 -
Global Spine Journal Oct 2022Systematic review and meta-analysis. (Review)
Review
STUDY DESIGN
Systematic review and meta-analysis.
OBJECTIVE
To evaluate systematically the complications of prolonged cervical immobilisation in a hard collar.
METHODS
Following registration with PROSPERO, a systematic search of electronic databases (MEDLINE, EMBASE) was conducted. Two reviewers independently screened the search results according to pre-determined search criteria. Data was extracted and tabulated. Joanna Briggs Institute checklists were used for assessing the quality of included studies.
RESULTS
The search identified 773 articles. A total of 25 studies were selected for final inclusion. The results largely comprised a mixture of case reports/series, cohort studies and reviews. The most commonly reported complications were pressure ulcers, dysphagia and increased intracranial pressure. A pressure ulcer pooled prevalence of 7% was calculated. There was insufficient data for quantitative analysis of any other complication.
CONCLUSIONS
There is significant morbidity from prolonged hard collar immobilisation, even amongst younger patients. Whilst based upon limited and low-quality evidence, these findings, combined with the low-quality evidence for the efficacy of hard collars, highlights a knowledge gap for future research.
PubMed: 35333123
DOI: 10.1177/21925682221087194 -
International Wound Journal Mar 2023This systematic review aimed to examine skin hydration and determine if this biophysical parameter can predict pressure ulcer development in at risk adults. A literature... (Review)
Review
This systematic review aimed to examine skin hydration and determine if this biophysical parameter can predict pressure ulcer development in at risk adults. A literature search was conducted in March 2022, using PubMed, CINAHL, SCOPUS, Cochrane, and EMBASE databases. A total of 1727 records were returned, with 9 studies satisfying the inclusion criteria. Data were extracted using a pre-designed extraction tool and a narrative synthesis of the data was undertaken. The methodological quality of the included articles was assessed using the evidence-based librarianship checklist. Included studies were published between 1997 and 2021, with most using a prospective cohort design (88.9%, n = 8). The mean sample size was 74 participants (SD = 38.6; median 71). All studies measured skin hydration objectively, with 55.6% (n = 5) using the Corneometer® CM825 and 33.3% (n = 3) of studies reported a statistically significant association between skin hydration and pressure ulcer development. The mean evidence-based librarianship percentage was 66.6% (SD: 20.7%), however, only 33.3% (n = 3) of studies scored ≥75%, indicating validity. The quality of included studies, methodology variation, and reported results has reduced the homogeneity of outcomes. This review highlights the requirement for future research evidence to ascertain the role of skin hydration in pressure ulcer development.
Topics: Humans; Adult; Pressure Ulcer; Prospective Studies
PubMed: 35989452
DOI: 10.1111/iwj.13934 -
World Journal of Plastic Surgery Sep 2019Patients with spinal cord injury (SCI) tend to develop pressure ulcers (PrUs) because of prolonged immobility. This study assessed the efficacy of vacuum assisted... (Review)
Review
BACKGROUND
Patients with spinal cord injury (SCI) tend to develop pressure ulcers (PrUs) because of prolonged immobility. This study assessed the efficacy of vacuum assisted closure for healing of PrUs in individuals with SCI.
METHODS
In a systematic review, CINAHL, PubMed, Cochrane Clinical Trials, DARE, MEDLINE, Scopus, Embase, Science Direct, PsycInfo and Spinal Cord Journal were searched in March 2019. The search combined related terms for pressure ulcer, spinal cord injury, and vacuum assisted closure. Each database was searched from its inception with no restrictions on year of publication.
RESULTS
The search yielded 7 studies for inclusion in a qualitative analysis. The studies included a variety of methodologies, specifically 2 randomized controlled trials, 2 assessor-blinded crossover and retrospective cohort study, 1 prospective non-randomized trial, 1 randomized case study and 1 case report. The meta-analysis was unsuccessful. Only descriptive results mean±SD were reported as well as time to heal and time to discharge after admission.
CONCLUSION
The studies that we included in our qualitative synthesis showed that vacuum assisted closure promoted the healing of PrUs in individuals with SCI.
PubMed: 31620327
DOI: 10.29252/wjps.8.3.279 -
International Wound Journal Aug 2023Pressure injuries (PIs) are one of the major and costliest medical problems with severe implications for patients. Cardiovascular surgery patients are at the higher risk... (Meta-Analysis)
Meta-Analysis Review
Pressure injuries (PIs) are one of the major and costliest medical problems with severe implications for patients. Cardiovascular surgery patients are at the higher risk of developing surgery-related PIs. So this study was conducted with the aim of investigating the prevalence and factors associated with PIs in patients undergoing open heart surgery. We identified articles through electronic databases such as Web of Science, Scopus, PubMed, ProQuest; and Persian Databases: SID, Magiran and Irandoc without restriction on language or publication period (from inception through June 2022). Finally, 17 studies that fulfilled eligibility criteria were included in final systematic review and meta-analysis. Data analyses were conducted using STATA version 14. The pooled prevalence of PI in patients undergoing open heart surgery was 24.06% (95% CI: 17.85-30.27). High heterogeneity was observed across the included studies (I = 96.0, P < 0.000). The prevalence by gender was reported as 25.19% (95% CI: 13.45-36.93) in men and 33.36% (95 CI%: 19.99-46.74) in women. The result showed there was statistically significant association between PI and Female sex (Pooled Est: 1.551, 95% CI: 1.199-2.006, z = 3.345, P = 0.001), diabetes (Pooled Est: 1.985, 95% CI: 1.383-2.849, z = 3.719, P = 0.000), advanced age (SMD: 0.33 years; 95% CI: 0.09-0.57), Duration of surgery (SMD: 0.47; 95% CI: 0.19-0.75) and preoperative serum albumin level (SMD: 0.56; 95% CI: 0.14-0.98). The relatively high PIs incidence among patients undergoing open heart surgery suggests that typical PI prevention methods are insufficient for this population. Targeted prevention measures must be developed and implemented.
Topics: Male; Humans; Female; Infant; Pressure Ulcer; Prevalence; Cardiac Surgical Procedures; Incidence
PubMed: 36447333
DOI: 10.1111/iwj.14040