比較傷口敷料處置於壓瘡預防之成效

A Comparison of the Efficacy of Different Wound Dressing Management Techniques in Preventing Pressure Ulcers

曹文昱(Wen-Yi Tsao) ； 羅淑芬(Shu-Fen Lo) ； 哈鐵木爾(Tomor Harmod) ； 李茹萍(Ru-Ping Lee)

《護理雜誌》 60卷4期 (2013/08) Pp. 65-75

https://doi.org/10.6224/JN.60.4.65

摘要

Background: Although high-technology wound dressings are widely used in clinical care worldwide, no evidence or discussions have been published regarding the efficacy of these dressings in preventing pressure ulcers.Purpose: This study presents a repositioning of routine management combined with hydrocolloid dressing or foam dressing for pressure ulcer prevention.Method: We used a quasi-experimental design and recruited a convenience sample of 90 from a surgical intensive care unit (SICU) at a medical center in Hualien County, Taiwan. Participants were allocated randomly to one of three groups: repositioning of routine management, hydrocolloid dressing, and foam dressing. Study instruments included a pressure ulcer risk table (Braden scale) and the pressure ulcer classification system of the European Pressure Ulcer Advisory Panel. An independent sample t-test, ANOVA, and Mann-Whitney U test were used to verify research hypotheses.Results: The repositioning of routine management group had the highest pressure ulcer incidence rate, followed by the hydrocolloid-dressing group. The foam-dressing group recorded no pressure ulcers. Pressure ulcer occurrence grades were primarily level 1 and 2. There was no significance difference in pressure ulcer occurrence time between the repositioning of routine-management group and the hydrocolloid-dressing group. Finally, there were significant differences (p＜ .05) among gender, hypertension history, and BMI regardless of pressure ulcer incidences.Conclusion: It is recommended that patients in high-risk groups in clinical settings adopt strategies including repositioning and regular visual skin examinations. Also, hydrocolloid or foam dressings may be used as appropriate to prevent sacral pressure ulcers.

關鍵字

加護病房 ； 預防 ； 壓瘡 ； 親水性敷料 ； 泡棉敷料

並列摘要

Background: Although high-technology wound dressings are widely used in clinical care worldwide, no evidence or discussions have been published regarding the efficacy of these dressings in preventing pressure ulcers.Purpose: This study presents a repositioning of routine management combined with hydrocolloid dressing or foam dressing for pressure ulcer prevention.Method: We used a quasi-experimental design and recruited a convenience sample of 90 from a surgical intensive care unit (SICU) at a medical center in Hualien County, Taiwan. Participants were allocated randomly to one of three groups: repositioning of routine management, hydrocolloid dressing, and foam dressing. Study instruments included a pressure ulcer risk table (Braden scale) and the pressure ulcer classification system of the European Pressure Ulcer Advisory Panel. An independent sample t-test, ANOVA, and Mann-Whitney U test were used to verify research hypotheses.Results: The repositioning of routine management group had the highest pressure ulcer incidence rate, followed by the hydrocolloid-dressing group. The foam-dressing group recorded no pressure ulcers. Pressure ulcer occurrence grades were primarily level 1 and 2. There was no significance difference in pressure ulcer occurrence time between the repositioning of routine-management group and the hydrocolloid-dressing group. Finally, there were significant differences (p＜ .05) among gender, hypertension history, and BMI regardless of pressure ulcer incidences.Conclusion: It is recommended that patients in high-risk groups in clinical settings adopt strategies including repositioning and regular visual skin examinations. Also, hydrocolloid or foam dressings may be used as appropriate to prevent sacral pressure ulcers.

並列關鍵字

intensive care unit ； prevention ； pressure ulcer ； hydrocolloid dressing ； foam dressing

參考文獻

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Chaiken, N. (2012). Reduction of sacral pressure ulcers in the intensive care unit using a silicone border foam dressing. Journal of Wound Ostomy and Continence Nursing, 39(2), 143－145. doi:10.1097/WON.0b013e318246400c