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- Differential diagnosis in pressure ulcers and medical devicesPublication . Alves, P.; Eberhardt, T.; Soares, R.; Pinto, M.; Pinto, C.; Vales, L.; Morais, J.; Oliveira, I.Background: Pressure ulcers (PU) are considered to an adverse event and constitute a constant challenge for all health professionals and institutions. Aim: Study the prevalence and incidence of PU in a intensive care unit (ICU) and the difficulties of classification and characterization of the lesions in critical ill patients. .Materials and methods: Retrospective cohort analysis of electronic health record database from adult patients admitted to a ICU during 2012/1013. Barriers/difficulty's to classification of PUs 'were also studied in the nursing staff. Results: Epidemiologic sample study included 600 participants, and differential diagnoses study 27 nurses. The episodes in the study period (n = 600), 98 'were identified with at least one PU present during hospitalization period, corresponding to a prevalence rate of 16.3%. The remaining 502 had no PU recording at entry or during hospitalization, 98 patients who were identified with PU, 40.8% presented it upon admission, and 59.2% developed ulceration in the service after 24 hours of admission (n = 58), which resulted in an incidence rate of 11.4%. The categorization of the PU ulcers identified in the present study, the most prevalent was category II (36,1%), followed by IV (35,4%), then I (13.1%) and III (10.8%). Regarding barriers of the differential diagnosis, 77.7% reported difficulty in evaluating PU in patients with peripheral arterial disease; 92.5% referred difficulty in evaluating Category I in dark skin; 81.5% referred subjectivity in the characterization in the mucosa; 40.7% reported difficulty PU associated to medical devices; 96.3% considered essential training as a way to reduce subjectivity. Conclusion: Extra attention needs to be taken to prevent PU in ICU. The incidence of PU is higher if associated with a medical device, Staff must adopt multiple strategies to prevent it. More education and sharing experiences is needed to reduce the subjectivity of differential diagnosis in PU.
- Prevention of pressure injury in the operating room: Heels operating room pressure injury trialPublication . Dresch Eberhardt, Thaís; Lima, Suzinara Beatriz Soares De; Soares, Rhea Silvia de Avila; Silveira, Lidiana Batista Teixeira Dutra; Pozzebon, Bruna Rossarola; Reis, Cassia Ribeiro; Paulino Santos, Karla Priscilla; Alves, Paulo Jorge PereiraThe objective was to evaluate the efficacy of multi-layered silicone foam (intervention) compared with transparent polyurethane film (control) in preventing heel pressure injuries caused by surgical positioning of individuals undergoing elective surgery. It was designed an intra-patient, open, parallel, randomised controlled trial was conducted in a university hospital in southern Brazil, from March 2019 to February 2020, with patients undergoing elective surgeries of cardiac and gastrointestinal specialties. The patients who met the selection criteria constituted, simultaneously, a single group receiving the intervention and active control, through paired analysis of the cutaneous sites (right heel and left heel). The outcome was the occurrence of PI, within the follow-up period was 72 hours. Brazilian Registry of Clinical Trials: RBR-5GKNG5. There was analysis of 135 patients/270 heels, with an overall incidence of 36.7%. The pressure injury incidence was significantly lower in the intervention group (26.7%), compared with the control group (P = .001); relative risk of 0.57. In the intervention group, the estimated pressure injury-free time (survival) was 57.5 hours and in the control group, 43.9 hours. It was concluded that Multi-layered silicone foam (intervention) is more efficacious than transparent polyurethane film (control) in the prevention of pressure injuries caused by surgical positioning of individuals undergoing elective surgery.
- Temperatura da pele de diferentes áreas corporais de idosos sem risco para lesões por pressãoPublication . Soares, Rhea Silvia de Avila; Lima, Suzinara Beatriz Soares de; Eberhardt, Thaís Dresch; Silveira, Lidiana Batista Teixeira Dutra; Pozzebon, Bruna Rossarola; Rodrigues, Liane Rocha; Alves, Paulo Jorge PereiraObjetivo: identificar a temperatura da pele de diferentes áreas corporais de idosos hospitalizados em unidade de clínica cirúrgica sem risco de desenvolver lesões por pressão a partir da Escala de Braden. Método: estudo correlacional descritivo, com corte transversal, realizado em unidade de clínica cirúrgica de um hospital universitário de maio a outubro de 2017, com 84 pacientes. Realizada análise estatística descritiva. Resultados: a região sacral apresentou média de temperatura mais alta e o calcâneo direito a mais baixa. Não há diferença na temperatura da pele entre os lados direito e esquerdo nas escápulas, trocânteres e calcâneo; entre os sexos e raças. Quando mensurada das 9:00 às 13:00h, a temperatura dos calcâneos foi menor do que quando mensurada das 13:01 às 17:00h na região dos calcâneos. Conclusão: a região sacral apresenta a média mais alta de temperatura da pele, em relação às áreas mensuradas. Há simetria entre os lados corporais.