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Management of incontinence-associated dermatitis patients using a skin protectant in acute care: a case series.

急症护理中使用皮肤保护剂治疗失禁相关性皮炎患者: 病例系列。

  • 影响因子:1.59
  • DOI:10.12968/jowc.2020.29.1.18
  • 作者列表:"Acton C","Ivins N","Bainbridge P","Browning P
  • 发表时间:2020-01-02
Abstract

OBJECTIVE:Incontinence-associated dermatitis (IAD) is a common type of irritant contact dermatitis. It is categorised by persistent erythema and can be associated with denudation and/or colonisation and infection. IAD is challenging to treat and affects 3.4-50% of patients. This case series evaluates a novel, elastomeric, advanced skin protectant (3M Cavilon Advanced Skin Protectant) in a UK acute health-care setting, for the management of IAD in patients suffering from moisture-associated skin damage (MASD) in the sacral/genital area. METHOD:The patient's skin was assessed by clinicians using the GLOBIAD classification tool at the point of recruitment and to monitor progress throughout the study period. The product was applied as a single layer in accordance with the instructions for use. Patients, when able, were asked to assess their own pain level using the Wong-Baker FACES pain scale. Photographs were taken as part of the ongoing assessment. RESULTS:The skin protectant was used on average every 2.28 days. Of the 18 IAD patients recruited, 79% (n=11) were classified as IAD-free, based on the GLOBIAD categorisation tool, by the end of the evaluation period. Skin deterioration during the evaluation period was seen in one patient (6%), and of the patients able to complete pain assessments, 55% (n=6) reported a reduction in pain. CONCLUSION:These results suggest that the elastomeric skin protectant, applied every three days, plays a role in the improvement of IAD. The skin protectant adheres to wet and weeping partial-thickness wounds and may aid IAD management. Reducing application to every third day supports a change in practice which may offer benefits to patients and caregivers.

摘要

目的: 失禁相关性皮炎 (IAD) 是一种常见的刺激性接触性皮炎。它被归类为持续性红斑,并可与剥蚀和/或定植和感染相关。IAD对治疗具有挑战性,并且影响3.4-50% 的患者。本病例系列评估了一种新型、弹性的高级皮肤保护剂 (3M Cavilon高级皮肤保护剂) 在英国急性卫生保健环境中的应用,用于治疗骶骨/生殖器区域水分相关皮肤损伤 (MASD) 患者的IAD。 方法: 临床医生在招募时使用GLOBIAD分类工具评估患者的皮肤,并在整个研究期间监测进展。根据使用说明将产品作为单层施用。当患者有能力时,被要求使用Wong-Baker FACES疼痛量表评估他们自己的疼痛水平。照片作为正在进行的评估的一部分。 结果: 皮肤保护剂平均每2.28天使用一次。在招募的18名IAD患者中,79% 名 (n = 11) 在评估期结束时根据GLOBIAD分类工具被分类为无IAD患者。在评估期间,在一名患者 (55%) 中观察到皮肤恶化,并且在能够完成疼痛评估的患者中,(n = 6) 报告疼痛减轻。 结论: 这些结果表明,每三天施用一次的弹性皮肤保护剂在IAD的改善中起作用。皮肤保护剂粘附在湿的和渗湿的部分厚度的伤口上,并可能有助于IAD管理。将应用减少到每三天支持实践中的改变,这可以为患者和护理人员提供益处。

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影响因子:1.46
发表时间:2020-01-01
来源期刊:The Journal of urology
DOI:10.1097/JU.0000000000000461
作者列表:["Lee J","Kim HY","Goh HJ","Heo JE","Almujalhem A","Alqahtani AA","Chung DY","Chang K","Choi YD","Rha KH"]

METHODS:PURPOSE:We compared early continence recovery after surgical treatment of prostate cancer with Retzius sparing robot-assisted radical prostatectomy and conventional robot-assisted radical prostatectomy. MATERIALS AND METHODS:Robot-assisted radical prostatectomy was done by a single surgeon in 1,863 cases between October 2005 and May 2018 using the conventional and the Retzius sparing technique in 1,150 and 713, respectively. To compare continence outcomes between the groups propensity score matching was performed using 9 preoperative variables, including age, body mass index, prostate specific antigen, biopsy Gleason Grade Group, clinical T stage, prostate volume on transrectal ultrasound, and the I-PSS (International Prostate Symptom Score), I-PSS quality of life score and International Index of Erectile Function-5 scores. Continence was assessed by the pad count every month postoperatively until month 6 and was converted to a binary outcome. RESULTS:After propensity score matching 609 cases per group were matched with no significant difference in all 9 variables. The Kaplan-Meier curve analysis revealed that Retzius sparing robot-assisted radical prostatectomy was associated with a significantly better continence recovery rate than conventional robot-assisted radical prostatectomy during the 6-month study period (p <0.001). CONCLUSIONS:Based on propensity score matching with multiple variables and a large case series, Retzius sparing robot-assisted radical prostatectomy can be a candidate for future robot-assisted radical prostatectomy. It achieves better early continence recovery, a short operative time and early recovery compared to conventional robot-assisted radical prostatectomy.

翻译标题与摘要 下载文献
影响因子:1.46
发表时间:2020-01-01
来源期刊:The Journal of urology
DOI:10.1097/JU.0000000000000458
作者列表:["McCrery R","Lane F","Benson K","Taylor C","Padron O","Blok B","De Wachter S","Pezzella A","Gruenenfelder J","Pakzad M","Perrouin-Verbe MA","Le Normand L","Van Kerrebroeck P","Mangel J","Peters K","Kennelly M","Shapiro A","Lee U","Comiter C","Mueller M","Goldman HB"]

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