Friction-Induced Skin Injuries—Are They Pressure Ulcers? An Updated NPUAP White Paper

Brienza, David M.; Antokal, Steven; Herbe, Laura; Logan, Susan K.; Maguire, Jeanine; Ranst, Jennifer Van; Siddiqui, Aamir

doi:10.1097/won.0000000000000102

Cited by 28 publications

(10 citation statements)

References 5 publications

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“…33,34 Authors of only one study 20 entered a shear-related variable into multivariate modeling; the study, which was of high quality, found that friction/shear (as defined by the Braden Scale) 35 was independently predictive of pressure injury development (Table 3). …”

Section: Resultsmentioning

confidence: 99%

Risk factors for pressure injuries among critical care patients: A systematic review

Alderden

Rondinelli

Pepper

et al. 2017

International Journal of Nursing Studies

200

156

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Objective To identify risk factors independently predictive of pressure injury (also known as pressure ulcer) development among critical-care patients Design We undertook a systematic review of primary research based on standardized criteria set forth by the Institute of Medicine. Data Sources We searched the following databases: CINAHL (EBSCOhost), the Cochrane Library (Wilson), Dissertations & Theses Global (ProQuest), PubMed (National Library of Medicine), and Scopus. There was no language restriction. Method A research librarian coordinated the search strategy. Articles that potentially met inclusion criteria were screened by two investigators. Among the articles that met selection criteria, one investigator extracted data and a second investigator reviewed the data for accuracy. Based on a literature search, we developed a tool for assessing study quality using a combination of currently available tools and expert input. We used the method developed by Coleman and colleagues in 2014 to generate evidence tables and a summary narrative synthesis by domain and subdomain. Results Of 1753 abstracts reviewed, 158 were identified as potentially eligible and 18 fulfilled eligibility criteria. Five studies were classified as high quality, two were moderate quality, nine were low quality, and two were of very low quality. Age, mobility/activity, perfusion, and vasopressor infusion emerged as important risk factors for pressure injury development, whereas results for risk categories that are theoretically important, including nutrition, and skin/pressure injury status, were mixed. Methodological limitations across studies limited the generalizability of the results, and future research is needed, particularly to evaluate risk conferred by altered nutrition and skin/pressure injury status, and to further elucidate the effects of perfusion-related variables. Conclusions Results underscore the importance of avoiding overinterpretation of a single study, and the importance of taking study quality into consideration when reviewing risk factors. Maximal pressure injury prevention efforts are particularly important among critical-care patients who are older, have altered mobility, experience poor perfusion, or who are receiving a vasopressor infusion.

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Section: Resultsmentioning

confidence: 99%

Risk factors for pressure injuries among critical care patients: A systematic review

Alderden

Rondinelli

Pepper

et al. 2017

International Journal of Nursing Studies

200

156

View full text Add to dashboard Cite

show abstract

“…33 Principal causes of PU are pressure, friction and shear, and the resulting sustained cell and tissue deformations, the e ects of which are exacerbated by moisture and temperature (Fig 1). 1,[34][35][36][37][38][39][40][41]…”

Section: Data From Intensive Care Settingsmentioning

confidence: 99%

Device-related pressure ulcers: SECURE prevention

et al. 2020

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“…Tissue ischaemia, with or without reperfusion injury, and cellular deformation caused by mechanical loading are the commonly accepted aetiological factors for pressure ulcer development . Furthermore, lymphatic dysfunction caused by compression or ischaemia likely contributes towards pressure ulcer development.…”

Section: Pathophysiology Of Pressure Ulcer Developmentmentioning

confidence: 99%

Subepidermal moisture (SEM) and bioimpedance: a literature review of a novel method for early detection of pressure‐induced tissue damage (pressure ulcers)

Moore

Patton

Rhodes

et al. 2016

International Wound Journal

101

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Current detection of pressure ulcers relies on visual and tactile changes at the skin surface, but physiological changes below the skin precede surface changes and have a significant impact on tissue health. Inflammatory and apoptotic/necrotic changes in the epidermal and dermal layers of the skin, such as changes in interstitial fluid (also known as subepidermal moisture (SEM)), may precede surface changes by 3-10 days. Those same epidermal and subepidermal changes result in changes in the electrical properties (bioimpedance) of the tissue, thereby presenting an objective, non-invasive method for assessing tissue damage. Clinical studies of bioimpedance for the detection of pressure ulcers have demonstrated that changes in bioimpedance correlate with increasing severity of pressure ulcer stages. Studies have also demonstrated that at anatomical locations with pressure ulcers, bioimpedance varies with distance from the centre of the pressure ulcers. The SEM Scanner, a handheld medical device, offers an objective and reliable method for the assessment of local bioimpedance, and therefore, assessment of tissue damage before signs become visible to the unaided eye. This literature review summarises pressure ulcer pathophysiology, principles of bioimpedance and clinical research using bioimpedance technology to assess pressure ulcers.

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Friction-Induced Skin Injuries—Are They Pressure Ulcers? An Updated NPUAP White Paper

Cited by 28 publications

References 5 publications

Risk factors for pressure injuries among critical care patients: A systematic review

Risk factors for pressure injuries among critical care patients: A systematic review

Device-related pressure ulcers: SECURE prevention

Subepidermal moisture (SEM) and bioimpedance: a literature review of a novel method for early detection of pressure‐induced tissue damage (pressure ulcers)

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