ISTAP classification for skin tears: Validation for Brazilian Portuguese

Abstract

The objective of this study was to evaluate interobserver reliability and the concurrent criterion validity of the adapted version of the International Skin Tear Advisory Panel (ISTAP) Skin Tear Classification System to Brazilian Portuguese. For the evaluation of interobserver reliability using the photograph database, 36 nurses classified 30 skin tears (STs) into three groups, according to its definitions (adapted version). For the evaluation through clinical application, 23 nurses classified 12 STs present in 8 thoracic and cardiovascular postoperative patients at a tertiary hospital in Sao Paulo, Brazil. For the data collection of patients, an enterostomal therapist nurse classified the ST found by simultaneously using the adapted ISTAP version and the Skin Tear Audit Research (STAR) Classification System to test the concurrent criterion validity. The average of 17.83 correct answers (SD = 5.03) resulted from 1080 photograph observations, with Fleiss κ = 0.279 (reasonable concordance level). The interobserver reliability in the clinical application resulted in a global correct answer percentage of 76.7% in 85 observations. The concurrent criterion validity was attested by the total correlation (r = 1) between ISTAP and STAR. The ISTAP classification for ST is a reliable instrument and also valid in Brazil, making it another option to be used in clinical practice.

Development of educational material for the prevention and treatment of friction injuries

“…The integument is the largest organ in the body, necessary for the survival of the human being and for the perfect physiological balance of the organism, being able to suffer aggressions by intrinsic and extrinsic pathological factors. These aggressions can cause changes in their constitution, such as burns, traumatic ulcers, dermatitis, friction injury (FI) and others, which can lead to the individual's functional disability and cause changes in their quality of life [1][2][3] .…”

“…The body topography most affected by the FI is the back of the hands, the arms, the elbows and the legs of elderly or very young people as neonates. The production of serous exudate, especially in the first 24 hours, makes the FI mostly moist [1][2][3][4] .…”

Desenvolvimento de um material educativo para a prevenção e o tratamento das lesões por fricção

“…O tegumento é o maior órgão do corpo, necessário para a sobrevivência do ser humano e para o equilíbrio perfeito fisiológico do organismo, podendo sofrer agressões por fatores patológicos intrínsecos e extrínsecos. Essas agressões podem causar modificações na sua constituição, como queimaduras, úlceras traumáticas, dermatite, lesão por fricção (LF) e outras, podendo levar à incapacidade funcional do indivíduo e provocar alterações na sua qualidade de vida [1][2][3] .…”

“…A topografia corporal mais é atingida pela LF é o dorso das mãos, os braços, os cotovelos e as pernas de pessoas idosas ou muito jovens como neonatos. A produção de exsudato seroso, especialmente nas primeiras 24 horas, torna as LF majoritariamente úmidas [1][2][3][4] .…”

“…Vários estudos relatam que 42% das LF estão localizadas nos cotovelos, 22% nas pernas e 13% nas mãos [1][2][3][4][5][6][7][8] .…”