phenylephrine-hydrochloride and Pressure-Ulcer

3M microfoam™ surgical tape (3ST: 3M Japan Limited) is used for pressure wound control of medical equipment. It is cushioned and can be fitted to any body part. Here we investigated whether 3ST prevents nasal pressure injury associated with nasotracheal intubation (NTI).. We conducted a prospective, randomized double-blind study, enrolling 63 patients aged 20 to 70 years, who underwent general anesthesia with NTI. They were divided into 2 groups; those treated with 3ST (group S; n = 31) and control (group C; n = 31). After NTI and before securing the nasotracheal tube, a 35 × 25 mm 3ST was used to protect the nasal wing in group S, and the nasotracheal tube was fixed in place after NTI without protection in group C. The primary outcome was the presence or absence of nasal pressure injury after extubation. The Chi-Square test was used to assess the association between the 2 categorical variables.. Nasal pressure injury was observed in 7 and 19 patients from groups S and C, respectively, representing a significant difference between the 2 groups (24.1% vs 67.8%, P = .001). Remarkably, none of the patients developed ulcers.. 3ST prevents nasal pressure injury associated with NTI.

Topics: Double-Blind Method; Humans; Intubation, Intratracheal; Nose; Pressure Ulcer; Prospective Studies; Surgical Tape

Due to the prolonged use of face mask in noninvasive ventilation, pressure ulcer is a common complication. Pressure ulcer can occur within a few hours at the site where the mask contacts in 2-70% of cases.. The aim of this study is to conduct a randomized controlled trial to investigate the effects of transparent film use on the duration of pressure ulcer formation in the nasal region in patients undergoing noninvasive ventilation.. This study was a randomized controlled trial. 46 patients who met the sample selection criteria and agreed to participate in the study were included in the study at a university hospital in İzmir, Turkey. Of them, 25 were assigned to the intervention group and 21 to the control group. Data were collected using the Socio-demographic and Disease-related Characteristics Questionnaire, The Noninvasive Ventilation Parameters Monitoring Form, and The Pressure Ulcer Classification Form at 4-hour intervals.. The duration of pressure ulcer formation in intervention group was longer than that in control group, and the difference between them was statistically significant (P < 0.05).. In this study, the use of nasal protective film (transparent film) prolonged the duration of pressure ulcer formation on the nasal bridge in patients who underwent noninvasive mechanical ventilation.

Topics: Adult; Female; Humans; Male; Masks; Middle Aged; Noninvasive Ventilation; Nose; Pressure Ulcer; Respiratory Insufficiency; Surgical Tape; Turkey

Pressure ulcers related to oronasal masks used with noninvasive ventilation (NIV), along with patient discomfort, occur due to improper fit of the mask. We developed a personalized fitting device using a 3-dimensional (3D) scanning solution to prevent the formation of NIV mask-related pressure ulcers. This study aimed to evaluate the effectiveness of the proposed personalized fitting device.. We conducted a randomized crossover experimental study of 20 healthy participants to study the use of this personalized fitting device between the face and an NIV mask designed with 3D solutions. The fitting device was not used under the NIV mask for the control. The outcome measures were the presence of blanchable erythema, standardized redness intensity, discomfort level, and contact pressure.. The incidence of blanchable erythema and standardized redness intensity values were significantly lower for subjects who used the fitting device when worn for 30 min (. Personalized fitting devices that incorporate 3D scanning solutions may contribute to the prevention of NIV mask-related pressure ulcers and the reduction of discomfort.

Topics: Adult; Cheek; Cross-Over Studies; Equipment Design; Erythema; Female; Forehead; Humans; Imaging, Three-Dimensional; Male; Masks; Noninvasive Ventilation; Nose; Pain; Pressure; Pressure Ulcer; Printing, Three-Dimensional

The use of noninvasive ventilation masks is known to cause damage to facial skin tissue, which affects both the efficacy of the intervention and the patient's quality of life. The use of humidification with noninvasive ventilation is a common practice, but its relative role in the development of facial pressure ulcers has not been fully studied.. A crossover cohort design was used in this study, with 15 healthy volunteers. Each volunteer randomly received both 10 cm H. Humidified CPAP significantly increased transepidermal water loss (. These findings indicated that noninvasive ventilation with humidification had a potential disrupting effect on the barrier function of facial skin, associated with changes in skin microclimate and function. Further research is required to establish the cause of mask-related skin damage and to evaluate the effects of mask design, application techniques, and air flow and humidity settings.

Topics: Adult; Continuous Positive Airway Pressure; Cross-Over Studies; Face; Facial Dermatoses; Female; Healthy Volunteers; Humans; Humidity; Hydrogen-Ion Concentration; Interleukin-1alpha; Male; Masks; Noninvasive Ventilation; Nose; Organism Hydration Status; Pressure Ulcer; Quality of Life; Skin; Surgical Tape

In acute respiratory failure, non-invasive ventilation (NIV) treatment is used to prevent the need for intubation. NIV applied through a face mask may contribute to the development of facial skin lesions. This study was conducted to compare the efficacy of protective dressings and of using no materials for pressure ulcer prevention.. There were 90 participants in this study. The participants were assigned into three groups: control group, tegasorb group, and tegaderm group.. The tegasorb group and tegaderm group, in contrast to the control group, had fewer pressure ulcers based on our statistics and occurrence duration time (p<.01). However, there were no significant difference in occurrence duration time between the tegasorb group and tegaderm group.. This result revealed that tegasorb and tegaderm could be used on the face of NIV patients to prevent pressure ulcers.

Topics: Acute Disease; Aged; Analysis of Variance; Bandages, Hydrocolloid; Clinical Nursing Research; Critical Care; Female; Humans; Incidence; Male; Masks; Nose; Pressure Ulcer; Respiration, Artificial; Respiratory Insufficiency; Risk Factors; Skin Care; Taiwan; Time Factors; Treatment Outcome

Nasal intermittent positive pressure ventilation (NIPPV) can provide symptom control and improved quality of life for patients with acute and chronic respiratory failure. Many patients using a Respironics mask for NIPPV develop nasal bridge pressure sores. Two dressing were compared for effectiveness in preventing such sores. Patients using Granuflex had less skin deterioration over time compared to a comparison group and patients using Spenco Dermal.

Topics: Adult; Aged; Aged, 80 and over; Bandages; Female; Humans; Intermittent Positive-Pressure Ventilation; Male; Masks; Middle Aged; Nose; Pressure Ulcer

Noninvasive ventilation (NIV) has become the preferable modality of respiratory support for spontaneously breathing premature infants in the neonatal ICU (NICU). Whereas NIV support contributes to the prevention of long-term respiratory sequelae from mechanical ventilation, the nasal interfaces used are well known for placing patients at risk for development of NIV device-related pressure injuries (PIs). After implementing clinical practice guidelines promoting the use of sealing NIV interfaces for respiratory support in a level IV NICU, an increase in the frequency of stage 2 or worse and deep tissue injury (DTI) PI was observed. We hypothesized that the implementation of a multifaceted skin care bundle (SCB) would reduce the incidence of NIV device-related PI.. Quality improvement methodology was used to evaluate the impact of implementing an SCB for patients supported with NIV via a nasal interface. Incidence rate of stage 2 or worse and DTI PI was reported per 100 NIV days over 4 distinct time periods: (1) pre-NIV guideline, (2) post-NIV guideline, (3) post SCB, and (4) sustainability phase. Incidence comparisons were made using one-sided. The NICU experienced a notable rise in NIV device-related PI after implementation of NIV guidelines (0.01 vs 0.34 per 100 NIV days;. A collaborative and multidisciplinary team approach was used to promote engagement with clinical staff to address a preventable harm. The implementation of a multifaceted PI prevention bundle contributed to reducing harm while permitting the continued use of appropriate respiratory support to a highly vulnerable patient population in the NICU.

Topics: Humans; Infant; Infant, Newborn; Intensive Care Units, Neonatal; Noninvasive Ventilation; Nose; Pressure Ulcer; Respiration, Artificial; Respiratory Insufficiency

Topics: Bandages, Hydrocolloid; Coronavirus Infections; COVID-19; Humans; Masks; Nose; Pain; Pain Management; Pandemics; Pneumonia, Viral; Pressure; Pressure Ulcer

Topics: Adult; Betacoronavirus; Coronavirus Infections; COVID-19; Facial Injuries; Humans; Male; Nose; Occupational Injuries; Pandemics; Physicians; Pneumonia, Viral; Pressure Ulcer; Respiratory Protective Devices; SARS-CoV-2

Initial examination and exploration of childhood injuries may not lead to an obvious explanation of abuse. Although abusive oronasal injuries have been described, ones including nasal destruction are rare. We describe 4 children abused using implements that ultimately were thought to have caused significant nasal tissue destruction. In 2 of the cases, a forced pacifier placement was implicated in causing pressure injuries. In the other 2 cases, gags were part of the children's injuries. All 4 children had other findings of abuse and neglect.

Topics: Burns; Child Abuse; Child, Preschool; Ear, External; Female; Humans; Infant; Lip; Nose; Pacifiers; Pressure Ulcer

Topics: Humans; Intubation, Intratracheal; Nasal Cavity; Nose; Pressure Ulcer; Suction

Topics: Humans; Noninvasive Ventilation; Nose; Pressure Ulcer; Respiration, Artificial; Respiratory Insufficiency

Topics: Bandages, Hydrocolloid; Humans; Noninvasive Ventilation; Nose; Pressure Ulcer; Respiration, Artificial

Device-related pressure ulcers from noninvasive ventilation masks alter skin integrity and cause patients discomfort.. To examine the incidence, location, and stage of pressure ulcers and patients' comfort with a nasal-oral mask compared with a full-face mask.. A before-after study of a convenience sample of patients with noninvasive ventilation orders in 5 intensive care units was conducted. Two groups of 100 patients each received either the nasal-oral mask or the full-face mask. Skin was assessed before the mask was applied and every 12 hours after that or upon mask removal. Comfort levels were assessed every 12 hours on a Likert scale of 1 to 5 (1, most comfortable).. A pressure ulcer developed in 20% of patients in the nasal-oral mask group and 2% of patients in the full-face mask group (P < .001). Comfort scores were significantly lower (more comfortable) with the full-face mask (mean [SD], 1.9 [1.1]) than with the nasal-oral mask (mean [SD], 2.7 [1.2], P < .001). Neither mean hours worn nor percentage adherence differed significantly: 28.9 (SD, 27.2) hours and 92% for full-face mask and 25 (SD, 20.7) and 92% for nasal-oral mask. No patients who had a pressure ulcer develop with the nasal-oral mask had a pressure ulcer develop with the full-face mask.. The full-face mask resulted in significantly fewer pressure ulcers and was more comfortable for patients. The full-face mask is a reasonable alternative to traditional nasal-oral masks for patients receiving noninvasive ventilation.

Topics: Causality; Female; Humans; Incidence; Male; Masks; Middle Aged; Noninvasive Ventilation; Nose; Patient Satisfaction; Pressure Ulcer; Respiratory Insufficiency; Time Factors

Topics: Continuous Positive Airway Pressure; Humans; Infant, Newborn; Infant, Premature, Diseases; Male; Necrosis; Nose; Pressure Ulcer; Treatment Outcome

Topics: Aged; Aged, 80 and over; Bacterial Infections; Carrier State; Cross-Sectional Studies; Female; Humans; Long-Term Care; Male; Nose; Pressure Ulcer; Prevalence; Urine

Topics: Catheterization; Epistaxis; Humans; Necrosis; Nose; Nose Deformities, Acquired; Pressure Ulcer

Topics: Burns; Contracture; Ear; Extremities; Eyelids; Hand Injuries; Humans; Melanoma; Nose; Pressure Ulcer; Radiation Injuries; Surgery, Plastic; Wounds and Injuries

Topics: Bacteriological Techniques; Carrier State; Cross Infection; Humans; Nose; Pressure Ulcer; Staphylococcal Infections; Staphylococcus; Statistics as Topic; Surgical Wound Infection