Incidence of Medical Adhesive-Related Skin Injuries and Associated Factors After Pediatric Congenital Heart Surgery A Prospective Cohort Study
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Citações na Scopus
3
Tipo de produção
article
Data de publicação
2022
Título da Revista
ISSN da Revista
Título do Volume
Editora
LIPPINCOTT WILLIAMS & WILKINS
Autores
AMARAL, Daniela Reuter do
FERRETTI-REBUSTINI, Renata Eloah de Lucena
Citação
JOURNAL OF WOUND OSTOMY AND CONTINENCE NURSING, v.49, n.2, p.137-142, 2022
Resumo
PURPOSE: The aim of this study was to identify the incidence, characteristics, and factors associated with medical adhesive-related skin injuries (MARSI). DESIGN: Prospective cohort study. SUBJECTS AND SETTINGS: The sample comprised 136 children in the postoperative period after congenital heart surgery. The study setting was in a 31-bed pediatric surgical intensive care unit (ICU) of a university hospital in Sao Paulo, Brazil. METHODS: Patients were followed from admission, with daily skin assessments, until the onset of MARSI or ICU discharge. Outcomes were compared by Fisher's exact test, Pearson's chi(2) test, Mann-Whitney test, Brunner-Munzel test, and Welch 2-sample t test. RESULTS: The incidence of MARSI was 60.3%, with 85 injuries in 82 patients. The highest occurrence was on postoperative day 2 (27 wounds; 31.8%). The most frequent medical adhesive associated with MARSI was transparent film dressing (n = 74; 86.6%). Factors associated with MARSI were age (P = .000), number of devices inserted (P = .000), Braden Q Scale score (P = .005), duration of surgery (P = .021), cardiopulmonary bypass duration (P = .000), duration of mechanical ventilation (P = .000), and length of ICU stay (P = .000). Children who developed MARSI received more blood components (P = .039), vasopressors (P = .000), and corticosteroids (P = 0.000); required longer sedation (P = .000); and had more edema (P = .001). CONCLUSION: This high incidence indicates the need for greater awareness and prompt action in response to MARSI. Polyurethane transparent film without concurrent use of a skin barrier product should be avoided.
Palavras-chave
Adhesives, Critical care nursing, Dressings, Intensive care units, Pediatric, Risk factors, Skin care, Skin injuries, Skin tears
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