Meta-analysis of patient-related factors of medical adhesive related skin injury in ICU

doi:10.3760/cma.j.issn.1007-1245.2022.02.031

Abstract

Abstract: Objective To investigate the patient-related factors of medical adhesive related skin injury (MARSI) in ICU. Methods The domestic and foreign literature database service systems were searched by the computer for literatures on the patient-related factors of MARSI in ICU, such as foreign PubMed, Web of Science, and ProQuest, and domestic CnKI, China Biomedical Literature Service System, Wanfang Data Paper Retrieval System, Baidu Academic, and VIP, from the establishment of the database to September 2020. Appropriate literatures were selected, the data of the literatures were extracted, and the quality evaluation was carried out. Meta-analysis was conducted by RevMan 5.3 and SPSS 22.0 software. The effect statistics of dichotomous variables were in the form of odds ratio (OR), weighted mean difference was selected for continuity variables, and 95% confidence interval (95%CI) was used for interval estimation. Results A total of 7 literatures with 2 967 patients were included, including 1 English article and 6 Chinese literatures, 6 experimental studies and 1 cross-sectional study. Meta-analysis results showed that age, body mass index (BMI), state of consciousness, fever, dry skin, skin moisture, skin edema, history of allergy, serum albumin level, low Barden /Waterlow score, and the score of Acute Physiology and Chronic Health Evaluation Scoring System (APACHE Ⅱ) higher than 10 points were all patient-related factors of MARSI in ICU (all P<0.01). Conclusion The incidence of MARSI in ICU is high, which is caused by a variety of factors. As internal factors of MARSI, patient-related factors need to be attached great importance to by medical staff.

Key words: Medical adhesive related skin injury, ICU, Patient-related factors; Meta-analysis

摘要： 目的探讨重症监护病房（ICU）医用粘胶相关性皮肤损伤（MARSI）的患者相关因素。方法使用计算机检索国内外文献数据库服务系统中关于ICU MARSI患者相关因素的文献，如国外的PubMed、Web of Science、ProQuest，国内的中国知网、中国生物医学文献服务系统、万方数据论文检索系统、百度学术、维普等，检索时间为建库至2020年9月。选取合适的文献并且对文献的数据进行提取及进行质量评价，并且使用RevMan 5.3和SPSS 22.0软件进行meta分析，二分类变量的效应统计量使用比值比（OR）的形式，连续性变量选择加权均数差，用 95% 可信区间（95%CI）进行区间估计。结果共纳入文献7篇，其中英文文献1篇、中文文献6篇，包含实验性研究6篇、横断面研究1篇，共纳入患者 2 967例。meta分析结果显示：年龄、体质量指数（BMI）、意识状态、发热、皮肤干燥、皮肤潮湿、皮肤水肿、过敏史、血清白蛋白水平、Barden/waterlow评分（Barden、waterlow为压疮风险评估量表）低、急性生理学及慢性健康状况评分系统Ⅱ（APACHE Ⅱ）评分高于10分均是ICU发生MARSI的患者相关因素（均P<0.01）。结论 ICU MARSI发生率高，由多种因素引起，患者相关因素作为发生MARSI的内在因素，需要引起医务人员的高度重视。

Pan Chunliu, Huang Zhihua. Meta-analysis of patient-related factors of medical adhesive related skin injury in ICU[J]. International Medicine and Health Guidance News, 2022, 28(2): 270-277.

潘春柳, 黄志华. ICU医用粘胶相关性皮肤损伤患者相关因素的meta分析[J]. 国际医药卫生导报, 2022, 28(2): 270-277.

References

[1] McNichol L, Lund C, Rosen T, et al. Medical adhesives and patient safety: state of the science: consensus statements for the assessment, prevention, and treatment of adhesive-related skin injuries[J]. J Wound Ostomy Conti Nurs, 2013, 40(4): 365-380. DOI: 10.1097/WON. 0b013e 3182995516.

[2] Mcnichol L, Lund C, Rosen T, et al. Medical adhesives and patient safety: state of the science: consensus statements for the assessment, prevention, and treatment of adhesive-related skin injuries[J]. Orthop Nurs, 2013, 32(5): 267-281. DOI: 10.1097/NOR.0b013e3182a39caf.

[3] Farris MK, Petty M, Hamilton J, et al. Medical adhesive-related skin injury prevalence among adult acute care patients: a single-center observational study [J]. J Wound Ostomy Continence Nurs, 2015, 42(6): 589-598. DOI: 10.1097/WON.0000000000000179.

[4] 黄小夏,张丽萍,陈艳,等 .新生儿医用粘胶剂相关性皮肤损伤风险评估量表的编制与信效度检验[J]. 中华护理杂志, 2019, 54(3): 380-384. DOI: 10.3761/j. issn. 0254-1769. 2019.03.010.

[5] Bauman KA, Hyzy RC. ICU 2020: five interventions to revolutionize quality of care in the ICU[J]. J Intensive Care Med, 2014, 29(1): 13-21. DOI: 10.1177/ 0885066611434399.

[6] 李海英 .成人 ICU患者医用黏胶相关性皮肤损伤危险因素分析及风险评估量表的研制[D].太原:山西医科大学,2018.

[7] Ofek Shlomai N, Rao S, Patole S. Efficacy of interventions to improve hand hygiene compliance in neonatal units: a systematic review and meta-analysis[J]. Eur J Clin Microbiol Infect Dis, 2015, 34(5): 887-897. DOI: 10.1007/ s10096-015-2313-1.

[8] Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses[J]. Eur J Epidemiol, 2010, 25(9): 603-605. DOI: 10.1007/s10654-010-9491-z.

[9] 胡雁 . 循证护理学 [M]. 北京 : 人民卫生出版社 , 2012: 83-89.

[10] 何娇波,尹志勤,楼志兰,等 . 综合性医院医用粘胶相关性皮肤损伤现状调查与影响因素分析[J]. 护理与康复, 2019,18(1): 1-4. DOI:10.3969/j.issn.1671-9875.2019.01.001.

[11] 李素玲,李雪莹,邓敏仪 . 医用粘胶相关性皮肤损伤影响因素分析及预防策略探究[J]. 现代诊断与治疗,2018, 29(10): 1660-1662. DOI: 10.3969/j.issn.1001-8174.2018.10.083.

[12] 王慧,孟晓芹,朱美意 . 血液科患者医用粘胶相关性皮肤损伤的现状及影响因素[J/CD]. 世界最新医学信息文摘(连续型电子期刊), 2019, 19(99): 5-7. DOI: 10.19613/j. cnki.1671-3141.2019.99.003.

[13] Farris MK, Petty M, Hamilton J, et al. Medical adhesive-related skin injury prevalence among adult acute care patients: a single-center observational study [J]. J Wound Ostomy Continence Nurs, 2015, 42(6): 589-598. DOI: 10.1097/WON.0000000000000179.

[14] 李海英,魏绍辉,李娟娟,等 . ICU 患者医用黏胶相关性皮肤损伤危险因素分析 [J]. 中国临床护理 , 2018, 10(6): 493-496, 501. DOI: 10.3969/j. issn. 1674-3768.2018. 06.009.

[15] 李保宁,郭锦丽. 儿童医用粘胶相关性皮肤损伤危险因素分析及预防措施[J]. 护理研究,2020, 34(5): 900-903. DOI: 10.12102/j.issn.1009-6493.2020.05.037.

[16] 吕娟,张雪梅,杨璐 . 老年患者发生医用黏胶相关性皮肤损伤的相关因素分析[J]. 华西医学,2016,31(6):1104-1107. DOI:10.7507/1002-0179.201600298.

[17] 王艳琼,宁宁,刘欢 . 医用胶粘剂相关性皮肤损伤研究的新进展 [J]. 中国实用护理杂志 , 2014, 30(36): 48-50. DOI: 10.3760/cma.j.issn.1672-7088.2014.36.015.

[18] 陈琛,陆巍,吴玲,等 . 医用粘胶剂相关性皮肤损伤文献的系统性回顾 [J]. 护理学杂志 , 2016, 31(20): 99-103. DOI: 10.3870/j.issn.1001-4152.2016.20.099.

[19] Cutting KF. Impact of adhesive surgical tape and wound dressings on the skin, with reference to skin stripping[J]. J Wound Care, 2008, 17(4): 157-158, 160-162. DOI: 10.12968/jowc.2008.17.4.28836.

[20] Gray M, Black JM, Baharestani MM, et al. Moisture-associated skin damage: overview and pathophysiology[J]. J Wound Ostomy Continence Nurs, 2011, 38(3): 233-241. DOI: 10.1097/WON. 0b013e 318215f798.

[21] Grove GL, Zerweck CR, Houser TP, et al. A randomized and controlled comparison of gentleness of 2 medical adhesive tapes in healthy human subjects[J]. J Wound Ostomy Continence Nurs, 2013, 40(1): 51-59. DOI: 10.1097/WON.0b013e318276f2a4.

[22] Schmid-Wendtner MH, Korting HC. The pH of the skin surface and its impact on the barrier function[J]. Skin Pharmacol Physiol, 2006, 19(6): 296-302. DOI: 10.1159/ 000094670.

[23] 郑兴珍.APACHE Ⅱ评分在临床应用的现状及进展[J].医学综述 , 2011, 17(21): 3297-3299. DOI: 10.3969/j. issn.1006-2084.2011.21.034.

[24] 陈洁茹, 陈伟燕,熊旭明. APACHE Ⅱ评分系统在综合ICU中的应用[J]. 广东医学,2013, 34(1): 86-89. DOI:10.3969/j. issn.1001-9448.2013.01.037.

[25] 辛明珠. 肿瘤外科病人发生医源性皮肤损伤的类型及预防 [J]. 护理研究 , 2005, 19(16): 1454-1455. DOI: 10.3969/j. issn.1009-6493.2005.16.021.