Prediction of pressure ulcer deterioration focused on persistent erythema, and development and evaluation of a new protective skin dressing

• Project/Area Number: 16390637
• Research Category: Grant-in-Aid for Scientific Research (B)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Clinical nursing
• Research Institution: The University of Tokyo
• Principal Investigator: SANADA Hiromi The University of Tokyo, Graduate School of Medicine, Professor, 大学院・医学系研究科, 教授 (50143920)
• Co-Investigator(Kenkyū-buntansha): SUGAMA Junko Kanazawa University, Graduate School of Medicine, Professor, 大学院・医学系研究科, 教授 (00203307) ; KONYA Chizuko Kanazawa University, Graduate School of Medicine, Associate Professor, 大学院・医学系研究科, 助教授 (20303282) ; OKUWA Mayumi Kanazawa University, Graduate School of Medicine, Research Associate, 大学院・医学系研究科, 助手 (30303291) ; KITAGAWA Atsuko The University of Tokyo, Graduate School of Medicine, Research Associate, 大学院・医学系研究科, 助手 (80343185)
• Project Period (FY): 2004 – 2006
• Project Status: Completed (Fiscal Year 2006)
• Budget Amount: ¥14,000,000 (Direct Cost: ¥14,000,000); Fiscal Year 2006: ¥3,900,000 (Direct Cost: ¥3,900,000); Fiscal Year 2005: ¥3,600,000 (Direct Cost: ¥3,600,000); Fiscal Year 2004: ¥6,500,000 (Direct Cost: ¥6,500,000)
• Keywords: pressure ulcer / persistent erythema / nursing / elderly / bed-ridden / nursing science and engineering / nursing technology / アセスメント / 転帰 / 予測

Research Abstract

The final study of this project is an evaluation of the effectiveness of a newly-developed dressing for preventing persistent erythema and pressure ulcer development and improving the skin water-holding capacity without increasing the skin pH in bedridden older patients. Shear forces and skin dryness play important roles in persistent erythema and pressure ulcer development. To eliminate these risks, we developed a dressing to reduce shear forces and improve the water-holding capacity. However, the effects of this dressing in clinical settings remain unknown. An experimental bilateral comparison study was conducted at a hospital in Japan in 2004 with 37 bedridden older patients at risk of pressure ulcer development. The dressing was randomly applied to the right or left greater trochanter for three weeks. No dressing was applied to the opposite side as a control. The skin was monitored weekly during the three-week application for persistent erythema and pressure ulcer development. Skin hydration and pH were also assessed during the intervention and for one week after dressing removal. The incidence of persistent erythema was significantly lower in the intervention area than the control area [P=0.007, RR 0.18 (95% C: 0.05-0.73) and NNT 4.11 (2.50-11.63)]. No pressure ulcers occurred in either intervention or control area. Skin hydration increased significantly during dressing application and remained high after removal (P<0.001) relative to the control area. Skin pH decreased significantly during the application (P<0.001) but returned to control levels after removal (P=0.38). This safe and effective dressing can be used for patients with highly prominent bones and dry skin to prevent pressure ulcers.

Research Products

• [Journal Article] Prognosis of stage I pressure ulcers and related factors. (2006)
  • Author(s): Sato M, Sanada H, Konya C, Sugama J, Nakagami G
  • Journal Title: Int Wound J. 3・4 Pages: 355-362
  • Description: 「研究成果報告書概要(和文)」より
• [Journal Article] Incontinence induces stratum corneum vulnerability and impairs the skin barrier function in the perianal region. (2006)
  • Author(s): Nakagami, G., Sanada, H., Kitagawa, A., Tadaka, E., Maekawa, T., Nagase, T., Konya, C.
  • Journal Title: Dermatology 213・4 Pages: 293-299
  • Description: 「研究成果報告書概要(和文)」より
• [Journal Article] Comparison of two pressure ulcer preventive dressings for reducing shear force on the heel. (2006)
  • Author(s): Nakagami, G., Sanada, H., Konya, C., Kitagawa, A., Tadaka, E., Tabata, K.
  • Journal Title: J Wound Ostomy Continence Nurs 33・3 Pages: 267-272
  • Description: 「研究成果報告書概要(和文)」より
• [Journal Article] Prognosis of stage I pressure ulcers and related factors. (2006)
  • Author(s): Sato M, Sanada H, Konya C, Sugama J, Nakagami G.
  • Journal Title: Int Wound J. 3(4) Pages: 355-362
  • Description: 「研究成果報告書概要(欧文)」より
• [Journal Article] Incontinence induces stratum corneum vulnerability and impairs the skin barrier function in the perianal region. (2006)
  • Author(s): Nakagami, G., Sanada, H., Kitagawa, A., Tadaka, E., Maekawa, T., Nagase, T., Konya, C.
  • Journal Title: Dermatology 213(4) Pages: 293-299
  • Description: 「研究成果報告書概要(欧文)」より
• [Journal Article] Comparison of two pressure ulcer preventive dressings for reducing shear force on the heel. (2006)
  • Author(s): Nakagami, G., Sanada, H., Konya, C., Kitagawa, A., Tadaka, E., Tabata, K.
  • Journal Title: Wound Ostomy Continence Nurs 33(3) Pages: 267-272
  • Description: 「研究成果報告書概要(欧文)」より
• [Journal Article] Prognosis of stage I pressure ulcers and related factors. (2006)
  • Author(s): Sato M, Sanada H, Konya C, Sugama J, Nakagami G.
  • Journal Title: Int Wound J. 3・4 Pages: 355-362
• [Journal Article] Incontinence induces stratum corneum vulnerability and impairs the skin barrier function in the perianal region. (2006)
  • Author(s): Nakagami, G., Sanada, H., Kitagawa, A., Tadaka, E., Maekawa, T., Nagase,.T, konya,C.
  • Journal Title: Dermatology 231・4 Pages: 293-299
• [Journal Article] Comparison of two pressure ulcer preventive dressings for reducing shear force on the heel. (2006)
  • Author(s): Nakagami, G., Sanada, H., Konya, C., Kitagawa, A., Tadaka, E., Tabata,K.
  • Journal Title: J Wound Ostomy Continence Nurs 33・3 Pages: 267-272
• [Journal Article] 新しい褥瘡予防用保護材の皮膚バリア機能回復効果とずれ力軽減効果に関する研究 (2005)
  • Author(s): 仲上 豪二朗
  • Journal Title: 日本褥瘡学会誌 7・1 Pages: 107-114