Lesions requiring wound management in a central tertiary neonatal intensive care unit

Meszes, Angéla; Tálosi, Gyula; Mader, Krisztina; Orvos, Hajnalka; Kemény, Lajos; Csoma, Zsanett

doi:10.1007/s12519-016-0070-6

Cited by 30 publications

(25 citation statements)

References 28 publications

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“…O adesivo é um dispositivo frequentemente utilizado nas unidades neonatais, porém sua retirada além de ser potencialmente dolorosa pode desencadear lesões de pele no RNPT. A pele do RN apresenta algumas peculiaridades em relação à do adulto, como: é mais fina (40 a 60%), menos pilosa, com menor coesão entre a epiderme e a derme, e a proporção entre a área de superfície corpórea e o peso é de cinco vezes a do adulto 24 .…”

Section: Discussionunclassified

Procedimentos dolorosos agudos no recém-nascido pré-termo em uma unidade neonatal

et al. 2019

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Objetivo: analisar o número de procedimentos dolorosos agudos e manejo da dor em recém-nascidos pré-termo em uma unidade neonatal. Método: estudo descritivo, transversal. Teve como campo uma unidade neonatal de uma instituição pública de saúde. Os participantes da pesquisa foram recém-nascidos abaixo de 35 semanas. Resultados: foram incluídos 17 recém-nascidos. Foi quantificado um total de 729 procedimentos dolorosos. Em média foram realizados 42,9 procedimentos por recém-nascido durante os primeiros 14 dias de vida, sendo aproximadamente três procedimentos realizados por bebê no serviço diurno. Dentre os procedimentos, o mais frequente foi a punção de calcâneo (23,9%). O manejo predominante foi a contenção facilitada (32,7%). A (re)inserção de pronga foi o segundo procedimento mais realizado. Conclusões: O estudo permitiu apreender que o manejo da dor no recém-nascido pré-termo internado em uma unidade neonatal ainda é um desafio.

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Section: Discussionunclassified

Procedimentos dolorosos agudos no recém-nascido pré-termo em uma unidade neonatal

et al. 2019

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“…62,64,70,75,79,87,102,104,[108][109][110][111]121,123,129,147,148,153,157,[159][160][161][162] In total, 163 individual participants were studied. Study characteristics are summarised in Table 7 with full treatment, intervention and outcome details presented in Appendix 3.…”

Section: Case Report Studiesmentioning

confidence: 99%

Treatment of extravasation injuries in infants and young children: a scoping review and survey

Corbett

Marshall

Harden

et al. 2018

Health Technol Assess

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BackgroundExtravasation injuries are caused by unintended leakages of fluids or medicines from intravenous lines, but there is no consensus on the best treatment approaches.ObjectivesTo identify which treatments may be best for treating extravasation injuries in infants and young children.DesignScoping review and survey of practice.PopulationChildren aged < 18 years with extravasation injuries and NHS staff who treat children with extravasation injuries.InterventionsAny treatment for extravasation injury.Main outcome measuresWound healing time, infection, pain, scarring, functional impairment, requirement for surgery.Data sourcesTwelve database searches were carried out in February 2017 without date restrictions, including MEDLINE, CINAHL (Cumulative Index to Nursing and Allied Health Literature) Plus and EMBASE (Excerpta Medica dataBASE).MethodsScoping review – studies were screened in duplicate. Data were extracted by one researcher and checked by another. Studies were grouped by design, and then by intervention, with details summarised narratively and in tables. The survey questionnaire was distributed to NHS staff at neonatal units, paediatric intensive care units and principal oncology/haematology units. Summary results were presented narratively and in tables and figures.ResultsThe evidence identified in the scoping review mostly comprised small, retrospective, uncontrolled group studies or case reports. The studies covered a wide range of interventions including conservative management approaches, saline flush-out techniques (with or without prior hyaluronidase), hyaluronidase (without flush-out), artificial skin treatments, debridement and plastic surgery. Few studies graded injury severity and the results sections and outcomes reported in most studies were limited. There was heterogeneity across study populations in age, types of infusate, injury severity, location of injury and the time gaps between injury identification and subsequent treatment. Some of the better evidence related to studies of flush-out techniques. The NHS survey yielded 63 responses from hospital units across the UK. Results indicated that, although most units had a written protocol or guideline for treating extravasation injuries, only one-third of documents included a staging system for grading injury severity. In neonatal units, parenteral nutrition caused most extravasation injuries. In principal oncology/haematology units, most injuries were due to vesicant chemotherapies. The most frequently used interventions were elevation of the affected area and analgesics. Warm or cold compresses were rarely used. Saline flush-out treatments, either with or without hyaluronidase, were regularly used in about half of all neonatal units. Most responders thought a randomised controlled trial might be a viable future research design, though opinions varied greatly by setting.LimitationsPaucity of good-quality studies.ConclusionsThere is uncertainty about which treatments are most promising, particularly with respect to treating earlier-stage injuries. Saline flush-out techniques and conservative management approaches are commonly used and may be suitable for evaluation in trials.Future workConventional randomised trials may be difficult to perform, although a randomised registry trial may be an appropriate alternative.FundingThe National Institute for Health Research Health Technology Assessment programme.

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“…A bőr-sérülések általában minor problémák voltak, míg a súlyos szö-vődményeket elsősorban a nosocomiális fertőzések és a lég-zőszervi komplikációk jelentették (22). Saját vizsgálatainkban azt tapasztaltuk, hogy a NIC-en egy év alatt észlelt bőrgyó-gyászati elváltozások 75,3 százaléka a bőr éretlenségével ösz-szefüggésben kialakult iatrogén elváltozás volt, illetve 39,3 százalékuk igényelt speciális sebkezelési ellátást (25,26).…”

Section: áBraunclassified

Neonatal wounds, neonatal scars

Meszes¹,

Kemény²,

Csoma³

2018

BVSZ

Self Cite

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ÖSSZEFOGLALÁS Key words: prenatal injuries -intranatal wounds -iatrogenic injuries -wound care -fetal wound healingRövidítések EB -epidermolysis bullosa NIC -neonatális intenzív centrum TEVV -transzepidermális vízveszteség Számos nem várt, ártalmas behatás érheti a magzatot in utero, illetve az újszülöttet a szülés alatt, valamint a szülést követő időszakban is. Az orvostudomány fejlődésének kö-szönhetően a perinatális mortalitás jelentősen csökkent az utóbbi évtizedek során; ebben kiemelkedő szerepet játsza-nak a neonatológiai intenzív ellátás során bevezetésre került diagnosztikus és terápiás innovációk. A prenatális diagnosztika jelentős segítséget nyújt a súlyos fejlődési rendellenességek, genetikai betegségek megfelelő időben történő felismeréséhez és napjainkban már a magzat életfunkciónak ellenőrzése, szoros észlelése is lehetséges. Természetesen a technológiai vív-mányok, a modern diagnosztikus és terápiás beavatkozások alkalmazása kapcsán is számolnunk kell számos szövődmény, iatrogén ártalom jelentkezésével. A mechanobullosus betegségek, a súlyos elszarusodási zavarok bizonyos típusai már 14 Levelező szerző: Meszes Angéla dr.

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Lesions requiring wound management in a central tertiary neonatal intensive care unit

Cited by 30 publications

References 28 publications

Procedimentos dolorosos agudos no recém-nascido pré-termo em uma unidade neonatal

Procedimentos dolorosos agudos no recém-nascido pré-termo em uma unidade neonatal

Treatment of extravasation injuries in infants and young children: a scoping review and survey

Neonatal wounds, neonatal scars

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