Pathology and Clinical Presentation of Friction Injuries

Berke, Christine

doi:10.1097/won.0000000000000087

Cited by 23 publications

(13 citation statements)

References 21 publications

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“…This is in agreement with another study that reports poor skin turgor increased the development of perioperative pressure injuries . This is likely because patients with poor skin turgor are affected by external factors such as friction and shear because of their skin elasticity . We also found that 95.1% of participants who developed pressure injuries had an intraoperative diastolic blood pressure less than or equal to 60 mm Hg, and that low diastolic blood pressure increased the likelihood of developing a pressure injury.…”

Section: Discussionsupporting

confidence: 92%

“…11 This is likely because patients with poor skin turgor are affected by external factors such as friction and shear because of their skin elasticity. 10,33 We also found that 95.1% of participants who developed pressure injuries had an intraoperative diastolic blood pressure less than or equal to 60 mm Hg, and that low diastolic blood pressure increased the likelihood of developing a pressure injury. Other studies report that a decrease in intraoperative diastolic blood pressure increased the development of pressure injury.…”

Section: Discussionmentioning

confidence: 61%

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The Effect of Selected Risk Factors on Perioperative Pressure Injury Development

Çelik¹,

Öğce²

2019

AORN Journal

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Patients undergoing operative and other invasive procedures are at high risk for developing pressure injuries. This study aimed to determine the incidence of perioperative pressure injuries in patients who underwent procedures lasting two hours or more in Turkey and the risk factors that affect the development of pressure injuries. Data were collected during the perioperative period. The incidence of perioperative pressure injuries was 40.4%. The results of univariate logistic regression analysis showed that intraoperative vasopressor use, skin turgor, and diastolic blood pressure less than or equal to 60 mm Hg were significantly related to the development of pressure injuries. There was no significant difference between patients who developed pressure injuries and patients who did not when comparing their preoperative Braden Scale scores. Perioperative nurses should assess each patient for pressure injury risk and perform interventions to prevent pressure injuries during each stage of the patient's perioperative course.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 61%

The Effect of Selected Risk Factors on Perioperative Pressure Injury Development

Çelik¹,

Öğce²

2019

AORN Journal

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“…The friction phenomenon is associated with shear deformations and stresses on the skin surface, within skin layers and subcutaneously, which may be static (if there is no relative movement between the skin and the contacting surface/object/device) or dynamic (when such relative movement occurs) 9,10 . Continuous rubbing or sliding of the skin against materials such as textiles can result in inflammation, abrasions, or wounds referred to as friction blisters 11 ; these blisters are not considered to be PUs/PIs 1,12 …”

Section: Mechanical Loads Applied To Soft Tissuesmentioning

confidence: 99%

“…9,10 Continuous rubbing or sliding of the skin against materials such as textiles can result in inflammation, abrasions, or wounds referred to as friction blisters 11 ; these blisters are not considered to be PUs/PIs. 1,12 Loaded skin and deeper soft tissues distort and deform in response to mechanical loads, resulting in localised strain (a measure of the relative deformation) and stress (force transferred per unit area) in tissues. Excessive internal strains and stresses or prolonged tissue exposures to sustained strains and stresses will impair transport phenomena in cells by causing damage to cell structures such as the cytoskeleton or plasma membrane.…”

Section: Mechanical Loads Applied To Soft Tissuesmentioning

confidence: 99%

Our contemporary understanding of the aetiology of pressure ulcers/pressure injuries

Gefen

Brienza

Cuddigan

et al. 2021

International Wound Journal

135

145

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In 2019, the third and updated edition of the Clinical Practice Guideline (CPG) on Prevention and Treatment of Pressure Ulcers/Injuries has been published. In addition to this most up‐to‐date evidence‐based guidance for clinicians, related topics such as pressure ulcers (PUs)/pressure injuries (PIs) aetiology, classification, and future research needs were considered by the teams of experts. To elaborate on these topics, this is the third paper of a series of the CPG articles, which summarises the latest understanding of the aetiology of PUs/PIs with a special focus on the effects of soft tissue deformation. Sustained deformations of soft tissues cause initial cell death and tissue damage that ultimately may result in the formation of PUs/PIs. High tissue deformations result in cell damage on a microscopic level within just a few minutes, although it may take hours of sustained loading for the damage to become clinically visible. Superficial skin damage seems to be primarily caused by excessive shear strain/stress exposures, deeper PUs/PIs predominantly result from high pressures in combination with shear at the surface over bony prominences, or under stiff medical devices. Therefore, primary PU/PI prevention should aim for minimising deformations by either reducing the peak strain/stress values in tissues or decreasing the exposure time.

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“…Friction skin injury (FcI) was first described in the literature in 2015 1. I searched the literature and found studies addressing this phenomenon.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Friction Skin Injury on the Buttocks and/or Posterior Thighs in an Acute Care Setting

Berke¹

2022

Journal of Wound, Ostomy &Amp; Continence Nursing

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PURPOSE: The prevalence of friction skin injury (FcI) in an acute care hospital was evaluated as part of a quality improvement initiative. PARTICIPANTS/SETTING: The setting for this quality improvement project was an academic medical center with 728 licensed beds in the central plains of the United States. Data were collected by 33 clinicians: 28 were RN staff members and 5 were patient care technicians. Six of the 28 nurses (21%) were board-certified wound nurses and 2 (7%) were in training but not yet certified. Prevalence data were collected on 354 hospitalized patients. APPROACH: Friction skin injuries were measured in conjunction with the institution's quarterly skin survey for the NDNQI PUPS (National Database of Nursing Quality Indicators Pressure Ulcer Prevalence Survey) in August 2019. The prevalence of FcI was calculated using the number of patients with FcI divided by the total number of patients surveyed. OUTCOMES: Three hundred fifty-four patients completed the survey in this PUPS; FcI was diagnosed in 8 patients, yielding a prevalence rate of 2.3%. Clinical manifestations of FcI such as lichenification, skin/soft tissue discoloration, skin/soft tissue deformation and/or callus formation, and skin ulceration were also documented. In addition, a majority of patients with FcI were found to have fecal or urinary incontinence (n = 5/8, 63%; 2 had both fecal and urinary incontinence, 25%). Braden Scale for Pressure Sore Risk subscales scores were analyzed; the mean subscale score for moisture was 3.4; the mean subscale score for friction/shear was 1.4; the mean subscale score for activity was 2.6; and the mean subscale score for mobility was 2.9. IMPLICATIONS FOR PRACTICE: To the best of my knowledge, this is the first published article documenting FcI prevalence in any care setting. Additional prevalence studies are needed to establish the epidemiology of FcI across care settings and in the community.

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Pathology and Clinical Presentation of Friction Injuries

Abstract: It is critical for wound clinicians and staff nurses to accurately identify the etiology of any wound. Wounds located on fleshy prominences exposed to repetitive friction should be labeled as friction injuries.

Cited by 23 publications

References 21 publications

The Effect of Selected Risk Factors on Perioperative Pressure Injury Development

The Effect of Selected Risk Factors on Perioperative Pressure Injury Development

Our contemporary understanding of the aetiology of pressure ulcers/pressure injuries

Prevalence of Friction Skin Injury on the Buttocks and/or Posterior Thighs in an Acute Care Setting

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