The aetiology of deep tissue injury: a literature review

Peart, Joanna

doi:10.12968/bjon.2016.25.15.840

Cited by 14 publications

(5 citation statements)

References 38 publications

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“…3). Previous research has shown that ischemia-reperfusion injury can promote and aggravate deep tissue injuries and even result in limb gangrene or shedding [5,31], suggesting that tissue hypoxia may play a prominent role in driving the complications associated with deep tissue injuries. Anti-inflammation and angiogenesis mechanisms were shown to be important factors in limiting damage to deep tissue muscle injuries [32,33]; thus, targeting these fundamental mechanisms of wound healing may help to limit damage resulting from pressure wounds.…”

Section: Discussionmentioning

confidence: 99%

“…Inflammatory responses and reductions in capillary density caused by ischemia/reperfusion are the main factors that affect deep tissue injury healing [4,5]. The main principles of deep tissue injury management are in the inhibition of inflammatory responses in conjunction with the restoration of blood microcirculation within the wound site [4,[6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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Chitosan hydrogel encapsulated with LL-37 peptide promotes deep tissue injury healing in a mouse model

et al. 2020

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Background LL-37 peptide is a member of the human cathelicidin family, and has been shown to promote the healing of pressure ulcers. However, the low stability of this peptide within the wound environment limits its clinical use. Chitosan (CS) hydrogel is commonly used as a base material for wound dressing material. Methods CS hydrogel (2.5% w/v) was encapsulated with LL-37. Cytotoxicity of the product was examined in cultured NIH3T3 fibroblasts. Effects on immune response was examined by measuring tumor necrosis factor-α (TNF-α) release from RAW 264.7 macrophages upon exposure to lipopolysaccharides. Antibacterial activity was assessed using Staphylococcus aureus. Potential effect on pressure ulcers was examined using a mouse model. Briefly, adult male C57BL/6 mice were subjected to skin pressure using magnets under a 12/12 h schedule for 21 days. Mice were randomized to receive naked LL-37 (20 μg), chitosan gel containing 20-μg LL-37 (LL-37/CS hydrogel) or hydrogel alone under the ulcer bed (n = 6). A group of mice receiving no intervention was also included as a control. Results LL-37/CS hydrogel did not affect NIH3T3 cell viability. At a concentration of 1–5 μg/ml, LL-37/CS inhibited TNF-α release from macrophage. At 5 μg/ml, LL-37/CS inhibited the growth of Staphylococcus aureus. The area of the pressure ulcers was significantly lower in mice receiving LL-37/CS hydrogel in comparison to all other 3 groups on days 11 (84.24% ± 0.25%), 13 (56.22% ± 3.91%) and 15 (48.12% ± 0.28%). Histological examination on days 15 and 21 showed increased epithelial thickness and density of newly-formed capillary with naked LL-37 and more so with LL-37/CS. The expression of key macromolecules in the process of angiogenesis (i.e., hypoxia inducible factor-1α (HIF-1α) and vascular endothelial growth factor-A (VEGF-A)) in wound tissue was increased at both the mRNA and protein levels. Conclusion Chitosan hydrogel encapsulated with LL-37 is biocompatible and could promote the healing of pressure ulcers.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Chitosan hydrogel encapsulated with LL-37 peptide promotes deep tissue injury healing in a mouse model

et al. 2020

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“…(4) Dado su carácter a menudo crónico, las LPPH tienen un impacto significativo en la evolución y la calidad de vida de los pacientes, incluyendo dolor, depresión y hospitalizaciones prolongadas, lo que aumenta la carga de trabajo para los equipos de salud. (5) Esta situación se torna aún más crítica si se estima que un 95 % de las LPPH son evitables. (6) Varios son los factores que se conjugan en la aparición de LPPH, incluyendo la falta de entrenamiento formal de los trabajadores de salud en su prevención; la inexperiencia en su manejo, (7) elevada carga de trabajo y frecuente rotación de los equipos de enfermería.…”

Section: Introductionunclassified

Hospital-acquired pressure injuries and factors affecting their development: multicentre study

Febré-Vergara,

Mondaca-Gómez,

Cartagena-Ramos

et al. 2024

Salud, Ciencia y Tecnología

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Introducción: Las Lesiones por presión de origen hospitalario (LPPH) representan un desafío significativo en salud pública. Comprender sus principales características y factores relacionados es esencial para contribuir a su prevención efectiva. El objetivo de esta investigación es analizar las características principales de LPPH en cuatro centros hospitalarios de alta complejidad en Chile. Metodología: Estudio secundario, observacional analítico. La muestra (n=1000) incluyó pacientes pediátricos y adultos. Las variables de estudio fueron: presencia de LPPH, estadio, edad, sexo, dermatitis, riesgo de LPPH, cambio de posición, superficie de alivio de presión, inmovilización y velocidad de aparición. La medición de variables incluyó examen físico y revisión de ficha clínica. Se realizó estadística descriptiva y modelos de regresión logística multivariada, aceptando IC95%, p<0,05.Resultados: Se estimó una prevalencia cruda de 18,7%. La mayoría de los pacientes con LPPH eran hombres (56,1%), con edades entre 18 a 59 años (39,6%) y 60 a 80 años (39,0%). En promedio, transcurrieron 10 días desde el ingreso del paciente hasta el desarrollo de las LPPH. El estadio I fue el más frecuente (50%), predominantemente en la región sacra (30,1%). El factor con mayor fuerza de asociación a la aparición de LPPH fue contar con clasificación de riesgo alto de ulceración (OR 2,6, IC95%1,5-4,4). Conclusiones: Este es el primer estudio en Chile que permitió caracterizar las LPPH en una muestra relevante de pacientes hospitalizados. Los hallazgos reflejan aspectos relevantes para el monitoreo y prevención de LPHH, como su prevalencia, ubicación y factores asociados a su aparición.

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“…Pressure injury is defined as local skin and subcutaneous soft tissue injury due to shear or friction alone or in combination, usually occurring at the site of bone protrusion in patients immobilized for an extended period ( 8 ). The pathogenesis of pressure injuries is generally recognized to result from tissue ischemia, ischemia–reperfusion injury, and skin injury caused by mechanical load ( 9 , 10 ). The prevalence of pressure injuries among patients in the wards ranged from 4.7 to 32.1%, with a higher incidence of pressure injuries in ICU ( 11 ).…”

Section: Introductionmentioning

confidence: 99%

Strategies to preventing pressure injuries among intensive care unit patients mechanically ventilated in prone position: a systematic review and a Delphi study

Wang,

Fan,

Chen

et al. 2023

Front. Med.

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BackgroundAlthough the incidence of pressure injury in the prone position is high for the mechanically ventilated patients in the intensive care unit, evidence-based strategies are still lacking.ProposeTo conduct a systematic review of current evidence, and to propose a series of strategies to prevent pressure injuries among mechanically ventilated patients with prone position in the intensive care unit.MethodsThe study was guided by the Medical Research Council framework. After a systematic review of current evidence of original articles, guidelines, expert consensus and theories, a strategy draft was developed. Then we invited 20 experts to modify and refine these strategies through two rounds of Delphi consensus method.ResultsAfter two rounds of Delphi process, the importance of coefficient of variation (Cv) and Kendall’s coefficient of concordance in the strategies repository were 0.067 and 0.311, respectively. And the operability of Cv and Kendall’s coefficient of concordance in the strategy draft was 0.055 and 0.294, respectively. Ultimately, we established 31 strategies for including 7 themes (assess risk factors, assess skin and tissue, body position management, skin care, nutrition, preventing medical device-related pressure injuries, education and supervision). In addition, we also developed a strategy framework to clarify our strategies.ConclusionAccording to the Medical Research Council framework, we developed 7 themes and 31 strategies to prevention prone-position pressure injuries among the intensive care unit mechanically ventilated patients. This study was considered to improve the clinical management of pressure injuries among prone position patients in the intensive care unit settings.

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The aetiology of deep tissue injury: a literature review

Cited by 14 publications

References 38 publications

Chitosan hydrogel encapsulated with LL-37 peptide promotes deep tissue injury healing in a mouse model

Chitosan hydrogel encapsulated with LL-37 peptide promotes deep tissue injury healing in a mouse model

Hospital-acquired pressure injuries and factors affecting their development: multicentre study

Strategies to preventing pressure injuries among intensive care unit patients mechanically ventilated in prone position: a systematic review and a Delphi study

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