Objective To analyze the applicability and the optimal cut-off of Braden Scale for the diagnosis of pressure injury in the elderly through the data of multicenter cross-sectional study of pressure injury in the elderly in China，so as to provide bases for the correct use of Braden scale in clinical practice. Methods 1067 trained and qualified nurses from 52 different medical institutions across the country were recruited in a group of 2. They included the inpatients over 60 years old by purpose sampling method，examined the skin and relevant data of patients，and evaluated whether there was pressure injury and its stage，and used the Braden Scale to predict the risk of pressure injury. The statistical software was used to analyze the epidemic characteristics of pressure injury in the elderly，and the area under the working characteristic curve（AUC），sensitivity，specificity and Yoden index of those with pressure injury were predicted and diagnosed by the Braden Scale. Results In the effective data of 3 3769 cases，the total prevalence of pressure injury was 3.12%（n=1 054），of which the incidence of hospital acquired pressure injury was 0.79%（n=267）. Hierarchical analysis showed that the AUC predicted by the Braden Scale for the diagnosis of pressure injury in elderly patients of different ages，gender，races and medical institutions was 0.85~0.96，and the sensitivity and specificity were 0.83~0.96 and 0.71~0.86，respectively. The AUC of the 6 cut-off values of total score≤15，≤16，≤17，≤18，≤19 and ≤20 points was 0.67~0.82; the sensitivity and specificity were 0.67~0.84 and 0.54~0.68，respectively; the Youden index was 0.25~0.49. The Youden index and AUC of ≤20 points was the largest. Conclusion Braden Scale is suitable for elderly patients of different ages，gender，race and medical institutions to assess and predict the risk of pressure injury. The total score of≤20 points can be used as the best cut-off，which can improve the prediction efficiency.

Objective To analyze the prevalence and risk factors of 3 types of skin injuries in the elderly through multicenter cross-sectional survey,so as to provide bases for formulating prevention strategies for skin injuries in the elderly. Methods On March 31,2021,1 067 nurses from 50 hospitals in 16 provinces,2 autonomous regions and 2 municipalities included inpatients over 60 years old and inspected their skin from head to toes to identify pressure injury（PI）,incontinence-associated dermatitis（IAD） and skin tear（ST）,and meanwhile collected demographic,healthcare condition and PI risk assessment data. Statistical software was used for descriptive analysis,Pearson correlation analysis and logistic regression analysis. Results Totally,14 470 cases were obtained. The average age was（73.35±8.90） years old. The total prevalence of skin injuries was 6.69%,and the prevalence of PI,IAD and ST was 3.91%,1.89% and 0.89%,respectively. Logistic regression analysis showed that the risk of PI,inability of self-care,hypoproteinemia and anemia,comorbidity over 2 chronic diseases and ≥70 years old were the independent risk factors of PI in the elderly. The risk of PI,inability of self-care,hypoproteinemia,comorbidity over 2 chronic diseases,length of hospital stay≥8 days and the age of over 80 years were the independent risk factors of IAD in the elderly. The risk of PI and hypoproteinemia were independent risk factors of ST in the elderly. Conclusion Skin injuries of the hospitalized elderly are the result of multiple factors,while PI and IAD are the most typical ones,and the risk factors of different types of skin injuries are also different. When formulating prevention strategies,we should not only pay attention to the independent role of risk factors,but also consider the combined role of risk factors,take comprehensive preventive measures to improve the prevention effect.

Objective To observe and analyze characteristics of occurrence and prognosis of moisture-associated skin damage （MASD） during negative pressure wound therapy（NPWT） between outpatient and inpatient,so as to provide bases for effective interventions. Methods From January 2018 to June 2019,39 cases in the General Hospital of Eastern Theater Command were selected as experimental group,40 cases in the First People’s Hospital of Lianyungang were selected as control group by convenience sampling method. The expected NPWT treatment and individualized standard moisture therapy （MT） were conducted and patients were followed up until the wounds were healed or for 3 months. The incidence of NPWT related MASD was the primary outcome indicator. The secondary outcome indicators were the time of occurrence,the time of healing of NPWT related MASD,the wound area and depth reduction rate of 14 days after NPWT,as well as wound healing rate and healing time in 3 months follow-up. Results There was a case dropped in the exposed group and no dropped case in the non-exposed group. In 2 groups,the incidence of NPWT related MASD was 17.95%（7/39） and 22.50%（9/40）;the occurrence time was（3.86 ±1.57）d and （3.33±1.12）d;the healing time was （5.14±1.77）d and （5.44±1.13）d,respectively. The differences were not statistically significant（all P>0.05）. The reduction rates of wound area and depth in 14 days of NPWT,the healing rate and healing time of 3 months follow-up between 2 groups were also close（P>0.05）. Conclusion There was a high incidence of NPWT related MASD in the family and hospital environment,and the time of occurrence and healing time were close. Early detection and active interventions can reduce the short-term and long-term effects of wound treatment. Considering the cost and convenience,family mode NPWT may be an exploratory direction of chronic wound care in the future.

Objective To explore the effect of two skin protecting methods in negative pressure wound therapy （NPWT） for chronic wounds in order to prevent NPWT-related moisture-associated skin damage（MASD）. Methods A total of 132 patients with chronic wounds were enrolled and randomly divided into two groups,66 cases in each group. During NPWT,the intervention group used a leak-proof paste for protecting peri-wound skin,and the control group was applied with a multi-polymer free pain skin protective dressing for protecting peri-wound skin. Both groups were treated for 14 days and then followed up with standard moisture therapy until healed or 3 months. Primary outcome：incidence of MASD around wound during NPWT;secondary outcomes：frequency of leakage alarm,skin impregnation frequency,the reduction rate of wound area,depth during NPWT,and rate of wound healing,and healing time during the follow-up. Results A total of 6 cases were dropped. In the full analysis set,the MASD incidence,the frequency of leakage alarm and skin impregnation in the intervention group were less than those in the control group（P<0.05）. The difference in the reduction rate of wound area between the two groups was significant（P<0.05）. The difference in the depth reduction rate between the two groups was no significance（P>0.05）. At the end of the follow-up period,the rate of wound healing in the intervention group was higher than that in the control group（P<0.05）,and healing time of both groups was close（P>0.05）. Conclusion The research proved that two protecting skin methods had some effects on protect peri-wound skin and preventing NPWT-related MASD.The leak-proof paste method was better and it played an important role in ensuring NPWT,improving wound treatment outcomes and promoting wound healing and it is suitable for patients with different types and locations of chronic wounds.