Research progress of acute skin failure in critically ill patients

doi:10.3761/j.issn.0254-1769.2021.03.010

Abstract

Abstract:

Patients in the intensive care units are prone to the loss of skin integrity. However,in some cases,the skin breakdown is not caused by pressure but by acute skin failure. In this paper,the definition,diagnostic criteria,risk factors,clinical manifestations,assessment,prevention,and management of acute skin failure are reviewed to provide references for clinical identification,as well as improving skin integrity outcomes in critically ill patients.

Key words: Intensive Care, Skin Failure, Pressure Injury, Review

摘要：

重症患者易出现皮肤完整性受损,但某些皮肤完整性受损是因低灌注引起的皮肤和皮下组织死亡,即急性皮肤衰竭。该文对重症患者急性皮肤衰竭的定义及诊断标准、危险因素、与压力性损伤的鉴别及其评估、预防、管理进行综述,以期提高我国护理工作者对重症患者急性皮肤衰竭的认识,拓展皮肤护理内涵,并为推动我国急性皮肤衰竭的研究提供借鉴。

关键词: 重症护理, 皮肤衰竭, 压力性损伤, 综述

CHEN Xiangping, LAO Yuewen, ZHANG Yi, GONG Xiaoyan, ZHUANG Yiyu. Research progress of acute skin failure in critically ill patients[J]. Chinese Journal of Nursing, 2021, 56(3): 376-380.

陈香萍, 劳月文, 张奕, 宫晓艳, 庄一渝. 重症患者急性皮肤衰竭的研究进展[J]. 中华护理杂志, 2021, 56(3): 376-380.

References 41

[1]	Langemo DK, Brown G . Skin fails too:acute,chronic,and end-stage skin failure[J]. Adv Skin Wound Care, 2006,19(4):206-211.
[2]	La Puma J . The ethics of pressure ulcers[J]. Decubitus, 1991,4(2):43-44.
[3]	Delmore B, Cox J, Rolnitzky L , et al. Differentiating a pressure ulcer from acute skin failure in the adult critical care patient[J]. Adv Skin Wound Care, 2015,28(11):514-526.
[4]	Levine JM . Unavoidable pressure injuries,terminal ulceration,and skin failure:in search of a unifying classification system[J]. Adv Skin Wound Care, 2017,30(5):200-202.
[5]	Koziak M . Etiology and pathology of ischemic ulcers[J]. Arch Phys Med Rehabil, 1959,40(2):62-69.
[6]	Ayello EA, Levine JM, Langemo D , et al. Reexamining the literature on terminal ulcers,scale,skin failure,and unavoidable pressure injuries[J]. Adv Skin Wound Care, 2019,32(3):109-121.
[7]	Cohen KE, Scanlon MC, Bemanian A , et al. Pediatric skin failure[J]. Am J Crit Care, 2017,26(4):320-328.
[8]	Delmore B, Cox J, Smith D , et al. Acute skin failure in the critical care patient[J]. Adv Skin Wound Care, 2019,33(4):192-201.
[9]	Dalgleish L, Campbell J, Finlayson K , et al. Acute skin failure in the critically ill adult population:a systematic review[J]. Adv Skin Wound Care, 2020,33(2):76-83.
[10]	Edsberg LE, Black JM, Goldberg M , et al. Revised national pressure ulcer advisory panel pressure injury staging system[J]. J Wound Ostomy Continence Nurs, 2016,43(6):585-597.
[11]	Delmore B, Cox J, Rolnitzky L , et al. Differentiating a pressure ulcer from acute skin failure in the adult critical care patient[J]. Adv Skin Wound Care, 2015,28(11):514-526.
[12]	刘艳, 王丽娟, 昂慧 , 等. ICU患者压疮危险因素的Meta分析[J]. 护理学杂志, 2018,33(4):84-87.
	Liu Y, Wang LJ, Ang H , et al. Meta-analysis of risk factors of pressure ulcers in patients admitted to intensive care unit[J]. J Nurs Sci, 2018,33(4):84-87.
[13]	Nowicki JL, Mullany D, Spooner A , et al. Are pressure injuries related to skin failure in critically ill patients?[J]. Aust Crit Care, 2018,31(5):257-263.
[14]	Sibbald RG, Ayello EA . Terminal ulcers,scale,skin failure,and unavoidable pressure injuries:results of the 2019 terminology survey[J]. Adv Skin Wound Care, 2020,33(3):137-145.
[15]	幺莉 . 护理敏感质量指标实用手册(2016版)[M]. 北京: 人民卫生出版社, 2016: 115-120.
	Yao L. Handbook of nursing sensitive quality indicators(2016)[M]. Beijing: People's Medical Publishing House, 2016: 115-120.
[16]	Kim JH, Shin HK, Jung GY , et al. A case of acute skin failure misdiagnosed as a pressure ulcer,leading to a legal dispute[J]. Arch Plast Surg, 2019,46(1):75-78.
[17]	Geofroy H, Jérémie J, Guillaume L , et al. Narrative review:clinical assessment of peripheral tissue perfusion in septic shock[J]. Ann Intensive Care, 2019,9(1):37-45.
[18]	Ait-Oufella H, Lemoinne S, Boelle PY , et al. Mottling score predicts survival in septic shock[J]. Intensive Care Med, 2011,37(5):801-807.
[19]	Ait-Oufella H, Joffre J, Boelle PY , et al. Knee area tissue oxygen saturation is predictive of 14-day mortality in septic shock[J]. Intensive Care Med, 2012,38(6):976-983.
[20]	Ait-Oufella H, Bourcier S, Alves M , et al. Alteration of skin perfusion in mottling area during septic shock[J]. Ann Intensive Care, 2013,3(1):31.
[21]	Coudroy R, Jamet A, Frat J , et al. Incidence and impact of skin mottling over the knee and its duration on outcome in critically ill patients[J]. Intensive Care Med, 2015,41(3):452-459.
[22]	潘选良, 韩春茂 . 临床皮肤灌注压检测作用的研究进展[J]. 中华烧伤杂志, 2016,32(11):702-704.
	Pan XL, Han CM . Advances in the research on effect of detecting skin perfusion pressure in clinic[J]. Chin J Burns, 2016,32(11):702-704.
[23]	Mongkolpun W, Orbegozo D, Cordeiro CPR , et al. Alterations in skin blood flow at the fingertip are related to mortality in patients with circulatory shock[J]. Crit Care Med, 2020,48(4):443-450.
[24]	Kawasaki T, Uemura T, Matsuo K , et al. The effect of different positions on lower limbs skin perfusion pressure[J]. Indian J Plast Surg, 2016,46(3):508-512.
[25]	Kawai M, Mihara S, Takahagi S , et al. Evaluation of skin perfusion pressure to assess refractory foot[J]. J Wound Care, 2017,26(5):267-270.
[26]	Utsunomiya M, Nakamura M, Nagashima Y , et al. Predictive value of skin perfusion pressure after endovascular therapy for wound healing in critical limb ischemia[J]. J Endovasc Ther, 2014,21(5):662-670.
[27]	Song Y, Soh S, Shim J , et al. Skin perfusion pressure as an indicator of tissue perfusion in valvular heart surgery:preliminary results from a prospective,observational study[J]. PLoS One, 2017,129(9):1-14.
[28]	Rhee C, Dantes R, Epstein L , et al. Incidence and trends of sepsis in US hospitals using clinical vs claims data,2009-2014[J]. JAMA, 2017,318(13):1241-1249.
[29]	Chien L, Lu K, Wo C , et al. Hemodynamic patterns preceding circulatory deterioration and death after trauma[J]. J Trauma, 2007,62(4):928-932.
[30]	Cecconi M, De Backer D, Antonelli M , et al. Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine[J]. Intensive Care Med, 2014,40(12):1795-1815.
[31]	Eduardo K, Ricardo C, Magdalena V , et al. Optimal target in septic shock resuscitation[J]. Ann Transl Med, 2020,8(12):789-800.
[32]	Loubani O, Green R . A systematic review of extravasation and local tissue injury from administration of vasopressors through peripheral intravenous catheters and central venous catheters[J]. J Crit Care, 2015,30(3):9-17.
[33]	Koskela M, Ala-Kokko TI, Gaddnas F , et al. Blister fluid and serum cytokine levels in severe sepsis in humans reflect skin dysfunction[J]. Acta Anaesthesiol Scand, 2017,61(1):53-61.
[34]	陈香萍, 张奕, 庄一渝 , 等. PROBAST:诊断或预后多因素预测模型研究偏倚风险的评估工具[J]. 中国循证医学杂志, 2020,20(6):123-130.
	Chen XP, Zhang Y, Zhuang YY , et al. PROBAST:a tool for assessing risk of bias in the study of diagnostic or prognostic multi-factorial predictive models[J]. Chin J Evid-based Med, 2020,20(6):123-130.
[35]	Lennen N, Miller B . Introducing interprofessional education in nursing curricula[J]. Teach Learn Nurs, 2017,12(1):59-61.
[36]	卫晓静, 闫凡, 景孟娟 , 等. ICU护士预防医疗器械相关性压力性损伤知信行的现状调查[J]. 中华护理杂志, 2020,55(1):45-50.
	Wei XJ, Yan F, Jing MJ , et al. Nurses' knowledge,attitudes and practice towards prevention of medical device related pressure injury in intensive care units:a cross-sectional study[J]. Chin J Nurs, 2020,55(1):45-50.
[37]	夏冬云, 史婷奇, 陆巍 , 等. 压力性损伤临床决策支持系统的研发与应用[J]. 中华护理杂志, 2020,55(1):50-54.
	Xia DY, Shi TQ, Lu W , et al. Development and application of clinical decision support system for pressure injury[J]. Chin J Nurs, 2020,55(1):50-54.
[38]	蒋琪霞 . 美国医院获得性压疮预防和管理方法分析与启示[J]. 中华现代护理杂志, 2016,22(27):3849-3852.
	Jiang QX . Analysis and revelation of prevention and management methods of hospital-acquired pressure ulcers in US[J]. Chin J Mod Nurs, 2016,22(27):3849-3852.
[39]	黄维健, 曲华, 丛超 , 等. 手术相关压疮信息化管理系统的设计及临床应用[J]. 中华护理杂志, 2016,51(10):1204-1207.
	Huang WJ, Qu H, Cong C , et al. The design and clinical application of information management system for pressure ulcer in surgical patients[J]. Chin J Nurs, 2016,51(10):1204-1207.
[40]	Brindle CT, Malhotra R , O'rourke S,et al. Turning and repositioning the critically ill patient with hemodynamic instability: a literature review and consensus recommendations[J]. J Wound Ostomy Continence Nurs, 2013,40(3):254-267.
[41]	Krapfl LA, Langin J, Pike CA , et al. Does incremental positioning(weight shifts)reduce pressure injuries in critical care patients?[J]. J Wound Ostomy Continence Nurs, 2017,44(4):319-323.