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Pressure Injury Prevention in AE and PFC

1 de marzo de 2022 actualizado por: Elizabeth Bridges, University of Washington

Prevention of Pressure Injuries During Aeromedical Evacuation or Prolonged Field Care

This study evaluates the effect of a multilayer skin dressing (Mepilex) placed on the sacrum or a fluid filled pad (LiquiCell) on risk factors for pressure injuries under conditions consistent with military long-distance transport or prolonged field care. Participants will be assigned to one of six groups - air transport, air transport on a spinal immobilization surface with or without Mepilex or on a field stretcher with or without LiquiCell.

Descripción general del estudio

Estado

Terminado

Condiciones

Intervención / Tratamiento

Descripción detallada

Combat casualties undergoing long distance aeromedical evacuation (AE), particularly casualties who are immobilized because of possible spine injuries, and casualties who required prolonged field care are at increased risk for pressure injuries. The risk factors pressure and shear are potentially modifiable via solutions appropriate for these austere conditions. Two interventions (Mepilex and LiquiCell) will be evaluated under conditions simulating military medical transport on a standard stretcher or with spinal immobilization in a vacuum spine board (VSB) or on a military stretcher used under field conditions. Mepilex is a multi-layer dressing that can be placed on the skin (sacrum/buttocks) and LiquiCell is a pad filled with pockets of fluid that is placed under the back and buttocks. The effect of these interventions compared to not using them will be studied under the three conditions with or without the intervention (Mepilex or LiquiCell) using measures obtained on the lower back/sacrum including skin interface pressure, oxygen, moisture, and temperature and a cytokine indicating possible tissue damage.

Tipo de estudio

Intervencionista

Inscripción (Actual)

72

Fase

  • No aplica

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

  • Estados Unidos
    • Washington
      • Seattle, Washington, Estados Unidos, 98195
        • University of Washington School of Nursing

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años a 55 años (Adulto)

Acepta Voluntarios Saludables

Sí

Géneros elegibles para el estudio

Todos

Descripción

Inclusion Criteria:

  • Men and women
  • Age 18 to 55
  • Meet the physical standards for military personnel
  • Weigh less than 250 pounds
  • Be able to remain in the study position for the duration of the study.

Exclusion Criteria

  • Previous injuries to sacrum/buttocks with scarring
  • History of pressure injuries
  • Cardiovascular disease
  • Neurological disease that would affect vascular response
  • Diabetes
  • History of malignancy
  • Current skin condition (e.g., eczema or psoriasis)
  • Current neck/back pain or history of chronic neck/back pain
  • Known vertebral/spinal cord disease/injury (scoliosis, kyphosis, or lordosis)
  • Self-reported pregnancy
  • Concern about ability to remain in the vacuum spine board for 120 minutes

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Otro
  • Asignación: Aleatorizado
  • Modelo Intervencionista: Asignación paralela
  • Enmascaramiento: Ninguno (etiqueta abierta)

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Experimental: Group 1: Mepilex on Litter + AE Mattress + 30 degree backrest
Intervention: Mepilex
Dispositivo: Mepilex
Mepilex Border Sacrum dressing is a multi-layered soft silicone dressing that is a recommended strategy to augment standard nursing interventions (i.e., repositioning, offloading) to prevent pressure injuries. The dressing will be placed on the sacrum.
Sin intervención: Group 2: Without Mepilex on Litter + AE mattress + backrest
Intervention: Control (no Mepilex)
Experimental: Group 3: Mepilex on VSB on AE mattress
Intervention: Mepilex
Dispositivo: Mepilex
Mepilex Border Sacrum dressing is a multi-layered soft silicone dressing that is a recommended strategy to augment standard nursing interventions (i.e., repositioning, offloading) to prevent pressure injuries. The dressing will be placed on the sacrum.
Sin intervención: Group 4: Without Mepilex on VSB on AE mattress
Intervention: Control (no Mepilex)
Experimental: Group 5 Prolonged Field Care (PFC) - LiquiCell on Talon litter
Intervention: LiquiCell mat
Dispositivo: LiquiCell
LiquiCell is a thin layer of low-viscosity fluid contained in a series of bursa-like pouches. Baffles within each pouch channel the liquid to disperse pressure and the volume of liquid in the pouch is so small that there is no pressure-build up. LiquiCell is available commercially as a 36 X 18-inch mattress overlay (LiquiCell Shear Reducing Mattress Overlay) with a soft pliable top and a non-slip bottom. The overlay is positioned from the shoulders to below the hips to minimize shear.
Sin intervención: Group 6: PFC Without LiquiCell on Talon Litter
Intervention: Control (no LiquiCell)

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Change in Interleukin-1/Total Protein (Skin)
Periodo de tiempo: Baseline through study completion - approximately 120 minutes
Skin cytokine (IL-1) and total protein will be obtained using a small strip of specialized tape placed on the sacrum/buttocks. After 1-minute application the tape is removed and analyzed for quantity of interleukin-1 (indicator of skin irritation)
Baseline through study completion - approximately 120 minutes
Change in Transcutaneous Tissue Oxygen (TcPO2)
Periodo de tiempo: Measured continuously during the baseline (sidelying), supine (120 minutes) and post-sidelying (15 minutes) periods
Tissue oxygen is measured continuously on the sacrum using a noninvasive sensor and on the midsternum (midchest) as a control
Measured continuously during the baseline (sidelying), supine (120 minutes) and post-sidelying (15 minutes) periods
Change in Skin Moisture (Epidermal and Subepidermal)
Periodo de tiempo: Baseline (before lying down) and after 120 minutes supine
Two components of skin moisture will be measured on the sacrum using the Delfin MoistureMeter. The epidermal moisture, which reflects perspiration and subepidermal moisture , which reflects water content of the tissues. The values range from 1-80, with higher numbers reflecting increased moisture.
Baseline (before lying down) and after 120 minutes supine
Change in Skin Temperature
Periodo de tiempo: Measured continuously during the baseline (sidelying), supine (120 minutes) and post-sidelying (15 minutes) periods
Skin temperature will be measured continuously on the sacrum using a laser doppler probe.
Measured continuously during the baseline (sidelying), supine (120 minutes) and post-sidelying (15 minutes) periods
Change in Skin Interface Pressure
Periodo de tiempo: Continuously during the supine phase of the study (120 minutes)
The pressure between the support surface and the skin will be measured continuously during the supine position using the X Sensor system. This system measures force/unit area (e.g., pressure). The peak and average pressure on the sacrum/buttocks will be measured.
Continuously during the supine phase of the study (120 minutes)

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Change in Pressure-Discomfort (Category Partitioning Scale-50)
Periodo de tiempo: The score will be obtained at baseline and every 30 minutes in the supine position (total 5 measurements).
This scale asks the participant to describe in verbal terms the pressure intensity or discomfort associated with the stimulus (i.e., sacral/buttocks pressure or discomfort). The participant can then fine tune their assessment using a numeric score. The final score is an analog. The score ranges from 0-52, with higher scores indicating higher pressure or more severe discomfort. The investigator will ask the participant to limit their evaluation to the pressure/discomfort sensed on the sacrum/buttocks, but the investigator will also ask the participants to identify on their body where they are experiencing the most pressure/discomfort.
The score will be obtained at baseline and every 30 minutes in the supine position (total 5 measurements).

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

University of Washington

Investigadores

  • Investigador principal: Elizabeth Bridges, PhD, RN, University of Washington

Publicaciones y enlaces útiles

La persona responsable de ingresar información sobre el estudio proporciona voluntariamente estas publicaciones. Estos pueden ser sobre cualquier cosa relacionada con el estudio.

Publicaciones Generales

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio (Actual)

20 de julio de 2019

Finalización primaria (Actual)

23 de septiembre de 2020

Finalización del estudio (Actual)

23 de septiembre de 2020

Fechas de registro del estudio

Enviado por primera vez

10 de abril de 2019

Primero enviado que cumplió con los criterios de control de calidad

19 de abril de 2019

Publicado por primera vez (Actual)

23 de abril de 2019

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

16 de mayo de 2022

Última actualización enviada que cumplió con los criterios de control de calidad

1 de marzo de 2022

Última verificación

1 de marzo de 2022

Más información

Términos relacionados con este estudio

Palabras clave

Términos MeSH relevantes adicionales

Otros números de identificación del estudio

  • STUDY00006022

Plan de datos de participantes individuales (IPD)

¿Planea compartir datos de participantes individuales (IPD)?

NO

Información sobre medicamentos y dispositivos, documentos del estudio

Estudia un producto farmacéutico regulado por la FDA de EE. UU.

No

Estudia un producto de dispositivo regulado por la FDA de EE. UU.

No

producto fabricado y exportado desde los EE. UU.

No

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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