Pressure Injury Prevention in AE and PFC
1 mars 2022 mis à jour par: 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.
Aperçu de l'étude
Statut
Résilié
Les conditions
Intervention / Traitement
Description détaillée
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.
Type d'étude
Interventionnel
Inscription (Réel)
72
Phase
- N'est pas applicable
Contacts et emplacements
Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.
Lieux d'étude
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Washington
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Seattle, Washington, États-Unis, 98195
- University of Washington School of Nursing
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Critères de participation
Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.
Critère d'éligibilité
Âges éligibles pour étudier
18 ans à 55 ans (Adulte)
Accepte les volontaires sains
Oui
Sexes éligibles pour l'étude
Tout
La description
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 d'étude
Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Autre
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
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Expérimental: Group 1: Mepilex on Litter + AE Mattress + 30 degree backrest
Intervention: Mepilex
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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.
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Aucune intervention: Group 2: Without Mepilex on Litter + AE mattress + backrest
Intervention: Control (no Mepilex)
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Expérimental: Group 3: Mepilex on VSB on AE mattress
Intervention: Mepilex
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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.
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Aucune intervention: Group 4: Without Mepilex on VSB on AE mattress
Intervention: Control (no Mepilex)
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Expérimental: Group 5 Prolonged Field Care (PFC) - LiquiCell on Talon litter
Intervention: LiquiCell mat
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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.
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Aucune intervention: Group 6: PFC Without LiquiCell on Talon Litter
Intervention: Control (no LiquiCell)
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Change in Interleukin-1/Total Protein (Skin)
Délai: Baseline through study completion - approximately 120 minutes
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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)
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Baseline through study completion - approximately 120 minutes
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Change in Transcutaneous Tissue Oxygen (TcPO2)
Délai: Measured continuously during the baseline (sidelying), supine (120 minutes) and post-sidelying (15 minutes) periods
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Tissue oxygen is measured continuously on the sacrum using a noninvasive sensor and on the midsternum (midchest) as a control
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Measured continuously during the baseline (sidelying), supine (120 minutes) and post-sidelying (15 minutes) periods
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Change in Skin Moisture (Epidermal and Subepidermal)
Délai: Baseline (before lying down) and after 120 minutes supine
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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.
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Baseline (before lying down) and after 120 minutes supine
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Change in Skin Temperature
Délai: Measured continuously during the baseline (sidelying), supine (120 minutes) and post-sidelying (15 minutes) periods
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Skin temperature will be measured continuously on the sacrum using a laser doppler probe.
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Measured continuously during the baseline (sidelying), supine (120 minutes) and post-sidelying (15 minutes) periods
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Change in Skin Interface Pressure
Délai: Continuously during the supine phase of the study (120 minutes)
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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.
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Continuously during the supine phase of the study (120 minutes)
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Change in Pressure-Discomfort (Category Partitioning Scale-50)
Délai: The score will be obtained at baseline and every 30 minutes in the supine position (total 5 measurements).
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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.
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The score will be obtained at baseline and every 30 minutes in the supine position (total 5 measurements).
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Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Parrainer
Les enquêteurs
- Chercheur principal: Elizabeth Bridges, PhD, RN, University of Washington
Publications et liens utiles
La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.
Dates d'enregistrement des études
Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.
Dates principales de l'étude
Début de l'étude (Réel)
20 juillet 2019
Achèvement primaire (Réel)
23 septembre 2020
Achèvement de l'étude (Réel)
23 septembre 2020
Dates d'inscription aux études
Première soumission
10 avril 2019
Première soumission répondant aux critères de contrôle qualité
19 avril 2019
Première publication (Réel)
23 avril 2019
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
16 mai 2022
Dernière mise à jour soumise répondant aux critères de contrôle qualité
1 mars 2022
Dernière vérification
1 mars 2022
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- STUDY00006022
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
NON
Informations sur les médicaments et les dispositifs, documents d'étude
Étudie un produit pharmaceutique réglementé par la FDA américaine
Non
Étudie un produit d'appareil réglementé par la FDA américaine
Non
produit fabriqué et exporté des États-Unis.
Non
Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .
Essais cliniques sur Lésion de pression
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Kessler FoundationInstituto Vocacional Enrique Díaz de León A.C., Guadalajara, MexicoRecrutementTBI (Traumatic Brain Injury) ou MS (Sclérose en Plaques)États-Unis, Espagne