Pressure Injury Prevention in AE and PFC
1 maart 2022 bijgewerkt door: 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.
Studie Overzicht
Toestand
Beëindigd
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
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.
Studietype
Ingrijpend
Inschrijving (Werkelijk)
72
Fase
- Niet toepasbaar
Contacten en locaties
In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.
Studie Locaties
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Washington
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Seattle, Washington, Verenigde Staten, 98195
- University of Washington School of Nursing
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Deelname Criteria
Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
18 jaar tot 55 jaar (Volwassen)
Accepteert gezonde vrijwilligers
Ja
Geslachten die in aanmerking komen voor studie
Allemaal
Beschrijving
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
Studie plan
Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Ander
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
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Experimenteel: 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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Geen tussenkomst: Group 2: Without Mepilex on Litter + AE mattress + backrest
Intervention: Control (no Mepilex)
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Experimenteel: 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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Geen tussenkomst: Group 4: Without Mepilex on VSB on AE mattress
Intervention: Control (no Mepilex)
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Experimenteel: 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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Geen tussenkomst: Group 6: PFC Without LiquiCell on Talon Litter
Intervention: Control (no LiquiCell)
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Change in Interleukin-1/Total Protein (Skin)
Tijdsspanne: 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)
Tijdsspanne: 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)
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Change in Pressure-Discomfort (Category Partitioning Scale-50)
Tijdsspanne: 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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Medewerkers en onderzoekers
Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.
Sponsor
Onderzoekers
- Hoofdonderzoeker: Elizabeth Bridges, PhD, RN, University of Washington
Publicaties en nuttige links
De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.
Studie record data
Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.
Bestudeer belangrijke data
Studie start (Werkelijk)
20 juli 2019
Primaire voltooiing (Werkelijk)
23 september 2020
Studie voltooiing (Werkelijk)
23 september 2020
Studieregistratiedata
Eerst ingediend
10 april 2019
Eerst ingediend dat voldeed aan de QC-criteria
19 april 2019
Eerst geplaatst (Werkelijk)
23 april 2019
Updates van studierecords
Laatste update geplaatst (Werkelijk)
16 mei 2022
Laatste update ingediend die voldeed aan QC-criteria
1 maart 2022
Laatst geverifieerd
1 maart 2022
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- STUDY00006022
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
NEE
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Nee
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
Nee
product vervaardigd in en geëxporteerd uit de V.S.
Nee
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