Chinese Journal of Emergency and Critical Care Nursing >
Construction and application of a prevention and graded management plan for skin tears in post-cardiac surgery patients
Received date: 2025-05-26
Online published: 2025-12-11
Objective To establish and implement a skin tear prevention and graded management plan for post-cardiac surgery patients. Methods Based on risk management theory and hierarchical nursing theory,an initial skin tear prevention and graded management plan for post-cardiac surgery patients was drafted through literature review and panel discussions,followed by finalization via an expert consensus meeting. Using a non-randomized controlled trial design,266 patients(September-November 2024) were allocated to the experimental group,while 254 patients(June-August 2024) were enrolled in the control group. The experimental group received a prevention and grading management plan,while the control group received routine skin care. A comparison was made between the two groups regarding skin tear incidence,severity,skincare costs,healing time,and nurses’ theoretical and practical assessment scores on skin tear management. Results The experimental group had significantly lower skin tear incidence,severity,healing time,and costs(P<0.05),while nurses achieved higher rates of timely/accurate risk assessment,intervention adherence,and test scores(P<0.05). Conclusion The prevention and graded management plan for skin tears in postoperative cardiac patients is scientific and feasible. It can reduce the incidence and severity of skin tears,decrease nursing workload,lower skin care costs,and enhance nurses’ awareness and management capabilities regarding skin tears,achieving predictive risk-based nursing for skin tears.
GUAN Yan , ZHOU Dan , CHEN Chen , JIN Hua , SU Yunyan , WANG Yan , WANG Zheyun . Construction and application of a prevention and graded management plan for skin tears in post-cardiac surgery patients[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025 , 6(12) : 1437 -1443 . DOI: 10.3761/j.issn.2096-7446.2025.12.004
| [1] | Van Tiggelen H, LeBlanc K, Campbell K, et al. Standardizing the classification of skin tears:validity and reliability testing of the international skin tear advisory panel classification system in 44 countries[J]. Br J Dermatol, 2020, 183(1):146-154. |
| [2] | 中国生物医学工程学会体外循环分会, 赵举, 黑飞龙, 等. 2021年中国心外科手术和体外循环数据白皮书[J]. 中国体外循环杂志, 2022, 20(4):196-199. |
| Extracorporeal Circulation Branch of Chinese Biomedical Engineering Association,Zhao J, Hei FL, et al. White book of Chinese cardiovascular surgery and extracorporeal circulation in 2021[J]. Chin J Extracorpor Circ, 2022, 20(4):196-199. | |
| [3] | 管艳, 王哲芸, 金花, 等. 心脏外科术后患者皮肤撕裂伤风险预测模型的构建与验证[J]. 护理学杂志, 2024, 39(24):25-30. |
| Guan Y, Wang ZY, Jin H, et al. Construction and validation of a risk prediction model for skin tear in postoperative cardiac surgery patients[J]. J Nurs Sci, 2024, 39(24):25-30. | |
| [4] | Chang YY, Carville K, Tay AC. The prevalence of skin tears in the acute care setting in Singapore[J]. Int Wound J, 2016, 13(5):977-983. |
| [5] | LeBlanc K, Campbell KE, Wood E, et al. Best practice recommendations for prevention and management of skin tears in aged skin:an overview[J]. J Wound Ostomy Continence Nurs, 2018, 45(6):540-542. |
| [6] | 陈卫中, 潘晓平, 宋兴勃, 等. ROC曲线中最佳工作点的选择[J]. 中国卫生统计, 2006, 23(2):157-158. |
| Chen WZ, Pan XP, Song XB, et al. Selection of the best working point in ROC curve[J]. Chin J Health Stat, 2006, 23(2):157-158. | |
| [7] | Koyano Y, Nakagami G, Iizaka S, et al. Skin property can predict the development of skin tears among elderly patients:a prospective cohort study[J]. Int Wound J, 2017, 14(4):691-697. |
| [8] | Serra R, Ielapi N, Barbetta A, et al. Skin tears and risk factors assessment:a systematic review on evidence-based medicine[J]. Int Wound J, 2018, 15(1):38-42. |
| [9] | 邵思语, 翟雨婷, 吴海燕, 等. 基于循证构建老年病人医用黏胶相关性皮肤损伤预防管理方案[J]. 实用老年医学, 2024, 38(11):1081-1085,1096. |
| Shao SY, Zhai YT, Wu HY, et al. Development of an evidence-based management programme for the prevention of adhesive-related skin injuries in elderly patients[J]. Pract Geriatr, 2024, 38(11):1081-1085,1096. | |
| [10] | 蒋琪霞, 展颖颖, 白育瑄. 老年皮肤损伤流行病学特征和预防现况研究进展[J]. 中国全科医学, 2022, 25(17):2164-2168. |
| Jiang QX, Zhan YY, Bai YX. Advances in the epidemiology and prevention of skin injuries in older adults[J]. Chin Gen Pract, 2022, 25(17):2164-2168. | |
| [11] | Hawk J, Shannon M. Prevalence of skin tears in elderly patients:a retrospective chart review of incidence reports in 6 long-term care facilities[J]. Ostomy Wound Manage, 2018, 64(4):30-36. |
| [12] | Beeckman D, Campbell KE, LeBlanc K, et al. Best practice recommendations for holistic strategies to promote and maintain skin integrit[EB/OL]. (2020-02-28)[2025-02-19]. https://www.woundsinternational.com/resources/details/best-practice-recommendations-holistic-strategies-promote-and-maintain-skin-integrit . |
| [13] | 王哲芸, 杨燕, 王岩, 等. 心脏外科患者加速康复气道管理方案的制订与应用研究[J]. 中华护理杂志, 2020, 55(11):1605-1611. |
| Wang ZY, Yang Y, Wang Y, et al. Construction and application of airway nursing in cardiac enhanced recovery after surgery[J]. Chin J Nurs, 2020, 55(11):1605-1611. |
/
| 〈 |
|
〉 |