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Objective: To understand how reviewers select and prespecify outcomes for systematic reviews (SRs), the authors report on the outcomes used in SRs of pressure injury (PI) intervention and treatment and evaluate their completeness of prespecification., Data Sources: The authors searched four electronic databases for SRs involving PI prevention and/or treatments., Study Selection: Inclusion criteria were SRs and meta-analyses evaluating interventions for preventing or treating PI. Studies without systematic search or risk-of-bias assessment, conference proceedings, and articles not in Chinese or English were excluded., Data Extraction: Two reviewers extracted and categorized the outcomes in domains, assessing outcome prespecification using a five-element framework. Data items included study characteristics, target population, type of interventions, and outcome variables., Data Synthesis: This review included 95 SRs that reported a total of 432 instances of 24 different outcome domains. An average of four outcome domains were reported per SR. The most frequently reported domains were PI healing, PI occurrence, and PI status. Of the 62 SRs that prespecified primary outcomes, 40 (64.52%) reported more than one primary outcome. Only 24 of the 432 instances (5.56%) were completely specified. Among the 24 outcome domains, 12 (50.00%) were listed as primary outcomes at least once. Primary outcomes were more completely specified than nonprimary outcomes., Conclusions: Systematic reviews of PI prevention and/or treatment report diverse, incompletely prespecified outcomes, highlighting the need for a core outcome set to standardize key clinical outcomes., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Abstract: Radiation therapy is often accompanied by skin toxicity in the irradiated area and radiation-induced DNA damage to skin tissue cells in the surrounding pigmented area. This case report describes a patient with radiation-induced skin injury who received wound treatment and psychological intervention with satisfactory results. A 60-year-old woman was admitted to the authors' hospital on January 18, 2021, with radiation-induced skin injury caused by carbon ion radiotherapy for tonsillar carcinoma. The patient underwent wound repair combined with psychological intervention (30 minutes per dressing change). Over a period of 1 month, the wound area was reduced from 11 × 12 cm2 to 1 × 1 cm2, and wound symptoms (exudate, blood odor, wound infection, wound edge dehydration and curling, periwound skin peeling, dryness, and hyperkeratosis) improved. The patient's anxiety factor scores decreased from 18 to 1, and her depression factor scores decreased from 16 to 3. When the patient was discharged from the hospital after 1 month of treatment, she had a satisfactory self-image and normal social activities., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: To comprehensively assess the association between operative positioning with intraoperative-acquired pressure injury (IAPI) development., Methods: This retrospective cohort study included 455 patients who underwent surgery between October 2020 and January 2021. The authors grouped patients by operative positioning into the prone position and nonprone position groups. They used propensity-score matching at a 1:2 ratio to control for preoperative confounders, applied multiple logistic regression models to analyze the effects between positioning and IAPI, and assessed interactions of positioning and intraoperative factors on IAPI., Results: The final enrollment was 92 cases in the prone position group and 181 in the nonprone position group. Multivariable logistic analysis suggested that the prone position had a 2.92 times higher risk of IAPI than the nonprone position (odds ratio, 2.92; 95% CI, 1.13-7.57; P = .026). Subgroup analysis showed a significant multiplicative interaction between positioning and foam dressing on IAPI (P < .05), which was not observed in other intraoperative factors (P > .05)., Conclusions: This study provides evidence that prone operative positioning can increase IAPI risk. Patients in the prone position may particularly benefit from using dressings in Chinese populations. Further large-sample longitudinal studies are required to confirm these findings., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: To determine the key factors influencing intraoperative-acquired pressure injury (IAPI)., Methods: Researchers assessed 413 surgical patients in a Shanghai tertiary hospital using an information collection form and an IAPI occurrence record form. Analysis took place using the classification and regression tree algorithm and multiple logistic regression., Results: A total of 43 surgical patients (10.4%) had IAPI, including 32 stage 1 cases (74.4%), and 11 stage 2 cases (25.6%). The multiple logistic regression analysis indicated that operation duration, surgical position, preoperative hypertension, and preoperative Braden Scale risk score were independently associated with IAPI development. The decision tree showed that preoperative Braden Scale score, surgical position, operation grade, operation duration, age, prealbumin level, and body mass index were important factors and that preoperative Braden Scale score was the most critical decision variable. The cross-validation method was used to indicate a model accuracy of 91.8%., Conclusions: The decision tree effectively identified key factors for IAPI, complementing the logistic regression analysis and providing a scientific basis for the further development of structural risk assessment, prevention, and treatment strategies for IAPI., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Abstract: Chronic lower extremity venous insufficiency can cause local dystrophy, and some patients will develop calf dystrophic calcification. In this case report, the authors describe a patient with varicose veins of both lower extremities, venous insufficiency of the lower extremities, recurring ulcers on the left leg for more than 20 years, and diabetes mellitus with dystrophic calcification of the calf. The patient's left leg ulcer showed extensive chronic inflammation, pathological calcification, and necrosis of the subcutaneous tissue with a thickness of approximately 0.5 to 1 cm. The computed tomography, X-ray, and hematoxylin-eosin staining results confirmed calcification; the leg skin thickened because of inflammatory irritation. After 11 months of treatment, the calcified and necrotic calcification and necrotic tissue were removed, and the wound healed., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: To investigate the prevalence of anxiety and depression among hospitalized patients with a chronic wound and explore the influence of demographic factors, disease characteristics, social support, and coping styles on their mental status., Methods: Investigators recruited 216 patients with a chronic wound. The Self-rating Anxiety Scale and Self-rating Depression Scale were used to measure anxiety and depression. Patients' coping style and their social support were assessed through face-to-face interviews., Results: Overall, 36.6% of participants presented with symptoms of anxiety, and 37% showed depressive symptoms. Participants who typically had less than 5 hours of sleep; experienced more severe pain; or had an odorous wound, negative coping style, or lower level of social support had a higher prevalence of anxiety and depression (P < .05). Men with higher monthly incomes who lived in the city were more likely to develop anxiety than women with lower monthly incomes who lived outside the city (P < .05). Participants with fewer years of education and without spouses were more likely to experience depression than married participants with more education (P < .05)., Conclusions: The prevalence of anxiety and depression among hospitalized patients with a chronic wound is high. Support from loved ones including a spouse and a positive coping style are key protective factors for mental health and well-being., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: To determine the incidence and influencing factors of medical adhesive-related skin injury (MARSI) among ICU patients., Methods: Study authors enrolled patients admitted to two ICUs at a class 3, grade A hospital in Beijing between January and June 2018 in this prospective cohort study. A data collection sheet was designed, and the data were collected by querying the electronic medical record and via direct assessment. Univariate and multivariate logistic regression analyses were performed to identify factors that independently influenced MARSI incidence. The STROBE checklist was used., Results: In total, 39 of 356 patients (27 men and 12 women with an average age of 61.51 ± 17.49 years) developed MARSI, an incidence of 10.96%. The median time from admission to MARSI occurrence was 26 days. Multivariate logistic regression analysis revealed that the ICU length of stay, Braden Scale score, and mechanical ventilation all independently influenced incidence. The Braden Scale score (odds ratio [OR], 0.758; 95% confidence interval [CI], 0.636-0.904; P < .05) was a protective factor against MARSI, with higher scores indicating lower risk. The ICU length of stay (OR, 1.098; 95% CI, 1.061-1.136; P < .05) and mechanical ventilation (OR, 3.373; 95% CI, 0.889-12.795; P < .05) were independent risk factors for MARSI., Conclusions: The incidence of MARSI in ICU patients was relatively high. Awareness of MARSI should be increased among medical staff, and proper skin care should be provided to prevent and treat MARSI effectively.