August 2022 Wound and Ostomy Journal
Medical Adhesive-Related Skin Injury Associated with Surgical Wound Dressing among Spinal Surgery Patients: A Cross-Sectional Study.
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Describe the method used by the author of the study:
ReplyDelete- The author states this is cross sectional, single -institutional study. As a cross sectional study, the study population of this article was selected based on inclusion and exclusion criteria in a neurosurgery clinics at Asan Medical Center, a tertiary hospital in Seoul, Republic of Korea; "The inclusion criteria were patients who were 20 years of
age or older who underwent planned surgery under general anesthesia due to spinal disease. Patients with disorientation, communication difficulties, or prior radiotherapy at the surgical site
were excluded." As a cross sectional study, the author observed the surgical wound assessing the site before the surgery and after removing medical adhesive dressings.The author found significant correlation between medical history of contact dermatitis and/or late postoperative ambulation and MARSI using SPSS (statistical significance p value < 0.05).
Discuss the limitations of the article:
- As the author mentioned, I agree one of the limitation is the generalization due that this was a single -institution study. I also concern that the method she used would make this research less objective adding bias since she is the only one, who did observe wound site before and after removing the dressing. It would be better to train some nurses ahead of time before and evaluate the wound site for the research. Then that way, the study would be more objective and the good practices based on the findings can be developed and continued.
Hi Sakiko, you make a good point about the results being bias due to the fact the author writing this paper is the one who verified results of the wounds. That is a good suggestion in training the nurses to also assess and provide data based off their findings. Ideally, an outside source that has no bias or conflict of interest to this research paper could also make a positive contribution to this article as well.
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ReplyDeleteDescribe the method used by the author of the study.
ReplyDeleteThe study was cross-sectional study which was to show us the incidence and factors associated with adhesive related skin injury. The study was done on adults who had spinal surgery with general anesthesia, the study was done in the Seoul, Korea hospital. The data was collected for one month. The patient's skin was assessed every morning. It was found that patients with the spinal surgery and patients with hx of dermatitis had increased risk for MARSI's.
Discuss the limitation of the article.
The limitation of this article was that study was done in the one hospital. Also the data was only collected for one month and patients skin was evaluated under dressing once a day. I think the stuff should be train to assess under dressing more often.
Hi Agnieszka, I agree with your discussion of the limitation of the short duration to evaluate the wounds as complications of wound healing may occur after 1 month. Additionally, the sample size coming from one hospital limits the results to a particular demographic and a culture of staff to a particular facility.
DeleteValarie Renaux
ReplyDeleteMedical Adhesive-Related Skin Injury Associated with Surgical Wound Dressing among Spinal Surgery Patients: A Cross-Sectional Study.
What are the advantages and disadvantages to the proposed recommendations in the article?
This was a research article on medical adhesive-related skin injuries (MARSIs). The advantages to this article highlight awareness of injuries provoked by adhesive use as well as techniques used to minimize skin tears including the "low and slow manner" as well as closer observing tension dressing provoked blisters, and application of a soft silicone dressing. One particular limitation mentioned was this study focused on spinal surgery patients. This is limiting factor because acute surgical wounds are different natured in healing compared to chronic and infected wounds
How does this research article compare to our practice, policy and/or procedure?
Similarities in our practice are we no longer use the plastic tapes we use to commonly use years ago. We also use the mepilex silicone dressings for pressure related wounds in both prevention and active treatment such as our PUPs. We do not have a policy in defining the management of skin tears or prevention of. Generally, if a skin tear becomes problematic a wound care consult will be ordered and the wound care nurse will provide recommendations based off of their observations.
Reference List
Kim J, Shin Y. Medical Adhesive-Related Skin Injury Associated with Surgical Wound Dressing among Spinal Surgery Patients: A Cross-Sectional Study. International journal of environmental research and public health. 2021;18(17). doi:10.3390/ijerph18179150
Discuss the Sample size used in this study?
ReplyDeleteThe participants are from a tertiary hospital Asan Medical Center in Seoul, Korea. From March- April 2019 a total of 143 people were enrolled in neurosurgery clinic, all participants were over the age of 20 who had underwent a general anesthesia surgery due to spinal disease.
How does this research article compare to our practice, policy/procedure?
ReplyDeleteI agree with Valarie, we stopped using plastic tape awhile ago due to injury to skin. Mepilex silicone dressings are the standard for pre-wound care and post wound care. Wound RNs are involved to help come up with a plan of care for any wounds.
Describe the method used by the author of the study.
ReplyDeleteThe author used a cross-sectional study done to show prevalence associated within adhesive related skin breakdown due to adults who had spinal surgery with general anesthesia. They conducted the study for one month, every morning and noticed patients with spinal surgery and a history of dermatitis had a increased risk for MARSI.
Discuss the limitation of the article.
What limits this study was that it was all done in one hospital in Korea. To do a proper study they should have compared within other hospitals within the vicinity, and assess it more than a month to compare data amongst one another.
1. Describe the method used by the author of the study:
ReplyDeleteThe method utilized in the study is a cross-sectional study regarding medical adhesive-related skin injuries (MARSI) for adult patients (20 years or older) who have had a planned spinal surgery under general anesthesia in Seoul, South Korea. The criteria used for this cross-sectional study includes the time from of March2019 through April 2019 (1 month) with 143 patients.
2.Discuss the limitations of the article:
A crucial limitation of the study done in the article is the sole sample size originating and being conducted from a single institution. In addition, the author observed a brisk timeframe of one study. There is no study of reference to compared to due to the study's qualifying criteria. However, the data collected maybe used to display trends that can help shape and improve nursing care, practice and policies within that hospital.
Describe the method used by the author of the study and Discuss the Sample size used in this study?
ReplyDeleteThe study was conducted on 143 adult patients over the age of 20 who volunteered from March to April 2019, after undergoing planned spinal surgery under general anesthesia due to spinal disease. I study was done at a tertiary hospital in Seoul, Korea, and was focused on post-surgical wound sites under current wound dressing protocols of that hospital. The data was collected using a cross-sectional study to better understand and evaluate MARSI (medical adhesive-related skin injury). Skin evaluation was preformed once every morning, up until the patient was discharged from the hospital. For the evaluation of the skin, any skin injury lasting more than 30 minutes was considered a MARSI. Along with this collection of data, logistic regression was used to help determine risk factors related with the incidence of MARSI’s
Describe the method used by the author of the study?
ReplyDeleteThe method used was a cross sectional study regarding MARSI for adult patients who had a planed spinal surgery in Seoul, South Korea. Gathering data every morning for one month to assess patients who have a high risk of dermatitis related to spinal surgery, or hx of dermatitis.
Discuss the limitations of the study.
Since the study was conducted only in one hospital, its a limitation of the study itself, especially since its all from one months of data. To gather more evidence, they should have conducted multiple studies in other hospitals close by
1.Describe the method used by the author of the study
ReplyDeleteThenstudy used a cross sectional method to evaluate MARSI( medical adhesive- realted skin innjury) with 143 surgical patients with spinal surgery in one specfic institution in Korea. Data were collected from March through April 2019. Skins under surgical wound dressings were evaluated for MARSI once every morning until discharge. Skin injuries lasting for 30 min or more were considered as MARSIs
2. Discuss the limitations of the article: limited sample size, design flaws, and/or author bias
The case was limted in one hospital in one speific area, which limited sample with certain groups. The study also was conducted with the patients with spinal injury which limted to certain area of body, which might be able to gather more diverse data. It will improve the result of data and sampling.
1) The Limitations of the article is that this is a sample size from a single institution, the sample size is small, and lastly the time period that was designated to the study was very short (March - April 2019). The study would be more credible had there been a longer time frame with a larger sample size.
ReplyDelete2) The advantages of implementing this article in our floor is that we are a surgical floor that aims to have low adverse effects from surgical procedures. Additional education on preventing MARSI and skin related injuries reduces the risk of surgical site infection. The disadvantage of implementing this article in our floor is that there is not enough detail as to pre op prophylaxis in reducing skin injury. We do not know if the same policies and procedures done in South Korea are the same as those in the US.
Suzanne Kang
Delete1. Discuss the limitations of the article, limited sample size, design flaws, and/or author bias
ReplyDeleteThis study was limited to a single institution so the limitation is in being able to apply the findings to spinal surgery patients in different settings. The article also notes that the process of applying and removing surgical drapes in the operating room was not sufficiently controlled and that the study’s follow-up period lasted a very short while.
2. Discuss the sample size used in this study
The sample size was 143 patients who underwent neurosurgery. The inclusion criteria was patients 20 years of age or older who underwent a spinal surgery. Exclusion criteria was patients who were disoriented, had communication difficulties or prior radiotherapy. This sample size seems quite small to me. Perhaps they could continue their study with a larger group in multiple settings.