Abstract
ABSTRACT Objective: to analyze the incidence of skin injuries, risk and clinical characteristics of critically ill patients. Method: a retrospective cohort study performed in the intensive care center with a sample of 125 patients whose outcome was skin injury. Results: the overall injury incidence was 28% (n=35), with 36.3% (n=8) being dermatitis associated with urinary and fecal incontinence, 19.2% (n=24) pressure injury, 7.2% (n=9) skin tears, and 0.8% (n=1) medical-adhesive-related skin injury. The appearance time of the injuries varied from 1 to 44 days. The average number of injuries per patient was 1.7. Factors such as enteral nutrition (p<0.001), mechanical ventilation (p=0.001), fecal incontinence (p=0.049), diaper use with a delayed urinary catheter or urinary diversion (p=0.004) were associated with injury onset. Conclusions: incontinence-associated dermatitis and pressure injury had a higher incidence in critically ill patients. Patients who developed pressure injuries were at higher risk.
Highlights
The skin is considered the largest organ in the human body in terms of surface area and weight
The surveyed variables included age, gender, reason which led to hospitalization, associated diseases, breathing mode, type of intake, risk of pressure injury according to the Braden scale[14], urinary and fecal incontinence, presence of medical devices, presence of medical adhesives, serum albumin (3.5g/dL to 5.7g/dL) and serum hemoglobin
Univariate logistic regression analyzes were performed to verify the significance of the variables that were associated with the appearance of skin injuries, as well as an Odds Ratio evaluation to verify the chance of a certain variable influencing the occurrence of injuries (Table 1)
Summary
The skin is considered the largest organ in the human body in terms of surface area and weight. It covers the whole organism and forms a protective barrier against external aggressions[1]. The occurrence of injuries of certain etiologies in health units is considered an avoidable event and their prevention is ensured by Brazilian and international guidelines on patient safety. The Brazilian Ministry of Health instituted the National Patient Safety Program in 2013, in which one of the objectives is to reduce the risk of unnecessary damage associated with healthcare, which includes the prevention of injuries, and most importantly pressure injuries[3]. It causes discomfort and pain to the patient, affecting their well-being and quality of life, and above all leaves a scar on the body
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