Abstract
Objective: To investigate the clinical effectiveness of Mepilex Border dressings for the prevention of medical device-related pressure ulcers (MDR PUs) caused by the nephrostomy tube securement with the drainage tube. Methods: Equally randomized 60 obstructive hydronephrosis patients in our hospital who were treated by ultrasound-guided percutaneous nephrolithotomy (from March 2018 to March 2019) into observation group and control group. The observation group was applied dressings beneath the junctions of nephrostomy tubes and drainage tubes before secured with 5*5cm I-shaped 3M elastic adhesive tape to avoid direct contact to patients’ skin; the control group was only secured with 5*5cm I-shaped 3M elastic adhesive tape to the bare skin. The incidences of skin indentations, local pain and pressure ulcers under the junctions were compared between two groups. Results: There were statistical significance (P<0.05) among two groups: all patients in control group (n=30) were presented with skin indentations in different degrees, 21 with local pain, 6 with first-stage pressure ulcers, while no evidence of the above situations was found in the observation group. Conclusions: Application of Mepilex Border dressings can prevent the occurrence of MDR PUs to improve patient comfort.
Highlights
Urolithiasis-caused obstructive hydronephrosis as a common disease
Fixation The junctions of postoperative tubes in the observation group were first centred on the 10×10 cm Mepliex Border dressings before secured with 5×5cm I-shaped 3M elastic adhesive tape to ensure drainage patency and avoid detachment; the control group were secured only with same tape that was slightly repositioned once a day during which the skin inspection was conducted (Figure 2)
To minimize infection and protect renal function, postoperative nephrostomy tube securement for drainage is usually conducted after ultrasound-guided percutaneous nephrolithotomy on urolithiasis-caused obstructive hydronephrosis patients
Summary
It is a therapeutic principle to relieve obstruction, drain urine and protect renal function. At present, It can be treated by an effective operation called ultrasound-guided percutaneous nephrolithotomy [1,2,3] which requires insertion of nephrostomy catheter for urine drainage. Percutaneous renal puncture fistula guided by B-ultrasound is a simple and effective method for the treatment of obstructive hydronephrosis. It is important to keep and fix the renostomy tube for drainage after puncture. Catheter nursing, focusing on patency, is crucial in postoperative care, especially for pyonephrosis and hydronephrosis patients, but for nephrostomy tube-catheterized patients, detachment prevention becomes the key, which is usually performed by 3M elastic adhesive tape clinically.
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