Skin integrity in critically ill and injured children. Am J Crit Care 2007 Nov;16(6):568-74
Date
10/27/2007Pubmed ID
17962501Scopus ID
2-s2.0-40449119752 (requires institutional sign-in at Scopus site) 48 CitationsAbstract
BACKGROUND: Skin breakdown increases the cost of care, may lead to increased morbidity, and has negative psychosocial implications because of secondary scarring or alopecia. The scope of this problem has not been widely studied in critically ill and injured children.
OBJECTIVES: To determine the incidence of skin breakdown in critically ill and injured children and to compare the characteristics of patients who experience skin breakdown with those of patients who do not.
METHODS: Admission and follow-up data for a 15-week period were collected retrospectively on children admitted to a large pediatric intensive care unit. The incidence of skin breakdown was calculated. The risk for skin breakdown associated with potential risk factors (relative risk) and 95% confidence intervals were determined.
RESULTS: The sample consisted of 401 distinct stays in the intensive care unit for 373 patients. During the 401 stays, skin breakdown occurred in 34 (8.5%), redness in 25 (6.2%), and breakdown and redness in 13 (3.2%); the overall incidence was 18%. Patients who had skin breakdown or redness were younger, had longer stays, and were more likely to have respiratory illnesses and require mechanical ventilatory support than those who did not. Patients who had skin breakdown or redness had a higher risk of mortality than those who did not.
CONCLUSIONS: Risk factors for skin breakdown were similar to those previously reported. Compared with children of other ages, children 2 years or younger are at higher risk for skin breakdown.
Author List
Schindler CA, Mikhailov TA, Fischer K, Lukasiewicz G, Kuhn EM, Duncan LAuthors
Theresa A. Mikhailov MD, PhD Professor in the Pediatrics department at Medical College of WisconsinChristine Schindler Ph.D., RN, CPNP, AC/PC Nurse Practitioner in the Nursing department at Marquette University
MESH terms used to index this publication - Major topics in bold
AdolescentAge Factors
Child
Child, Preschool
Exanthema
Humans
Iatrogenic Disease
Infant
Intensive Care Units, Pediatric
Nursing Audit
Pediatric Nursing
Pressure Ulcer
Prospective Studies
Risk Assessment
Risk Factors
Skin Care
Skin Ulcer
Wisconsin