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| Name | Class |
|---|---|
| University Hospital, Ghent | OTHER |
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This study aims to identify differences and similarities between superficial pressure ulcers (category II and III) and incontinence-associated dermatitis (category IIA) at tissue level.
Skin biopsies will be obtained from 30 patients with pressure ulcers (n = 10), incontinence-associated dermatitis (n = 10), and combined lesions (n = 10).
The results from the histopathologic examination will be compared with the clinical diagnosis by wound care experts, which will be based on photographs and relevant patients' characteristics.
Despite current preventive strategies, prevalence of pressure ulcers and incontinence-associated dermatitis (IAD) is still estimated at 5.9-6.9% in hospitalised patients, and 5.0-5.9 in home care patients. Both skin conditions may occur in the same body region but are considered as separate entities, based on differences in etiology.
At tissue level, it is assumed that pressure ulcers are characterised by ischemia and tissue deformation. In contrast, IAD is assumed to be characterised by an irritative pattern. These assumptions are reflected in current preventive strategies. However, a small scale study, performed by Houwing et al. (2007), described the additional presence of an ischemic pattern in patients with IAD. More insights into the histopathologic pattern of pressure ulcers and IAD is needed to optimise current preventive strategies.
Tha aim of this study is to compare superficial pressure ulcers (category II and III) and IAD (category IIA) at tissue level.
A prospective interventional study will be performed during which skin biopsies (punch biopsies) will be collected from 30 incontinent patients. In each patient patient, two punch skin biopsies will be performed, one at the border of the skin lesion and one at the adjacent healthy skin. Sections from the biopsies will be stained with hematoxiline and eosine and examined by two independently working, blinded skin pathologists. In addition, photographs from the skin lesions will be analysed by 10 national and international wound care experts to promote correct diagnosis. Finally, findings from the histopathologic examination will be compared with the clinical diagnoses based on photographs.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Pressure ulcers | Patients with pressure ulcers category II/III at sacrum or trochanter |
| |
| Incontinence-associated dermatitis | Patients with incontinence-associated dermatitis category IIA at sacrum (or trochanter) |
| |
| Combined lesion | Patients with pressure ulcer category II/III and incontinence-associated dermatitis category IIA at sacrum or trochanter |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Punch skin biopsy | Procedure | Two punch biopsies will be performed in each patient, one at the border of the skin lesion, and one at the adjacent healthy skin. A disposable biopsy punch of 4 mm will be used. A biopsy punch is a small circular blade (like an apple corer) which is rotated into the skin to obtain a cylindrical specimen. Local anaesthesia will be applied and the circular wound will be closed by a single suture. Sutures will be removed after one week. |
| Measure | Description | Time Frame |
|---|---|---|
| Prevalence of pressure ulcers and incontinence-associated dermatitis | Presence of pressure ulcers and/or incontinence-associated dermatitis based on photographs and patient characteristics | 1 day |
| Histopathologic pattern | Characteristics of epidermis, dermis, and subcutis based on histopathologic examination | 1 day |
| Measure | Description | Time Frame |
|---|---|---|
| Rate of agreement between visual and histopathologic diagnosis | Agreement between diagnosis of wound care experts (based on photographs), and diagnosis by skin pathologists (based on histopathologic examination) | 1 day |
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Inclusion Criteria:
Exclusion Criteria:
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Patients admitted on following wards of a university hospital
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| Name | Affiliation | Role |
|---|---|---|
| Sofie De Schepper | University Hospital, Ghent | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ghent University Hospital | Ghent | Belgium |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27841440 | Background | Beeckman D, Van Damme N, Schoonhoven L, Van Lancker A, Kottner J, Beele H, Gray M, Woodward S, Fader M, Van den Bussche K, Van Hecke A, De Meyer D, Verhaeghe S. Interventions for preventing and treating incontinence-associated dermatitis in adults. Cochrane Database Syst Rev. 2016 Nov 10;11(11):CD011627. doi: 10.1002/14651858.CD011627.pub2. |
| Label | URL |
|---|---|
| Website of the research group | View source |
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| ID | Term |
|---|---|
| D003668 | Pressure Ulcer |
| D017453 | Dermatitis, Irritant |
| D003963 | Diaper Rash |
| D007511 | Ischemia |
| ID | Term |
|---|---|
| D012883 | Skin Ulcer |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D003877 | Dermatitis, Contact |
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Punch skin biopsy
|
| D003872 |
| Dermatitis |
| D017443 | Skin Diseases, Eczematous |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |