Authors (including presenting author) :
Yeung ST(1),Yu YH(1),Lai CY (2), Chan TF (1)(2), Fan J(3), Tsang SF(1), Leung YF(1)
Affiliation :
(1)M&G, Our Lady of Maryknoll Hospital,(2)HDU, Our Lady of Maryknoll Hospital,(3)Podiatrist, Our Lady of Maryknoll Hospital
Introduction :
Besides sacrum area, heel was the second most common site for developing pressure injury (PI) in bedbound patients. The promotion of the heels free and prophylactic silicone foam dressing were already carried out in OLMH to eliminate associated PI. However, incident of hospital acquired pressure injury (HAPI) on the heels was still significant. Hyperoxygenated fatty acid oil (HOFAO) is a formula to hydrate and moisten the skin and reduce the shearing and frictional forces. HOFAO is also clinically significant to treat grade 1 PI (Candela-Zamora et al, 2010). In addition, regular skin inspection should be promoted (DeMarco, 2021). In this study, we enhance skin care to heels. By applying HOFAO or Vaseline to patient with stage 1 PI, to evaluate the treatment and prognostic effect.
Objectives :
1. To prevent pressure injury by enhancing skin care to heels 2. To increase nurse awareness on pressure injury on heels
Methodology :
1. Patients with Barden score less than 12/23 or presence of stage 1 PI on heel / ankle was recruited. 2. On site staff briefing on the usage and application of HOFAO and Vaseline was arranged. 3. Recruited patients would receive one or two sprays of HOFAO or Vaseline daily for 2 weeks on pressure areas, such as ankle and heel. 4. Barden score, incidence rate of stage 1 PI and the healing time would be analyzed to evaluate the effectiveness of the HOFAO and Vaseline.
Result & Outcome :
A total of 48 cases were completed in the study. There was 25 in the HOFAO group from 9/6/20 to 22/6/2020 and 23 in Vaseline group from 30/6/2020 to 13/7/2020. In the HOFAO group, 22 cases had developed stage 1 PI before applying HAFAO. 3 cases did not have PI but their Braden score was under 12. The application of HOFAO ranging from 1 – 10 days and the average was 5 days. 10 cases (45%) showed PI healing after applying HOFAO from 2-10 days, the average was 6.3 days. 12 cases (48%) showed no significant improvement or change after applying HOFAO. In Vaseline group, 18 cases had developed stage 1 PI before applying Vaseline. 5 cases did not have PI even their Braden scale was under 12. The application of Vaseline from 1-13 days and the average was 7.4 days. 6 cases (33%) showed healing after applying Vaseline from 3-13 days; the average was 7.7 days. 12 cases (52%) showed no significant improvement or change after applying Vaseline from 1-13 days. All of them did not escalated the PI staging or develop new PI. Conclusion: After the application of HOFAO or Vaseline, we observed the skin over the feet was hydrated and increased blood circulation and stimulates skin elasticity by gentle massage (Inge GP Duimel-Peeters et al, 2005; Díaz-Valenzuela A et al, 2019) that facilitated prevention of PI. On the other hand, the change of skin condition can be detected early by daily skin care. We noticed that applying topical agent (HOFAO or Vaseline) to foot was an effective and simple measure for prevention of PI. Since there is no significant difference between the effect of HOFAO and Vaseline, the latter is more user-friendly in terms of its cost effectiveness and availability. Future Implication: The result increases the staff awareness on prevention of stage I PI on foot. Both HOFAO and Vaseline can be introduced to other wards and family to apply in the future.
