Three Kinds Of Biological Dressing In Prevention From Nasal Facial Pressure Ulcer In Patients Using The Non-invasive Positive Pressure Ventilation:Observation Study

Objective:In this study, three biological dressings were used in NIPPV patients to observe and analyze the incidence and occurrence time of nasal pressure ulcers stage I using noninvasive positive pressure ventilation and comparison of dressing value. It provided effective preventive measures for nasal pressure ulcers using noninvasive positive pressure ventilation which increased the comfort degree of patients, reduced pain, improved the quality of nursing, and enhanced the tolerance to NIPPV therapy. Methods:From 2013 July to 2015 January in the Departments of RICU and respiratory department of a Grade-III Class-A hospital in Zhengzhou, 120 patients in the treatment of non-invasive positive pressure ventilation were chosen. Nurses choose dressing according to the wishes of patients and their families, and all the samples were divided into the experimental group 1(Transparent Dressing), experimental group 2(Adhesive Dressing) and experimental group 3(Foam dressing). Before use, the dressings were cut into type O. The skin of nose was cleaned up using physiological saline. After drying, the dressings with no fold were expanded outward from the center, and while sticking fingers were used to press the circumference uniformly. Lastly, a ventilator mask was used on the biological dressings which protected the pressed skin. 40 seconds of observation and assessment evaluation of the patients’ skins every 30 minutes. If fold or fall of the dressings, or a large area off into ash happened, the biological dressings were timely replaced. In the end, the analysis was made for occurrence time and the number of the stage I nasal pressure ulcers and the comfort of skin among three groups. Results:1. Each group had 40 cases: experimental group 1 had 20 cases(50%) of the stage I nasal pressure ulcers; experimental group 2 had 10 cases(25%) of the stage I nasal pressure ulcers; experimental group 3 had 8 cases(20%) of the stage I nasal pressure ulcers.2. There was statistically significant difference(P< 0.017) between experimental group 1 and experimental group 2 in the incidence of the stage I nasal pressure ulcers, and there was also statistically significant difference(P<0.017) between experimental group 1 and experimental group 3. There was no statistically significant difference(P> 0.05) between experimental group 2 and experimental group 3.3. The stage I nasal pressure ulcers of experimental group 1 occurred earlier than experimental group 2 and experimental group 3(P<0.017). There was no statistically significant difference in occurrence time between experimental group 2 and experimental group 3(P>0. 05).4. The comfort of skin in experimental group 1 was worse than that in experimental group 2 and experimental group 3, and there was statistically significant difference(P< 0.017). There was no statistically significant difference(P> 0.05) in the comfort of skin between experimental group 2 and experimental group 3. Conclusion:1. The incidence of the stage I nasal pressure ulcers using Transparent Dressing was significantly higher than that using in Adhesive Dressing group and Foam Dressing group.2. The comfort of skin using Transparent Dressing was significantly lower than that using in Adhesive Dressing group and Foam Dressing.