Avaliação do microclima e pressão de interface como fatores de risco de lesão por pressão: aplicabilidade clínica

Abstract

Introduction: The constant and prolonged application of pressure on areas of bony prominences triggers various physiological reactions that lead to the appearance of lesions. However, there are other external factors that can accelerate this process, such as microclimate and interface pressure. As they are external variables, these factors can be easily controlled and changed once they are known and observed, which favors the prevention of pressure injuries. Objective: To evaluate the microclimate characteristics, which include temperature, humidity, and skin oiliness, as well as interface pressure, in body regions considered to be at risk of developing pressure injuries in patients with restricted mobility. Method: This is a cross-sectional, analytical study of adult patients with restricted mobility admitted to a university hospital in Minas Gerais. Data was collected using a structured instrument which included sociodemographic information, physical examination, lifestyle habits, current and past health history, skin characteristics and preventive measures. Data was collected from September 2022 to February 2023 and analyzed using descriptive and inferential statistics. Patients on contact and/or aerosol precautions were excluded. The data was analyzed using the Statistical Package for the Social Sciences (SPSS) version 25, trial. To describe the profile of the sample, frequency tables were drawn up with the sociodemographic variables. The Braden Scale was used as a parameter for measuring risk, in accordance with the institutional protocol. The data was analyzed using the x² test and the T-test for the quantitative variables. Results: The average time for data collection and use of the device was 25 minutes. The majority of participants were female (57.5%), white (55%), with low levels of education (57.5%) and an average age of 59. The presence of comorbidities was found in 87.5% of the patients. The nutritional diagnoses of underweight or eutrophic amounted to 72.5%. Incontinence with the need to use a diaper was predominant, appearing in 70% of the patients. Previous or current smoking stood out, reported by 75% of the participants. The body areas with the highest interface pressure were the calcaneus and sacrum, with average pressure values of: 62 mmHg and 39.9 mmHg, respectively. Conclusion: The skin moisture and oil sensor is simple to apply and its use proved to be clear and easy to handle. Temperature was easily measured, as the team used an infrared thermometer that they had already mastered. Although the interface sensor is a less common instrument, it proved to be feasible in a clinical environment, provided the team is well trained. In addition, it is possible to identify the value of the pressure exerted on the skin tissue corresponding to the risk of injury.