Prevalence of wounds in hospitalised neonates: a systematic review
DOI:
https://doi.org/10.29352/mill0220e.37650Keywords:
infant; newborn; wounds and injuries; prevalence; systematic reviewAbstract
Introduction: The integrity of the newborn's skin is essential for its well-being and survival, as it acts as a protective barrier, promotes thermoregulation, and prevents the absorption of chemical agents.
Objective: To determine the prevalence of wounds in neonates admitted to the hospital.
Methods: A systematic prevalence review with meta-analysis was carried out following the method proposed by the Joanna Briggs Institute. The search was carried out in nine databases and included studies in English, Portuguese, French and Spanish, with no limit on the date of publication. The selection, critical evaluation, and extraction of data were carried out by two independent reviewers. Binary random-effect meta-analyses of prevalence were carried out using the inverse variance method with Freeman-Tukey double arcsine transformation.
Results: The search strategy identified 1964 records, of which only 26 articles formed part of the review corpus. The binary meta-analysis of prevalence was carried out with 22 studies and included a sample of 3768 neonates. The combined prevalence of injuries was 39% (95% CI= 28-50%; p<0.01). The studies included in this review show the need for interventions aimed at the prevention and management of skin lesions in newborns admitted to the hospital.
Conclusion: There is a significant prevalence of skin lesions in hospitalized newborns. It is essential to implement interventions within the framework of risk assessment and evidence-based practices to ensure the integrity of the neonate's skin.
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Ahmadizadeh, L., Valizadeh, L., Rahkar Farshi, M., Broom, M. M., Asghari Jafarabadi, M., Saeidi, F., & Neshat, H. (2022). Skin injuries in neonates admitted to three Iranian neonatal intensive care units. Journal of Neonatal Nursing, 28(3), 159–163. https://doi.org/10.1016/j.jnn.2022.01.014
August, D. L., Edmonds, L., Brown, D. K., Murphy, M., & Kandasamy, Y. (2014). Pressure injuries to the skin in a neonatal unit: Fact or fiction. Journal of Neonatal Nursing, 20(3), 129–137. https://doi.org/10.1016/j.jnn.2013.08.006
Azevedo, T. M. D., Morais, L. L. de, & Batista, I. B. C. (2022). Prevalência de lesão de septo nasal em recém-nascidos prematuros por uso de pressão positiva contínua nas vias aéreas (CPAP) em uma unidade de terapia intensiva neonatal. ASSOBRAFIR Ciência, 13, e44541. https://doi.org/10.47066/2177-9333.ac.2022.0049
Beitz, J. M. (2022). Wound healing. In Core curriculum: wound management (2nd ed.). Wolters Kluwer.
Boyar, V. (2020). Pressure injuries of the nose and columella in preterm neonates receiving noninvasive ventilation via a specialized nasal cannula: a retrospective comparison cohort study. Journal of Wound, Ostomy and Continence Nursing, 47(2), 111–116. https://doi.org/10.1097/WON.0000000000000616
Broom, M. M., Burton, W. A., Ehrlich, L. M., Dunk, A. M., & Abdel-Latif, M. E. (2017). Developing an Australian skin risk assessment and management tool for neonates. Wound Practice and Research, 25(1), 15–22. https://abrir.link/TSghN
Broom, M. M., Dunk, A. M., & E Mohamed, A. L. (2019). Predicting Neonatal Skin Injury: The First Step to Reducing Skin Injuries in Neonates. Health Services Insights, 12, 1–10. https://doi.org/10.1177/1178632919845630
Csoma, Z., Meszes, A., Mader, K., Kemény, L., & Tálosi, G. (2015). Overview of dermatologic disorders of neonates in a central regional intensive care unit in Hungary. In Pediatric Dermatology (Vol. 32, Issue 2, pp. 201–207). Blackwell Publishing Inc. https://doi.org/10.1111/pde.12443
Dai, T., Lv, L., Liu, X., Chen, J., Ye, Y., & Xu, L. (2020). Nasal pressure injuries due to nasal continuous positive airway pressure treatment in newborns: a prospective observational study. Journal of Wound, Ostomy and Continence Nursing, 47(1), 26–31. https://doi.org/10.1097/WON.0000000000000604
Euro-Peristat Project. (2022). European Perinatal Health Report. Core indicators of the health and care of pregnant women and babies in Europe from 2015 to 2019 (5th Report). Euro-Peristat. https://www.europeristat.com/
Faria, M. F., Ferreira, M. B. G., Felix, M. M. dos S., Calegari, I. B., & Barbosa, M. H. (2019). Factors associated with skin and mucosal lesions caused by medical devices in newborns: observational study. Journal of Clinical Nursing, 28(21–22), 3807–3816. https://doi.org/10.1111/jocn.14998
Faria, T. F., & Kamada, I. (2018). Lesiones de la piel en neonatos en cuidados intensivos neonatales. Enfermería Global, 17(1), 220–228. https://doi.org/10.6018/eglobal.17.1.273671
Fontenele, F. C., & Cardoso, M. V. L. M. L. (2011). Skin lesions in newborns in the hospital setting: type, size, and affected area. Revista da Escola de Enfermagem USP, 45(1), 127–133. https://doi.org/10.1590/S0080-62342011000100018
Fox, M. D. (2011). Wound care in the neonatal intensive care unit. Neonatal Network, 30(5), 291–303. https://doi.org/10.1891/0730-0832.30.5.291
Gardner, S., Carter, B., Hines, E., & Hernandez, J. (2016). Merenstein & Gardner’s handbook of neonatal intensive care (8th ed.). Elsevier.
Grebinski, A. T. K. G., da Silva, C. C., Tonial, D. A., Zilly, A., & da Silva, R. M. M. (2023). Nasal septal injury in hospitalized newborns: exploratory descriptive study. Online Brazilian Journal of Nursing, 22. https://doi.org/10.17665/1676-4285.20236630
Guimarães, A. R., Rocha, G., Rodrigues, M., & Guimarães, H. (2020). Nasal CPAP complications in very low birth weight preterm infants. Journal of Neonatal-Perinatal Medicine, 13(2), 197–206. https://doi.org/10.3233/NPM-190269
Habiballah, L. (2017). Prevalence of neonate adhesive skin injuries in a Jordanian intensive care unit. Nursing Children and Young People, 29(10), 42–46. https://doi.org/10.7748/ncyp.2017.e966
Irving, V. (2006). Wound care for preterm neonates. Infant, 2(3), 102–106. https://www.infantjournal.co.uk/pdf/inf_009_wcf.pdf
Jani, P., Mishra, U., Buchmayer, J., Maheshwari, R., D’Çruz, D., Walker, K., Gözen, D., Lowe, K., Wright, A., Marceau, J., Culcer, M., Priyadarshi, A., Kirby, A., Moore, J. E., Oei, J. L., Shah, V., Vaidya, U., Khashana, A., Godambe, S., … Satardien, M. (2023). Global variation in skin injuries and skincare practices in extremely preterm infants. World Journal of Pediatrics, 19(2), 139–157. https://doi.org/10.1007/s12519-022-00625-2
Kostogloudis, N., Demiri, E., Tsimponis, A., Dionyssiou, D., Ioannidis, S., Chatziioannidis, I., & Nikolaidis, N. (2015). Severe extravasation injuries in neonates: a report of 34 cases. Pediatric Dermatology, 32(6), 830–835. https://doi.org/10.1111/pde.12664
Lund, C., & Singh, C. (2022). Skin and wound care for neonatal and pediatric populations. In A.T. Wicks, & T.L. Smith (Eds.), Core curriculum: wound management (2nd ed.). Wolters Kluwer.
Machado, C. P., Magalhães, F. J., Costa, M. S. B., Rovere, G. P., Gurgel, E. D. P. P., & Veloso, C. G. (2022). Lesões associadas a dispositivos médicos em recém-nascidos e crianças em situação crítica. Revista Enfermagem Atual In Derme, 96(38), 7–23. https://doi.org/10.31011/reaid-2022-v.96-n.38-art.1426
Magalhães, C. (2016). Trends on neonatal hospitalizations: a 10-year nationwide big data analysis [Dissertation, Instituto de Ciências Biomédicas Abel Salazar]. https://hdl.handle.net/10216/128222
Maguire, D. P. (1999). Skin protection and breakdown in the ELBW infant: a national survey. Clinical Nursing Research, 8(3), 222–234.
Marcatto, J. O., Santos, A. S., Oliveira, A. J. F., Costa, A. C. L., Regne, G. R. S., Trindade, R. E., Couto, D. L., Noronha, K. V. S. M., & Andrade, M. V. (2022). Medical adhesive-related skin injuries in the neonatology department of a teaching hospital. Nursing in Critical Care, 27(4), 583–588. https://doi.org/10.1111/nicc.12621
Meszes, A., Tálosi, G., Máder, K., Orvos, H., Kemény, L., & Csoma, Z. R. (2017). Lesions requiring wound management in a central tertiary neonatal intensive care unit. World Journal of Pediatrics, 13(2), 165–172. https://doi.org/10.1007/s12519-016-0070-6
Migoto, M. T., de Souza, S. N. D. H., & Rossetto, E. G. (2013). Skin lesions of newborns in a neonatal unit: descriptive study. Online Brazilian Journal of Nursing, 12(2), 377–392.https://www.redalyc.org/pdf/3614/361433916013.pdf
Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., Shekelle, P., & Stewart, L. A. (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic Reviews, 4(1), 1. https://doi.org/10.1186/2046-4053-4-1
Munn, Z., Moola, S., Lisy, K., Riitano, D., & Tufanaru, C. (2019). Chapter 5: Systematic reviews of prevalence and incidence. In JBI Reviewer’s Manual. https://doi.org/10.46658/jbirm-17-05
Newman, K. M., McGrath, J. M., Salyer, J., Estes, T., Jallo, N., & Bass, W. T. (2015). A comparative effectiveness study of continuous positive airway pressure-related skin breakdown when using different nasal interfaces in the extremely low birth weight neonate. Applied Nursing Research, 28(1), 36–41. https://doi.org/10.1016/j.apnr.2014.05.005
Ohuma, E. O., Moller, A. B., Bradley, E., Chakwera, S., Hussain-Alkhateeb, L., Lewin, A., Okwaraji, Y. B., Mahanani, W. R., Johansson, E. W., Lavin, T., Fernandez, D. E., Domínguez, G. G., de Costa, A., Cresswell, J. A., Krasevec, J., Lawn, J. E., Blencowe, H., Requejo, J., & Moran, A. C. (2023). National, regional, and global estimates of preterm birth in 2020, with trends from 2010: a systematic analysis. The Lancet, 402(10409), 1261–1271. https://doi.org/10.1016/S0140-6736(23)00878-4
Oudtshoorn, S., Wood, F., & McWilliams, T. (2021). Neonatal burns: a 10-year review of community- and hospital-acquired neonatal burns in Western Australia. ANZ Journal of Surgery, 91(11), 2503–2506. https://doi.org/10.1111/ans.17198
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. The BMJ, 372(71). https://doi.org/10.1136/bmj.n71
Reza, C. G., Mejía-Flores, M. A., Pérez, L. G., & Martínez, V. G. (2018). Intervenciones de enfermería en neonatos con presión positiva continua. Investigación en Enfermería: Imagen y Desarrollo, 20(1). https://doi.org/10.11144/Javeriana.ie20-1.ienp
Santos, E., & Cunha, M. (2022). Uma breve história da evolução do tratamento de feridas. Millenium - Journal of Education, Technologies, and Health, 2(10e), 9–11. https://doi.org/10.29352/mill0210e.27313
Silva, R. de C., & Paiva, E. D. (2022). Cuidados de enfermagem para prevenção de lesão de pele em recém-nascidos pré-termo: revisão integrativa. Nursing, 25(292), 8688–8699. https://abrir.link/igEhX
Sociedade Portuguesa de Pediatria. (2014a). Atuação no micronato. SPP. https://www.spneonatologia.pt/wp-content/uploads/2016/11/2014-Micronato.pdf
Sociedade Portuguesa de Pediatria. (2014b). Cuidados cutâneos no recém-nascido. SPP.
Sousa, N. F. C., Bonfim, S. de F. S. F., Vasconcelos, M. G. L., Bezerra, J. L. de O., Silva, D. V. C., & Leal, L. P. (2013a). Prevalence of nasal septum injury in premature infants using nasal prongs. Revista da Escola de Enfermagem, 47(6), 1285–1290. https://doi.org/10.1590/S0080-623420130000600005
Sousa, N. F. C., Bonfim, S. de F. S. F., Vasconcelos, M. G. L., Bezerra, J. L. de O., Silva, D. V. C., & Leal, L. P. (2013b). Prevalence of nasal septum injury in premature infants using nasal prongs. Revista da Escola de Enfermagem, 47(6), 1285–1290. https://doi.org/10.1590/S0080-623420130000600005
Steen, E. H., Wang, X., Boochoon, K. S., Ewing, D. C., Strang, H. E., Kaul, A., Masri, L., Balaji, S., Hollier, L. H., & Keswani, S. (2020). Wound healing and wound care in neonates: current therapies and novel options. Advances in Skin and Wound Care, 33(6), 294–300. https://doi.org/10.1097/01.ASW.0000661804.09496.8c
Timbó, C. C., Godinho, D. B., Fontenele, F. C., De, M. R., Barbosa, J., Lancia, L., Cláudia, R., Dodt, M., & Rocha, R. S. (2015). Skin lesions in preterm infants in a neonatal intensive care unit. Children’s Nurses-Italian Journal of Pediatric Nursing Sciences, 7(3), 132–135.
World Health Organization. (2023). Born too soon: decade of action on preterm birth. In the WHO. https://doi.org/10.3828/liverpool/9781949979688.003.0009
Zanatta, D. A., Carvalho, V. O., & da Silva, R. P. G. V. C. (2023). What the skin of 341 premature newborns says - a transversal study. Jornal de Pediatria, 99(6), 582–587. https://doi.org/10.1016/j.jped.2023.04.005
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