Dalgleish L, Campbell J, Finlayson K, Coyer F, et al.
Advances in skin & wound care. Date of publication 2020 Feb 1;volume 33(2):76-83.
1. Adv Skin Wound Care. 2020 Feb;33(2):76-83. doi:
10.1097/01.ASW.0000617844.69248.92.
Acute Skin Failure in the Critically Ill Adult Population: A Systematic Review.
Dalgleish L, Campbell J, Finlayson K, Coyer F.
GENERAL PURPOSE: To present a systematic review of the literature conducted to
define and extend knowledge of the risk factors, causes, and antecedent
conditions of acute skin failure (ASF) in adult intensive care patients.
TARGET AUDIENCE: This continuing education activity is intended for physicians,
physician assistants, nurse practitioners, and nurses with an interest in skin
and wound care.
LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity,
the participant should be better able to:1. Outline the background information
helpful for understanding the authors' systematic review of ASF in adult
intensive care patients.2. Summarize the results of the authors' review of the
risk factors, causes, and antecedent conditions of ASF in adult intensive care
patients.
ABSTRACT: To define and extend knowledge of the risk factors, causes, and
antecedent conditions of acute skin failure (ASF) in the adult intensive care
patient cohort.The Cochrane Library, Joanna Briggs Institute Evidence-Based
Practice Database, PubMed, Medical Literature Analysis and Retrieval System,
Cumulative Index of Nursing and Allied Health Literature, and Google
Scholar.Studies were selected if they were qualitative or quantitative research
that reported ASF in adult human patients in an ICU setting. The preliminary
search yielded 991 records and 22 full texts were assessed for eligibility. A
total of three records were included. Studies were appraised using the Mixed
Methods Appraisal Tool.Data from the included studies were extracted by one
reviewer and summarized in data collection tables that were checked and verified
by a second reviewer.Study authors identified five independent predictors of ASF:
peripheral vascular disease, mechanical ventilation longer than 72 hours,
respiratory failure, liver failure, and sepsis. However, the term ASF was applied
to retrospective cohorts of patients who developed severe pressure injuries.
This, combined with the absence of evidence surrounding the assessment, clinical
criteria, and diagnosis of ASF, could impact these variables' predictability
relative to the condition.These results highlight a substantial evidence gap
regarding the etiology, diagnostic biomarkers, and predictors of ASF. Further
research focused on these gaps may contribute to an accurate and agreed-upon
definition for ASF, as well as improved skin integrity outcomes.
DOI: 10.1097/01.ASW.0000617844.69248.92
PMID: 31972579 [Indexed for MEDLINE]
