Clinical Effect Of Different Methods To Prevent Neck Skin Injury In Tracheotomy Patients

Objective:To study the effect of three gauze,hydrocolloid dressing and foam dressing on the neck and skin between patients undergoing tracheotomy,and compare the effect of the two nursing methods on preventing the neck skin injury of tracheotomy patients.All,improve the quality of life of patients.Methods:160 patients who were admitted to Xingtai peopleundefineds Hospital from December 2017 to November 2018 were selected for tracheotomy.160 patients were randomly divided into 3 groups:group 1 was gasket gauze group,group 2 was adhesive colloid dressing group,and the other two groups were treated with adhesive colloid dressings,and the patients were divided into 3 groups,one group was pad gauze group,the other group was adhesive colloid dressing group.Group 3 was gasket foam dressing group.On the day of tracheotomy,nurses involved in the study recorded patientsundefined gender,age,diagnosis,craniotomy,conization and interventional operations,GCS scores,Braden scores,hemoglobin and albumin counts.All the patients in the three groups received routine nursing care and fixed the trachea tube with ordinary cloth tape,and single layer gauze was used to replace the tracheotomy opening.On the basis of this,one group of patients put gauze lining between tracheotomy fixation band and neck,two groups of patients adhered hydrocolloid dressing between fixed band and neck skin,and three groups of patients were treated with foam dressing between fixed band and neck skin.The relevant indexes were recorded by the nursing staff involved in the study,and the incidence and severity of neck skin injury in the three groups were finally compared,the frequency of replacing the gasket dressing,the time used to replace the dressing,the difficulty of replacing the dressing,economic cost and whether or not the trachea cannula had been released from the three groups were compared.To evaluate the effect of three nursing methods on preventing skin injury in neck of tracheotomy patients.The data were analyzed by SPSS20.0 software(P<0.05).Results:1.Incidence of neck skin injuryAmong 160 cases of tracheotomy in three groups,the incidence of cervical skin injury was 11.88%,including 13 cases of neck skin injury in gauze group,25%of skin injury rate,5 cases of neck skin injury in hydrocolloid group,and 9.6%of cases in hydrocolloid group.One case of cervical skin injury occurred in foam group,and the incidence of skin injury was 1.8%.There was a significant difference in the incidence of cervical skin injury among the three groups(X~2=14.3,P<0.001).The incidence of skin injury between gauze group and water gel group,gauze group and foam group showed significant difference(P<0.05),but there was no significant difference between water gel group and foam group(P>0.05).2.Comparisons of time and difficulty of dressing replacementNurses in the three groups of patients to change the liner dressing time(H=105.209,P<0.001)and self evaluation of the difficulty of change(H=107.478,P<0.001),the difference was statistically significant,the difference between the three groups of 22 is also statistically significant,replacement foam dres-sing the shortest time,the most easy to replace,replacement of hydrocolloid dressing takes the longest time,the most difficult.3.Frequency comparison of dressing replacementGauze dressing was the most frequent replacement,and the frequency of foam dressing change was the lowest.The frequency of replacement between the three groups was compared(H=82.289,P<0.001),the difference was statistically significant.The difference between the two groups was also statistically significant.4.Economic cost comparisonThe economic cost of gauze group was lower than that of hydrocolloid group and foam group.The cost of dressing in the three groups was statistically significant(P<0.05).The difference between gauze group and hydrocolloid group,gauze group and foam group was statistically significant(P<0.05),but there was no significant difference between hydrocolloid group and foam group(P>0.05).5.Comparison of extubation rateThree groups of tracheotomy patients,there is no phenomenon of untubule.Conclusion:1.The application of hydrocolloid dressing and foam dressing pad is more effective in preventing neck skin damage than tracheal incised belt and neck skin than liner gauze dressing.2.Liner foam dressing is better than gauze dressing and better than hydrocolloid dressing in the time and difficulty of replacement.3.The replacement frequency of liner foam dressing is lower than that of hydrocolloid dressing and gauze dressing.4.Application of foam dressing pad can effectively prevent neck skin injury in patients with tracheotomy.Although the cost is slightly higher,the replacement of nursing staff is easier,shorter time consuming and lower replacement frequency,which is more conducive to clinical operation and more suitable for patients with tracheotomy.