The effect of evidence-based skin care and hydrocolloid dressing in the prevention of nasogastric tube-related pressure injury: A randomized controlled clinical trial

Abstract

Objective: The aim of this study is to determine the effect of evidence-based skin care and hydrocolloid dressing in the prevention of nasogastric (NG) tube-related pressure injuries (PIs).

Design: This study was a three-arm parallel-group randomized controlled clinical trial registered on Clinicaltrials.gov (NCT04682925).

Methods: The study was conducted with 102 patients who underwent NG tube insertion immediately after admission to the anesthesiology and reanimation intensive care unit of a university hospital in Turkey. Patients were randomly assigned to three groups: a control arm (n = 34), a hydrocolloid dressing arm (n = 34), and a skin care arm (n = 34). Patients in the hydrocolloid dressing arm received daily application of hydrocolloid dressing to the nasal mucosa and alae nasi where the NG tube was inserted. Patients in the skin care arm received skin care interventions in preventing PIs twice daily. No interventions were administered to the control group.

Results: No NG tube-related PIs occurred in any patients in the hydrocolloid dressing arm. However, PIs occurred in 97.1 % of patients in the control arm and 94.1 % of patients in the skin care arm. According to the results of regression analysis, failure to apply hydrocolloid dressing increased the risk of NG tube-related PIs by 20.3 times [OR = 20.301, 95 % CI = 6.335-65.053, p < 0.001]. Additionally, a one-unit increase in the duration of ventilation days reduced the risk of NG tube-related PIs by 17.7 % (1-0.823) [OR = 0.823 (95 % CI = 0.684-0.989), p = 0.038].

Conclusion: Results revealed that hydrocolloid dressing is effective in preventing of NG tube-related PIs, whereas skin care did not demonstrate the same effectiveness.

Keywords: Evidence; Hydrocolloid dressing; Nasogastric tube; Pressure injury; Skin care.