Objective:To investigate the status and influencing factors of skin cleaning outside wound (hereinafter referred to as skin) in adult trauma patients.Methods:A multicenter cross-sectional investigation was conducted. From September 1 to 30, 2020, a total of 952 adult trauma patients who met the inclusion criteria were admitted to wound care clinics or trauma surgery wards of 13 military or local Grade Ⅲ Level A hospitals, including the General Hospital of the Eastern Theater Command of People's Liberation Army and the Army Medical Center, etc. A self-designed questionnaire on cleaning status of skin in trauma patients was released through the "questionnaire star" website to investigate basic information such as gender, age, education level, living status, and self-care ability, trauma information such as cause of injury, wound duration, trauma site, trauma depth, wound pain, wound peculiar smell, and wound cleaning solution, and skin cleaning status after injury such as whether to clean or not, cleaning method, cleaning frequency, cleaning duration in each time, or reasons for not cleaning. The patients who cleaned skin regularly after injury were included in cleaning group, and the other patients were included in no cleaning group. The basic information, trauma information, and skin cleaning status after injury of patients in 2 groups were investigated. Data were statistically analyzed with chi-square test, and binary multivariate logistic regression analysis was performed on indicators with statistically significant differences between the two groups to screen the independent influencing factors of skin cleaning in trauma patients.Results:A total of 952 questionnaires were received, and the recovery rate was 100%. Three invalid questionnaires were eliminated, and 949 valid questionnaires were obtained, with an effective rate of 99.68%. In 949 patients, there were 461 (48.6%) males and 488 (51.4%) females, aged 18-100 (50±18) years. Most patients were less than 60 years old, lived with their families, and could take care of themselves completely. Nearly half of the patients were with junior high school or below education level. The main causes of injury were sharp cutting injury and falling injury, the wound duration was 2-365 days, most of the injured parts were limbs and trunk, the wound depth was mostly full-thickness injury, and most patients had wound-related pain and no peculiar smell and used 5 g/L iodophor to clean the wound. Totally 684 (72.1%) patients cleaned their skin after injury, mainly by scrubbing with warm water, the cleaning frequency was mainly once or twice a week, and the cleaning time was mainly 10 or 15 min for each time. Totally 265 (27.9%) patients didn't clean their skin after injury, and the main causes for not cleaning were following the doctor's advice, followed by worrying about wound infection and loss of self-care ability. There were significantly statistical differences in constituent ratios of education level, self-care ability, cause of injury, wound pain, and wound peculiar smell of patients in 2 groups ( χ2=12.365, 24.519, 22.820, 9.572, 92.342, P<0.01). Education level, self-care ability, cause of injury, wound pain, and wound peculiar smell were potential influencing factors of skin cleaning in patients. Binary multivariate logistic regression analysis showed that self-care ability, wound pain, and wound peculiar smell were independent influencing factors of skin cleaning in patients (odds ratio=1.51, 0.52, 3.72, 95% confidence interval=1.08-2.12, 0.42-0.89, 2.66-5.22, P<0.05 or P<0.01). Conclusions:Self-care ability, wound pain, and wound peculiar smell are independent influencing factors of skin cleaning in adult trauma patients.

Objective: To evaluate the effect of biofeedback training on bowl function among rectal cancer patients with chemoradiotherapy and temporary enterostomy. Methods: Using randomized controlled trial design, 109 rectal cancer patients were randomly divided into three groups, the first blank control group, the second group pelvic floor muscle exercise group, the third group biofeedback group. High resolution anorectal manometry was used for 6 longitudinal traces in 16 months. Data of bowel function were collected by Memorial Sloan Kettering Cancer Center (MSKCC) Bowel Function Instrument. Results: The main effect of the change of five indicators, anal resting pressure, rectal resting pressure, maximum squeeze pressure, maximum squeeze time and high pressure zone, was time. The other four indicators, rectal volume at first senory, rectal volume at sense of convenience, maximal tolerable rectal volume and rectal compliance, among patients of biofeedback group were (32.71±5.00) ml, (74.26±8.30) ml, (188.40±12.68) ml, (5.69±1.18) ml/kPa and (68.09±6.38). The rectal volume at first senory, rectal volume at sense of convenience, maximal tolerable rectal volume and rectal compliance, among patients of biofeedback group were significant higher than blank control group and pelvic floor muscle exercise group (F=3.589-26.826, P<0.05). Conclusion The biofeedback could significantly improve the sensory indicators of patients with middle and low rectal cancer. High-resolution anorectal manometry could effectively evaluate the effect of biofeedback training in patients with middle and low rectal cancer.

Objective? To explore the effect of biofeedback exercise on the recovery of rectal function in patients with middle and low rectal cancer. Methods? From June 2015 to December 2016, 126 patients with low and middle rectal cancer who were going to undergo preoperative radiotherapy and chemotherapy, anterior rectal resection and preventive stoma were selected by purposive sampling. They were randomly divided into control group 1 (blank control group), control group 2 (pelvic floor muscle exercise group) and invention group (biofeedback exercise group) by random coding generated by SPSS software and were tracked longitudinally for 6 times in 16 months by high resolution anorectal manometry, 11 manometric indices including initial rectal sensory capacity and rectal fecal sensory capacity were measured. Results? The study was completed in 109 cases, including 38 cases in control group 1, 35 cases in control group 2, and 35 cases in invention group. The main effects of the changes of five indices, including anal resting pressure, rectal resting pressure, anal maximum systolic pressure, anal maximum systolic time and anal high pressure zone, were time (P＜ 0.05). The four indices of rectal initial capacity, rectal fecal sensory capacity, rectal maximum tolerance capacity and rectal compliance in the invention group were higher than those in the control group 1 (P＜0.05); the maximum rectal tolerance capacity and rectal compliance in the invention group were higher than those in the control group 2 (P＜ 0.05). Conclusions? The biofeedback exercise could significantly improve the sensory indicators of patients with middle and low rectal cancer and promote recovery.

Objective? To evaluate the effect of biofeedback on bowel function among rectal cancer patients with chemoradiotherapy and temporary enterostomy. Methods? This study was designed as a randomized controlled trial. The patients with low and middle rectal cancer in a Cancer Hospital of Guangzhou from June 2015 to December 2016 were randomly divided into pelvic floor muscle exercise group (control group, n=36) and biofeedback training group (intervention group, n=35). The intestinal function questionnaire of the Chinese version of Memorial Sloan-Kettering Cancer Cente(r MSKCC) was used to longitudinally track and compare the intestinal function of the two groups for 16 months and 5 times in total. Results? The total score of MSKCC, frequency and urgency of defecation and defecation sensory disturbance in intervention group were higher than those in control group at 4 days and 3 months after stoma inclusion operation, and the differences were statistically significant (P＜ 0.05). Conclusions? Biofeedback training can improve the intestinal function of patients with middle and low rectal cancer, promote their recovery, and prevent intestinal and anal dysfunction of patients with middle and low rectal cancer.

Objective To systematically assess the effects of self-adhesive soft silicone film dressings on preventing and treating radioactive skin lesion. Methods Randomized controlled trials (RCT) about self-adhesive soft silicone film dressings on preventing and treating radioactive skin lesion were retrieved from PubMed, Web of Science, Cochrane Library, Embase, CNKI, VIP and Wanfang databases, and RevMan 5.3 was used for Meta-analysis of the trials which met the inclusion criteria. Results Totally 10 RCTs were included, with a sample size of 1 231 cases. Meta-analysis revealed that self-adhesive soft silicone film dressings could reducethe incidence of GradeⅡ or above radiodermatitis (OR=0.14,95%CI 0.08-0.25,P＜ 0.01), shorten the occurrence time of radiodermatitis within the field of radiotherapy (OR=0.07,95%CI 0.02-0.32, P＜ 0.01), and reduce subjective and objective symptom scores of radiodermatitis (Radiation-induced Skin Reaction Assessment Scale, RISRAS) (MD=-3.33,95%CI-5.96--0.70,P＜ 0.05). Conclusions Self-adhesive soft silicone film dressings applied on the cutaneous surface within the field of radiotherapy can reduce the severity of radiodermatitis, shorten the occurrence time of radioactive skin lesion within the field of radiotherapy, and effectively ameliorate cutaneous discomfort within the field of radiotherapy and the effects of radiotherapy-induced skin reaction on daily activities.

Objective To describe the current situation of pre-hospital delay and health belief in patients with colorectal cancer and explore the relationship between them. Methods With convenient sampling methods,totally 385 patients with colorectal cancer were recruited from January to June 2016. Patients with colorectal cancer were investigated using a general data survey questionnaire, visit situation questionnaire and the Champion Health Belief Model Scale. Results The median pre-hospital delay time was 3.00 months.The rate of pre-hospital delay was 43.1%(166/385). The score of the overall health belief was (119.52 ± 12.62) points. The two dimensions of"perceived susceptibility and perceived severity" scored lower, and the two dimensions of "health motivation and perceived therapeutic benefits" scored higher. The health belief was negatively correlated with the pre- hospital delay among colorectal cancer patients (r=- 0.737, P<0.01). Conclusions Pre-hospital delay occurred among patients with colorectal cancer is severe. Patients with a higher level of health belief have shorter pre-hospital delay.It′s important to improve the level of health belief of"perceived susceptibility and perceived severity"and reduce the time of pre-hospital delay to improve outcomes in patients with colorectal cancer.

Pressure injury (PI) is a common health problem in kinds of medical institutions. For years,with the strengthening of PI prevention consciousness,improvement of pressure-reducing device and the development of wound treatment,PI prevention,treatment and its management had been formulating to a scientific system. Nowadays,more and more medical devices were used in clinic. Medical staff came to realize that sustained pressure from a medical device may cause localized injury to the skin or underlying tissue. By reviewing literature home and abroad and clinical practice,the paper reviewed the definition,epidemiology, classification,risk factors,risk assessment and prevention of medical-device related PI,so as to provide a theoretical guide for clinical nurses.

Healthy granulation tissue played an important role in the wound healing process. However, some factors which interfered the process would result in unhealthy granulation tissue. Unhealthy granulation tissue may affect wound repairing. This article would focus on the concept, mechanisms, interventions of unhealthy granulation tissue.

Objective To analyze the prevention condition of skin tears of inpatients in level-III hospitals, so as to provide basis for making prevention strategies.Methods 14 level-III hospitals were involved in the cross-section survey. Within the same time period, using the same research tools, methods and procedure, 964 trained nurses inspected patients from head to toes, who were selected by convenience sampling, with hospital stay ≥24 h, with age≥18 years old, and with signature on the informed consent documents, and also investigated implementation of prevention measures. Results A total of 18 806 effective cases were obtained, with 238 locations of skin tears in 199 patients found. Incidence of hospital-acquired skin tears was 1. 06%. Implementation rate of risk assessment and nutrients and water supplement was 3. 92% and 10. 35%. Implementation rate of prevention of falling and falling down from bed was 51. 58% and 47. 20%. Usage of assistant tools and emollients accounted for 28. 23% and 2. 69%. Adopting suitable moving techniques and wearing long sleeves, trousers or long stockings accounted for 8.07% and 6.95%. Differences of incidence rate, risk assessment and implementation of prevention measures of skin tears among teaching hospitals, comprehensive hospitals and specialty hospitals were statistically meaningful ( P < 0. 05 for all ) . Conclusions Risk assessment and prevention of skin tears in these 14 level-III hospitals were not satisfactory. Prevention measures vary from different types of the hospitals. In future, nurses should be trained to strengthen awareness of risk assessment and prevention, and implementation rate and consistency of preventive measures should be improved.

Objective To study the psychosocial behavior reaction,psychosocial needs,anxiety and depression among colostomy patients prior to discharge and to explore the relationship between them.Methods Totally 67 colostomy patients from 2 hospitals in Guangzhou were recruited and investigated by demographic questionnaire,Ostomy Psychosocial Behavior Reaction Questionnaire,Ostomy Psychosocial Needs Questionnaire,Hospital Anxiety and Depression Scale 1-2 days prior to discharge.Results The psychosocial behavior reaction among coIostomy patients was in the moderate level with the mean score 2.15±0.27.The psychosocial needs were in medium to high level with the mean score 2.09±0.41.About 37.3％ of colostomy patients showed anxiety,while 20.9％ patients showed depression.Significant positive correlation was shown between psychosocial behavior reaction and psychosocial needs(r=0.565,P＜0.01),while significant positive correlation was also shown between psychosocial behavior reaction and anxiety-depression(r=-0.472,-0.319,P＜0.01).Psychosocial needs and anxiety could predict psychosocial behavior reaction positively(β=0.486,-0.375,P＜0.01).Conclusion The positive acknowledgement and reconstruction are the main psychosocial behavior reactions prior to discharge in colostomy patients.Patients with more psychosocial needs,severe anxiety show more psychosocial behavior reaction.