A Comparative Study of Two Toothpad-Free Fixation Methods for Preventing Oral Mucosal Pressure Injuries in Patients with Oral Endotracheal Intubation: Quasirandomized controlled trial study
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Background In ICU patients with oral endotracheal intubation, the toothpad-free fixation method demonstrates comparable safety to the toothpad fixation method. However, the optimal fixation technique and other therapeutic outcomes remain to be clearly defined. Objective The current study sought to examine the effectiveness of two toothpad-free fixing methods for oral mucosal pressure injuries and other factors in patients undergoing oral endotracheal intubation. Methods A total of 80 patients were selected as subjects, with the control group using the traditional toothpad-free fixation method and the intervention group adopting a novel toothpad-free fixation approach; both groups were managed under the "PDCA cycle management model." The degree of oral mucosal pressure damage, rate of tracheal intubation, rate of biting tube, and oral health of patients in the two groups were all recorded. Results Intergroup comparisons revealed that the intervention group had significantly lower rates of oral mucosal pressure injuries (\(\:\text{x}\) 2 =4.943, P = 0.026), oral health total scores (t=-3.701, P<0.001), and tube-biting rates (\(\:\text{x}\) 2 =4.110, P = 0.043) compared to the control group, with statistically significant differences. The displacement rate of tracheal intubation was not significantly different between the two groups (\(\:\text{x}\) 2 =5.400, P = 0.067). Intragroup comparison revealed that the control group's dental condition had statistically significant differences in oral mucosal pressure injury (\(\:\text{x}\) 2 =6.589, P = 0.036) and bite tube rate (\(\:\text{x}\) 2 =6.427, P = 0.035), but no statistically significant difference in oral health or tracheal intubation displacement rate (P > 0.05). The intervention group's dental condition had no significant impact on oral mucosal pressure damage, oral health, tracheal intubation displacement rate, or bite rate (P > 0.05). Conclusions The above findings indicate that the novel fixation method can significantly improve the oral mucosal pressure injury and maintain oral health in patients with orotracheal intubation, and reduce the rate of bite tube. The impact of preventing pipeline displacement is identical to the traditional fixing approach, but the procedure is easier.
