Physical Restraint-related Skin Injuries Among Patients in Intensive Care: A Prospective Cohort Study

OBJECTIVE: This study aimed to assess the incidence and risk factors of physical restraint-related skin injuries among patients in intensive care units (ICUs). METHODS: This prospective cohort study included 260 patients who were physically restrained from 5 ICUs in a hospital. Data were collected using the Physical Restraint Monitoring Form and the Skin Injury Assessment Guide. RESULTS: The most common physical restraint-related skin injuries were edema (71.9%), ecchymosis (52.3%), scaling (30.8%), and pressure injuries (20%). Pressure injuries were most frequently observed in the neurosurgery and anesthesia/reanimation ICUs. They were more common among patients who were 70 years old or younger, male, had a high body mass index, received antiepileptic therapy, were restrained for more than 46 hours, or were restrained using gauze or tight bonds ( P < .001). Male sex, overweight/obesity, and a restraint duration of ≥46 hours were identified as independent risk factors for pressure injury. CONCLUSIONS: Physical restraint-related skin injuries in patients who are critically ill are influenced by factors such as sex, body mass index, restraint duration, and restraint material. The implementation of evidence-based guidelines and regular monitoring can help mitigate these risks and improve patient safety.