Oral Hygiene Post ABI

Author/Year/ Country/Study Design/PEDro Score/N

 

Methods

 

Outcome

Seguin et al.
(2014)
France
RCT
PEDro=7
N=167

Population: Povidone-Iodine group (n=85): TBI=62, Stroke=23; Mean Age=48yr; Gender: Male=60, Female=25; Mean Time Post Injury=6hr; Mean GCS=6. Placebo group (n=82): TBI=61, Stroke=21; Mean Age=48yr; Gender: Male=64, Female=18; Mean Time Post Injury=6hr; Mean GCS=6.
Intervention: Patients were randomly assigned to either receive Povidone-Iodine for decontamination of the oropharyngeal tract, or placebo.   
Outcome Measures: Incidence of ventilator-associated pneumonia (VAP).

  1. VAP occurred in 31% of patients in the Povidone-Iodine group and 28% of patients in the placebo group (p=0.69).

Robertson and Carter
(2013)
Canada
N=83

 

Population: TBI, Intracranial hemorrhage, tumour, Other. Standard oral care (SOC) Group (n=51): Mean Age=57yr; Gender: Male=27, Female=24. Enhanced oral care (EOC) group (n=32): Mean Age=61yr; Gender: Male=23, Female=9.
Intervention: Patients in the SOC group received a standard protocol for oral hygiene and were reviewed retrospectively; patients in the EOC group were prospectively studied and received an enhanced oral hygiene protocol. The oral care kit was kept beside the patient’s bed and nurses were trained prior. The EOC consisted of brushing, mouth rinse and swabs.
Outcome Measures: Incidence of non-ventilator hospital-acquired pneumonia (NV-HAP).

  1. A significant decrease in in the rate of NV-HAP was observed in the EOC group compared to the SOC group (p=0.039).

Zasler et al.
(1993)
RCT
USA
PEDro=4
N=20

Population: TBI; Mean Age=30yr; Gender: Male=14, Female=6; Time Post-Injury>1mo; Intervention Group (n=10): Mean GCS=7; Control Group (n=10): Mean GCS=6.
Treatment: Patients in the intervention group received verbal oral hygiene instructions and were supervised in the removal of plaque. Those in the control group did not receive any oral hygiene instructions. Assessments were done at baseline and follow-up (5-6wks).
Outcome Measure: Plaque index score.

  1. No differences were found between the intervention and control group when examining the mean plaque scores at baseline (1.94 vs 2.12, p>0.05).
  2. Following intervention, the mean plaque index scores for the treatment group was significantly lower than those of control group (1.06 vs. 2.19, p<0.01).
  3. Plaque scores improved significantly from pre- to post-intervention for the intervention group only (p<0.01).

PEDro = Physiotherapy Evidence Database rating scale score (Moseley et al., (2002).