Effect of pressure duration applied after blood sample collection on ecchymosis in older patients using...

Ecchymosis occurs when blood leaks into subcutaneous tissue or capillaries rupture. In older patients, adequate pressure after venipuncture may prevent it, but the optimal duration is unclear. This study evaluated the effect of applying 20 N of direct pressure for 1, 3, or 5 minutes after blood collection on ecchymosis at 24, 48, and 72 hours in older patients using oral or subcutaneous anticoagulants.

The study used a parallel-group, prospective, single-blind randomized controlled design. The study sample consisted of 164 patients hospitalized at the geriatric clinic of a city hospital. Ecchymosis development was assessed by making and recording observations at 24, 48 and 72 h after routine blood sampling. Opsite Flexigrid was used to measure the size of the ecchymosis.

The mean age of the patients was 76.26±8.01 years, 50 % were women, and 56.1 % used subcutaneous anticoagulants. A statistically significant difference was found between the groups in terms of the frequency and size of ecchymoses at 24, 48, and 72 h after blood collection (24th hour: χ²=30.792, p < 0.001; 48th hour: χ²=28.698, p = 0.001; 72nd hour: χ²=26.429, p = 0.002). The incidence of ecchymoses ≥1 cm² in the control group was 14 % at all time points, and this rate was significantly higher than in all other groups (p < 0.05).

In geriatric patients receiving oral or subcutaneous anticoagulants but without coagulopathy, applying pressure to the venipuncture site for 5 min after blood collection reduced the development of ecchymosis.