title: Effect of local cold and hot pack on the bruising of enoxaparin sodium injection site: a randomized controlled trial.
abstract: OBJECTIVE
  This study aimed to assess the effect of the application of local cold and cold-hot packs upon the size of bruising at the injection site of subcutaneous enoxaparin sodium.
  
  
  METHODS
  One-hundred and eighty patients with coronary diseases were allocated randomly to three groups: (i) local cold gel pack group; (ii) local cold-hot gel pack group; and (iii) control group. Assessment of the presence of a bruise was conducted at 24, 48 and 72 hours after the injections for all patients.
  
  
  RESULTS
  The cold-hot pack group had significantly less and smaller injection site bruising than the two other groups at 48 and 72 hours (both p < 0.001).
  
  
  CONCLUSIONS
  The local application of cold-hot packs is more effective on reducing bruises following enoxaparin sodium injections when compared with local cold pack application alone.Thus, this process can improve the quality of nursing care for hospitalized patients receivingthese injections.
authors.affiliation: a Faculty of Nursing and Midwifery , Tehran University of Medical Sciences , Tehran , Iran.
authors.forename: Sara
authors.initials: S
authors.lastname: Amaniyan
authors.affiliation: a Faculty of Nursing and Midwifery , Tehran University of Medical Sciences , Tehran , Iran.
authors.forename: Shokoh
authors.initials: S
authors.lastname: Varaei
authors.affiliation: b Faculty of Professional Studies , Nord University , Bodø , Norway.
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Vaismoradi
authors.affiliation: c School of Health Management and Information Sciences , Iran University of Medical Sciences , Tehran , Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Haghani
authors.affiliation: d College of Nursing , Montana State University , Bozeman , MT , USA.
authors.forename: Christina
authors.initials: C
authors.lastname: Sieloff
mesh_terms: D003080:Cold Temperature; D003288:Contusions / Q000517:prevention & control*; D017984:Enoxaparin / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006358:Hot Temperature; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged
chemical_list: D017984:Enoxaparin
keywords: bruising; cold application; enoxaparin; hot application; injections; low-molecular-weight heparin