Skip to content
DraconiticResearch
Search Sources API
197,768 studies31 sourcesUpdated 20 min ago
Peer-reviewedCC BY-NC 4.0BMJ Open

Diagnostic challenges in distinguishing oral mucosal membrane pressure injuries from HSV-1-related oral mucosal lesions in intubated people in intensive care units: a scoping review protocol

  • Hermione Shea1,2
  • Philip Russo3
  • Sebastian Probst1,4,5,6
  • Johannes S Kern1,2
  • Olivia Cook1,2
6 affiliations
  1. 1Monash University - Clayton Campus, Clayton, Victoria, Australia
  2. 2Alfred Care Group, Melbourne, Victoria, Australia
  3. 3School of Nursing and Midwifery, Cabrini Monash University, Melbourne, Victoria, Australia
  4. 4HES-SO Genève, Genève, Switzerland
  5. 5University of Geneva, Geneva, Switzerland
  6. 6University of Galway, Galway, Ireland
Open at sourcePDFDOICite

Abstract

Introduction: Oral mucosal membrane pressure injuries (MMPIs) and herpes simplex virus type 1 (HSV-1)-related oral mucosal lesions can present with overlapping risk factors and clinical features in intubated people in intensive care units (ICUs), making differentiation challenging. Misclassification may lead to inappropriate management, delayed healing, missed infection-prevention measures and increased healthcare costs. These consequences differ depending on the direction of misclassification. International pressure injury guidelines do not recommend routine HSV testing for suspected MMPIs and standardised diagnostic pathways are lacking. This protocol outlines a planned scoping review to map the nature, extent and types of diagnostic challenges encountered when distinguishing oral MMPIs from HSV-1-related oral mucosal lesions in intubated people in the ICU, and to summarise available evidence on the incidence, characteristics, assessment and terminology.

Methods and analysis: This scoping review protocol follows the Joanna Briggs Institute scoping review methodology using a Population-Concept-Context framework, which will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. The MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science Core Collection and Scopus databases will be searched. Grey literature and unpublished sources will also be searched. Data will be extracted using a standardised tool, and the results will be presented using descriptive tables, and visual and narrative summaries.

Ethics and dissemination: Ethical approval is not required as the review uses publicly available literature and does not involve data collection or direct human interaction. The results of the completed review will be disseminated through peer-reviewed publications and conference presentations. This protocol has been registered on the Open Science Framework ( https://osf.io/nrkm5/overview ). Registration DOI: 10.17605/OSF.IO/82JF9 .

Related

  1. Magnitude of tracheal stenosis and contributing factors among adult intubated patients in intensive care units in Northern Ethiopia
    Gebrewahd Alemu, Filmawit Gebremeskel Asfaha, Gebrekiros Gebremichael Meles +3
    Scientific ReportsPeer-reviewedCC BY-NC-ND 4.0Full textGeneral medicineCrossref
  2. OA30 Distinguishing active tuberculosis from flare in a child with severe systemic lupus erythematosus: Diagnostic and therapeutic challenges in a high TB-burden setting
    Atreya Ramanan, Pavneet Kaur, D R Rudra +2
    Rheumatology advances in practicePeer-reviewedCC BYFull textGeneral medicineEurope PMCPMC
  3. Paradoxical relief after seizures: a diagnostic signal distinguishing functional/dissociative from epileptic seizures
    A. Masharani, A. Koreki, M. Marcelo +9
    medRxivPreprintAll rights reservedFull textNeurologymedRxiv
  4. Diagnostic challenge in distinguishing intestinal endometriosis-associated carcinoma from primary colorectal adenocarcinoma: a case report
    Norie Tojo, Hisashi Kataoka, Yuko Izumi +2
    Journal of Surgical Case ReportsPeer-reviewedCC BY-NC 4.0Full textObstetrics, gynaecology & paediatricsPMC
  5. Diagnostic Utility of PRAME Immunohistochemistry for Distinguishing Acral Melanoma From Acral Melanocytic Nevi
    Kritsada Phatcharamaneepakorn, Panitta Sitthinamsuwan, Penvadee Pattanaprichakul +2
    Journal of Cutaneous PathologyPeer-reviewedCC BY-NC-ND 4.0Full textOncologyPMC

Cite

BibTeXRIS
BibTeX
@article{shea2026diagnostic,
  title = {{Diagnostic challenges in distinguishing oral mucosal membrane pressure injuries from HSV-1-related oral mucosal lesions in intubated people in intensive care units: a scoping review protocol}},
  author = {Hermione Shea and Philip Russo and Sebastian Probst and Johannes S Kern and Olivia Cook},
  journal = {BMJ Open},
  year = {2026},
  month = sep,
  doi = {10.1136/bmjopen-2026-123374},
  url = {https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-123374},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Diagnostic challenges in distinguishing oral mucosal membrane pressure injuries from HSV-1-related oral mucosal lesions in intubated people in intensive care units: a scoping review protocol
AU  - Hermione Shea
AU  - Philip Russo
AU  - Sebastian Probst
AU  - Johannes S Kern
AU  - Olivia Cook
PY  - 2026
DA  - 2026/09/30
JO  - BMJ Open
DO  - 10.1136/bmjopen-2026-123374
UR  - https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-123374
AB  - Introduction: Oral mucosal membrane pressure injuries (MMPIs) and herpes simplex virus type 1 (HSV-1)-related oral mucosal lesions can present with overlapping risk factors and clinical features in intubated people in intensive care units (ICUs), making differentiation challenging. Misclassification may lead to inappropriate management, delayed healing, missed infection-prevention measures and increased healthcare costs. These consequences differ depending on the direction of misclassification. International pressure injury guidelines do not recommend routine HSV testing for suspected MMPIs and standardised diagnostic pathways are lacking. This protocol outlines a planned scoping review to map the nature, extent and types of diagnostic challenges encountered when distinguishing oral MMPIs from HSV-1-related oral mucosal lesions in intubated people in the ICU, and to summarise available evidence on the incidence, characteristics, assessment and terminology.  Methods and analysis: This scoping review protocol follows the Joanna Briggs Institute scoping review methodology using a Population-Concept-Context framework, which will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. The MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science Core Collection and Scopus databases will be searched. Grey literature and unpublished sources will also be searched. Data will be extracted using a standardised tool, and the results will be presented using descriptive tables, and visual and narrative summaries.  Ethics and dissemination: Ethical approval is not required as the review uses publicly available literature and does not involve data collection or direct human interaction. The results of the completed review will be disseminated through peer-reviewed publications and conference presentations. This protocol has been registered on the Open Science Framework ( https://osf.io/nrkm5/overview ). Registration DOI: 10.17605/OSF.IO/82JF9 .
SN  - 2044-6055
SN  - 2044-6055
ER  -