Principles and prevention of pressure sores in the ICU

2016 ◽  
Author(s):  
Laura Crawford ◽  
Ruth Kleinpell
Keyword(s):  
Risk Assessment ◽  
Critically Ill ◽  
Pressure Ulcer ◽  
Critically Ill Patients ◽  
Pressure Ulcers ◽  
Critically Ill Patient ◽  
Advisory Panel ◽  
Pressure Sores ◽  
Pressure Ulcer Development ◽  
Preventative Interventions

A pressure ulcer, defined by the National Pressure Advisory Panel and European Pressure Ulcer Advisory Panels as localized injury to the skin or tissue as the result of pressure or pressure in combination with shear, can be an adverse complication of a hospital stay, especially for acute and critically-ill patients. Factors that can contribute to pressure ulcer development include the intensity and duration of pressure, tissue tolerance, shear, and friction. Common anatomical sites for pressure ulcers development are over bony prominences. The National Pressure Advisory Panel and European Pressure Ulcer Advisory Panels define pressure ulcers in six stages according to the degree of tissue damage present in the wound. A risk assessment should be performed to identify the vulnerability of pressure ulcer development and provide guidance for the implementation of preventative interventions. For the critically-ill patient, several specific measures are advocated for preventing pressure ulcers.

Validity of the current risk assessment scale for pressure ulcers in intensive care (EVARUCI) and the Norton-MI scale in critically ill patients

2017 ◽  
Vol 38 ◽  
pp. 76-82
Author(s):  
Sara Lospitao-Gómez ◽  
Tomás Sebastián-Viana ◽  
José M. González-Ruíz ◽  
Joaquín Álvarez-Rodríguez
Keyword(s):  
Risk Assessment ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Pressure Ulcers ◽  
Assessment Scale ◽  
Current Risk

Pressure Ulcer Prevention in Critical Care: State of the Art

1990 ◽  
Vol 1 (3) ◽  
pp. 602-613 ◽  
Author(s):  
Connie Glavis ◽  
Susan Barbour
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Critically Ill Patient ◽  
Predictive Tool ◽  
Pressure Relief ◽  
Pressure Ulcer Prevention ◽  
Increased Risk ◽  
Ulcer Prevention

Prevention of pressure ulcers in the critically ill patient is a major responsibility of the critical care nurse. The authors review the causes of pressure ulcer development and the methods of identifying the patient at increased risk. Pressure relief strategies for use in critical care are presented, and currently available pressure reduction and relief devices are discussed. Because few research studies address pressure ulcer prevention in the critical care setting, future research in this area is needed to develop a reliable predictive tool for use with the critically ill patient. Level of risk needs to be linked with intervention to assist the nurse in managing the pressure relief options available in today’s market. In the meantime, prevention of pressure ulcers in critical care patients requires vigilance and the best use of available knowledge in the field

Cytokine and Chemokine Release Upon Sustained Mechanical Loading of the Epidermis

2007 ◽  
Author(s):  
Debbie Bronneberg ◽  
Lisette H. Cornelissen ◽  
Cees W. J. Oomens ◽  
Frank P. T. Baaijens ◽  
Carlijn V. C. Bouten
Keyword(s):  
Risk Assessment ◽  
Health Care ◽  
Soft Tissue ◽  
Mechanical Loading ◽  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Objective Measures ◽  
Subjective Measures ◽  
Non Invasive ◽  
Pressure Ulcer Development

Pressure ulcers are areas of soft tissue breakdown resulting from sustained mechanical loading of the skin and underlying tissues. These ulcers are painful, difficult to treat, and represent a burden to the community in terms of health care and money. Currently, pressure ulcer risk assessment is dominated by subjective measures and does not predict pressure ulcer development satisfactorily [1]. Objective measures are therefore needed for early, non-invasive detection.

A clinimetric analysis of the Pressure Ulcer Risk Primary or Secondary Evaluation Tool: PURPOSE-T

2019 ◽  
Vol 28 (20) ◽  
pp. S4-S8
Author(s):  
Matthew Wynn ◽  
Samantha Holloway
Keyword(s):  
Risk Assessment ◽  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Evidence Base ◽  
Assessment Tools ◽  
Future Research ◽  
Advisory Panel ◽  
Evaluation Tool ◽  
Risk Assessment Tools ◽  
Patients At Risk

The assessment of patients' risk for developing pressure ulcers is a routine and fundamental nursing process undertaken to prevent avoidable harm to patients in all care settings. Many risk assessment tools are currently used in clinical practice, however no individual tool is recommended by advisory bodies such as the National Institute for Health and Care Excellence or the European Pressure Ulcer Advisory Panel. The evidence base on the value of structured risk assessment tools in reducing the incidence or severity of pressure ulcers is poor. This purpose of this article is to provide a clinimetric analysis of the recently developed Pressure Ulcer Risk Primary or Secondary Evaluation Tool (PURPOSE-T) and identify areas for future research to improve the utility of structured risk assessment in identifying patients at risk of developing pressure ulcers.

Risk Assessment for Pressure Ulcers: An Adaptation of the National Pressure Ulcer Advisory Panel Risk Factors to Spinal Cord Injured Patients

1993 ◽  
Vol 16 (3) ◽  
pp. 169-177 ◽  
Author(s):  
Paula A. Rochon ◽  
Marie P. Beaudet ◽  
Regina McGiinchey-Berroth ◽  
Linda A. Morrow ◽  
Margaret M. Ahlquist ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Spinal Cord ◽  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Advisory Panel ◽  
Injured Patients ◽  
Spinal Cord Injured

Predictors of Pressure Ulcers in Adult Critical Care Patients

2011 ◽  
Vol 20 (5) ◽  
pp. 364-375 ◽  
Author(s):  
Jill Cox
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Length Of Stay ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Pressure Ulcers ◽  
Critical Care Patients

BackgroundPressure ulcers are one of the most underrated conditions in critically ill patients. Despite the introduction of clinical practice guidelines and advances in medical technology, the prevalence of pressure ulcers in hospitalized patients continues to escalate. Currently, consensus is lacking on the most important risk factors for pressure ulcers in critically ill patients, and no risk assessment scale exclusively for pressure ulcers in these patients is available.ObjectiveTo determine which risk factors are most predictive of pressure ulcers in adult critical care patients. Risk factors investigated included total score on the Braden Scale, mobility, activity, sensory perception, moisture, friction/shear, nutrition, age, blood pressure, length of stay in the intensive care unit, score on the Acute Physiology and Chronic Health Evaluation II, vasopressor administration, and comorbid conditions.MethodsA retrospective, correlational design was used to examine 347 patients admitted to a medical-surgical intensive care unit from October 2008 through May 2009.ResultsAccording to direct logistic regression analyses, age, length of stay, mobility, friction/shear, norepinephrine infusion, and cardiovascular disease explained a major part of the variance in pressure ulcers.ConclusionCurrent risk assessment scales for development of pressure ulcers may not include risk factors common in critically ill adults. Development of a risk assessment model for pressure ulcers in these patients is warranted and could be the foundation for development of a risk assessment tool.

scholarly journals Enteral n-3 fatty acids and micronutrients enhance percentage of positive neutrophil and lymphocyte adhesion molecules: a potential mediator of pressure ulcer healing in critically ill patients

2011 ◽  
Vol 107 (7) ◽  
pp. 1056-1061 ◽  
Author(s):  
Miriam Theilla ◽  
Betty Schwartz ◽  
Yael Zimra ◽  
Haim Shapiro ◽  
Ronit Anbar ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Fish Oil ◽  
Critically Ill ◽  
Adhesion Molecule ◽  
Pressure Ulcer ◽  
Critically Ill Patients ◽  
Pressure Ulcers ◽  
Intervention Group ◽  
Control Group ◽  
The Impact

n-3 Fatty acids are recognised as influencing both wound healing and immunity. We assessed the impact of a fish oil- and micronutrient-enriched formula (study formula) on the healing of pressure ulcers and on immune function in critically ill patients in an intensive care unit. A total of forty patients with pressure ulcers and receiving nutritional support were enrolled (intervention group, n 20, received study formula; and a control group, n 20, received an isoenergetic formula). Total and differential leucocyte count and percentage of adhesion molecule positive granulocyte and lymphocyte cells (CD11a, CD11b, CD18 and CD49b) were measured on days 0, 7 and 14. Percentage of positive lymphocytes for CD54, CD49b, CD49d and CD8 were also measured on days 0, 7 and 14. The state of pressure ulcers was assessed by using the pressure ulcer scale for healing tool score on days 7, 14 and 28 of treatment. No between-group differences in patient demographics, anthropometry or diagnostic class were observed. Patients who received the study formula showed significant increases in the percentage of positive CD18 and CD11a lymphocytes and of CD49b granulocytes as compared to controls (P < 0·05). While the severity of pressure ulcers was not significantly different between the two groups on admission, severity increased significantly over time for the control group (P < 0·05), but not for the study group. The present study suggests that a fish oil- and micronutrient-enriched formula may prevent worsening of pressure ulcers and that this effect may be mediated by an effect on adhesion molecule expression.

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