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Zeitschrift Fur Gerontologie Und... Feb 2022Pressure sores occur when soft tissue of the skin, subcutaneous fat tissue or musculature is exposed to pressure or friction over a long period of time, which leads to...
Pressure sores occur when soft tissue of the skin, subcutaneous fat tissue or musculature is exposed to pressure or friction over a long period of time, which leads to local ischemia with subsequent necrosis. All areas of the skin lying over bones with only a thin layer of soft tissue are predilection sites. In older patients the risk factors for the development of a pressure sore must be systematically documented at admission and during the course of the disease. Accordingly, the necessary prophylactic procedures must be initiated. The classification of the European Pressure Ulcer Advisory Panel (EPUAP) is used to describe a pressure sore. For the differential diagnosis, incontinence-associated dermatitis and a manifest peripheral artery occlusive disease must be excluded. The treatment consists of positioning procedures and local and systemic supportive wound treatment. In cases of deep pressure sores, coverage by plastic surgery can effectively accelerate healing. The multiprofessional geriatric team has the appropriate prerequisites for comprehensive treatment of pressure sores.
Topics: Aged; Humans; Pressure Ulcer; Risk Factors
PubMed: 34994853
DOI: 10.1007/s00391-021-02002-6 -
Journal of Hospice and Palliative... Aug 2019Kennedy terminal ulcers, a subset of pressure injuries, are associated with the dying process. This scoping review aimed to identify and map the published literature on... (Review)
Review
Kennedy terminal ulcers, a subset of pressure injuries, are associated with the dying process. This scoping review aimed to identify and map the published literature on Kennedy terminal ulcers in terms of its definition, prevalence, assessment, treatment, management, health care costs, and quality of life for patients in all health care settings. Using the Arksey and O'Malley scoping review framework, we systematically searched the Cochrane Library, CINAHL, EMBASE, MEDLINE, and ProQuest databases and 5 guideline repositories between 1983 and 2018. The following search terms were used: Kennedy ulcers, Kennedy terminal ulcers, terminal ulcer, skin failure, and Skin Changes at Life's End. Data were extracted using a purposely developed data collection tool. Initial searches yielded 2997 sources, with 32 included in this review. Most Kennedy terminal ulcer literature was published by nurses in the United States. Kennedy terminal ulcer prevalence data are limited, with no validated assessment tools available. Kennedy terminal ulcers may be misclassified as pressure injuries, potentially resulting in financial penalties to the institution. This scoping review revealed significant knowledge and clinical practice gaps in patient assessment, management, and treatment of Kennedy terminal ulcers. Timely patient education may help them to make informed care and quality end-of-life decisions. Further research is needed to inform clinical practice to improve patient care.
Topics: Critical Illness; Humans; Needs Assessment; Pressure Ulcer
PubMed: 30933013
DOI: 10.1097/NJH.0000000000000563 -
Journal of Wound Care Jul 2023Operating room (OR)-related pressure injuries (PIs) constitute the majority of all hospital-acquired PIs. The aim of this study is to reveal the prevalence and risk...
OBJECTIVE
Operating room (OR)-related pressure injuries (PIs) constitute the majority of all hospital-acquired PIs. The aim of this study is to reveal the prevalence and risk factors of OR-related PIs.
METHOD
This study used a cohort design. The data were collected at Acıbadem Maslak Hospital in Istanbul between November 2018 and May 2019. The study population consisted of all patients undergoing surgery between these dates (n=612). The haphazard sampling method was used following application of the inclusion criteria. A patient identification form, the 3S intraoperative pressure ulcer risk assesment scale and the Braden Scale were used to collect data.
RESULTS
Within the scope of the study, data were collected from 403 patients, of which 57.1% (n=230) were female and 42.9% (n=173) were male; mean age was 47.90±18.15 years. During surgery, PIs were detected in 8.4% of patients. In total, 42 PIs were detected in patients in the study; 92.8% were stage 1 and 7.2% were stage 2. It was determined that the PIs observed in 11.8% (n=4) of the patients were related to device/instrument use and 23.5% (n=8) were related to the positioning device. Risk factors found to be significant in the development of PIs were sex (male) (p=0.049), large amount of bleeding during surgery (p=0.001), dry (p=0.020) and lighter skin (p=0.012), duration of surgery (p=0.001), type of anaesthesia (p=0.015), and medical devices used (p=0.001).
CONCLUSION
Early identification of risk factors may reduce OR-related PIs. Guidelines and procedures that focus on preoperative, intraoperative and postoperative evaluation can be developed to reduce and prevent surgery-related PIs and to standardise care.
Topics: Humans; Male; Female; Adult; Middle Aged; Aged; Pressure Ulcer; Operating Rooms; Risk Factors; Risk Assessment; Skin
PubMed: 37405971
DOI: 10.12968/jowc.2023.32.Sup7a.cxxviii -
International Journal of Molecular... Dec 2020Pressure ulcers are preventable, yet highly prevalent, chronic wounds that have significant patient morbidity and high healthcare costs. Like other chronic wounds, they... (Review)
Review
Pressure ulcers are preventable, yet highly prevalent, chronic wounds that have significant patient morbidity and high healthcare costs. Like other chronic wounds, they are characterized by impaired wound healing due to dysregulated immune processes. This review will highlight key biochemical pathways in the pathogenesis of pressure injury and how this signaling leads to impaired wound healing. This review is the first to comprehensively describe the current literature on microRNA (miRNA, miR) regulation of pressure ulcer pathophysiology.
Topics: Animals; Apoptosis; Disease Management; Disease Susceptibility; Extracellular Matrix; Gene Expression Regulation; Gene Regulatory Networks; Humans; Immunity; MicroRNAs; Oxidative Stress; Pressure Ulcer; RNA Interference; Reperfusion Injury; Signal Transduction; Wound Healing
PubMed: 33374656
DOI: 10.3390/ijms22010064 -
British Journal of Community Nursing Jun 2020Understanding the differential diagnosis between device-related pressure ulcers (DRPUs) and pressure ulcers ensures that appropriate prevention, management and...
Understanding the differential diagnosis between device-related pressure ulcers (DRPUs) and pressure ulcers ensures that appropriate prevention, management and intervention plans are identified. National reporting systems now include DRPUs alongside other categories of pressure ulcers listed by international pressure ulcer advisory panels. Medical devices are not the only cause of DRPUs, and, in the community setting, other objects can also cause pressure ulcers, such as spectacles and hearing aids. Skin assessment around the site of devices is essential to ensure the skin is intact, the micro-climate is considered and the skin is properly cleansed. Risk assessment for devices should be undertaken, and prevention according to the device itself may include fixation and the use of prophylactic dressings. Advice and support must be given to patients and carers to facilitate self-care and identify signs of skin damage and infection.
Topics: Bandages; Equipment and Supplies; Humans; Independent Living; Pressure Ulcer; Risk Assessment; Skin Care
PubMed: 32501759
DOI: 10.12968/bjcn.2020.25.Sup6.S14 -
International Wound Journal Dec 2023Pressure ulcers (PUs) are one of the most important care-related ailments, making their prevention a pressing concern for hospital structures. Epidemiology of PU is...
Pressure ulcers (PUs) are one of the most important care-related ailments, making their prevention a pressing concern for hospital structures. Epidemiology of PU is interesting to adapt human resources and observe the impact of targeted public health measures. Very few data are presented in the French literature. In this context, a dedicated "Pressure ulcer, Wounds and Healing" task force was created in 1996 by a multidisciplinary team of physicians, administrative staff, and paramedics in the CH of Le Mans. Alongside this, an annual prevalence study was performed between 1996 and 2019 in CH of Le Mans, collecting relevant data: the number of patients who presented pressure ulcers, the number of patients who were at risk of developing pressure ulcers, and the severity of these ulcers. This study brings new data about PU epidemiology in France and shows a significant decrease in the prevalence, becoming lower than the national prevalence. Also, a significant time-related regression of the prevalence was observed, the severity level continually decreased whereas the number of geriatric patients grew and patients with PU's risk remained constant. Finally, the number of patients who developed a PU within the hospitalization decreased too. We observed a link between the creation of the task force and the evolution of pressure ulcer epidemiology, thus recommending that the same practices be adopted in other hospitals and fields of application.
Topics: Male; Humans; Aged; Pressure Ulcer; Hospitals, General; Wound Healing; Hospitalization; Physicians
PubMed: 37488747
DOI: 10.1111/iwj.14302 -
Journal of Advanced Nursing Sep 2023To explore patient perceptions and understanding of their pressure ulcer risk and how information is communicated between a nurse and patient in the home setting.
AIMS
To explore patient perceptions and understanding of their pressure ulcer risk and how information is communicated between a nurse and patient in the home setting.
DESIGN
A pragmatic qualitative research design including community-dwelling patients, who were deemed at risk of developing a pressure ulcer.
METHODS
Observation of routine interactions between nurse and patient regarding their pressure ulcer risk and semi-structured interviews with 15 community patients following the nursing interaction.
RESULTS
Four key overarching themes emerged from the data analysis that were related to patient perceptions and understanding of pressure ulcer risk. These included Pressure Ulcer Awareness, Importance of Repositioning, Healthy Eating and Risk Interpretation.
CONCLUSION
Patient perception and understanding of pressure ulcer risk is different from the scientific, professional view. Patient risk perception was based on heuristics and wider personal factors and social influences.
IMPACT
The study provides important new insights into clinical practice in relation to how pressure ulcer advice and information are provided and interpreted in the community setting.
REPORTING METHOD
Adhered to the Standards for Reporting Qualitative Research (SRQR) PATIENT OR PUBLIC CONTRIBUTION: A small selection of patients within the NHS Trust in which the research was conducted contributed to the design of the study, in particular some of the interview questions and timing.
Topics: Humans; Pressure Ulcer; Patients; Qualitative Research
PubMed: 36919007
DOI: 10.1111/jan.15637 -
Advances in Skin & Wound Care Mar 2023
Topics: Humans; Pressure Ulcer
PubMed: 36806267
DOI: 10.1097/01.ASW.0000918888.97533.37 -
Journal of Tissue Viability Nov 2020
Topics: Guidelines as Topic; Humans; Pressure Ulcer; Wound Healing
PubMed: 32978043
DOI: 10.1016/j.jtv.2020.09.003 -
Advances in Skin & Wound Care Mar 2022To review neonatal pressure injuries (PIs), including clinical features and challenges in evaluation and staging related to the unique anatomic features of preterm... (Review)
Review
GENERAL PURPOSE
To review neonatal pressure injuries (PIs), including clinical features and challenges in evaluation and staging related to the unique anatomic features of preterm neonatal skin as well as the common sites and mechanisms of injury.
TARGET AUDIENCE
This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.
LEARNING OBJECTIVES/OUTCOMES
After participating in this educational activity, the participant will:1. Recognize the causes of PIs in preterm neonates.2. Choose the outcomes of PIs in preterm neonates.3. Distinguish the common characteristics of preterm neonates' skin.4. Summarize the challenges clinicians face when classifying the PIs of preterm neonates.
Topics: Crush Injuries; Humans; Infant, Newborn; Pressure Ulcer
PubMed: 35188482
DOI: 10.1097/01.ASW.0000818580.47852.68