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Medical Archives (Sarajevo, Bosnia and... Nov 2018The occurrence of a pressure ulcer constitutes a major psychological and physiological burden and it has been linked with a reduced quality of life and increased stress...
INTRODUCTION
The occurrence of a pressure ulcer constitutes a major psychological and physiological burden and it has been linked with a reduced quality of life and increased stress of the individual.
OBJECTIVE
The main objective was to investigate the impact that stress has on pressure ulcer healing process and on the psychophysiological environment of the individual suffering from them.
METHOD
The scientific literature was reviewed through Cinahl, Pub-med, EBSCO, Medline and Google scholar. The articles were chosen due to their direct correlation with the objective under study and their scientific relevance.
RESULTS
Increased stress has been demonstrated to increase the glucocorticoids levels affecting negatively the production of wound healing cytokines (IL1α, IL1β and TNFα). Matrix metalloproteases has been identified to be unregulated in occasions of increased stress in acute wounds. Stress has also been correlated with poor health behaviors that may not have a direct link on the wound healing process, although they can in part explain or enhance some of the effects of stress on wound healing.
CONCLUSION
The correlation between stress and wound healing in acute wounds has been thoroughly investigated and its negative effects have been established. The presence of a pressure ulcer can have a detrimental impact on the stress level of an individual although further investigation is needed to establish the role of stress in chronic wounds such as pressure ulcers.
Topics: Humans; Pressure Ulcer; Quality of Life; Stress, Psychological; Wound Healing
PubMed: 30524170
DOI: 10.5455/medarh.2018.72.362-366 -
The Pan African Medical Journal 2020Pressure ulcers (PUs) are defined as localised injuries to the skin and/or underlying tissue as a result of pressure or pressure together with shear. PUs present... (Review)
Review
Pressure ulcers (PUs) are defined as localised injuries to the skin and/or underlying tissue as a result of pressure or pressure together with shear. PUs present significant health implications to patients; costing billions to manage and/or treat. The burden of PU prevention in hospitals must be the concern of all healthcare professionals, including radiographers. The purpose of this narrative review article was to identify and critically evaluate relevant literature and research conducted into pressure ulcers (PUs) relevant to medical imaging. It is expected that this review article will increase the level of awareness about PUs amongst radiographers and help to develop appropriate interventions to minimise the risk of PUs. A literature search was conducted in PubMed/Medline, Scopus, CINAHL, and Google Scholar to retrieve relevant articles. Also, books, professional body guidelines, magazines, grey and unpublished literatures were also searched. The search was limited to English Language articles. Only five articles were retrieved and reviewed. There are limited studies on PUs relevant to medical imaging. Available studies provide some evidence that radiographic procedures and settings subject patients attending for radiographic procedures to the risk of PUs. Further studies are needed into PU risk assessment, minimisation and management in medical imaging to help raise awareness and address the problem of the potential for PU development.
Topics: Humans; Pressure Ulcer; Radiography; Risk Assessment; Risk Factors; Risk Management
PubMed: 32754293
DOI: 10.11604/pamj.2020.36.66.19431 -
Intensive & Critical Care Nursing Feb 2024To describe published work on the current situation of mucosal membrane pressure injury of patients in the intensive care unit. (Review)
Review
AIM
To describe published work on the current situation of mucosal membrane pressure injury of patients in the intensive care unit.
BACKGROUND
Device-related pressure injuries in critically ill patients are mostly focused on skin surface injuries, and less attention is paid to mucosal membrane pressure injury.
METHODS
We searched PubMed, Embase, Web of Science, CINAHL, and Cochrane Library from database construction until March 1, 2023. Two researchers independently screened and extracted data.
RESULTS
Eighteen articles met our criteria and were published in 2014-2023. The included studies showed that the incidence of mucosal membrane pressure injury in critically ill patients ranged from 0.83% to 88.2%, and the prevalence ranged from 0.16% to 55.6%. The most frequently reported site of mucosal injury is the oral mucosa, followed by the nasal mucosa. Ten studies used Braden to assess the risk of mucosal membrane pressure injury, and only six studies reported specific stages of mucosal membrane pressure injury. Thirteen studies described 30 risk factors for mucosal membrane pressure injury, with albumin being the most frequently reported risk factor, followed by the vasoconstrictive drugs use. Thirty risk factors were summarized in six aspects: medical device-related factors, disease-related factors, treatment- related factors, physiological and biochemical parameters, demographic-related factors, and microbial colonisation.
CONCLUSIONS
The incidence or prevalence of mucosal membrane pressure injury varies widely, and specific risk assessment tools and standardized staging criteria need to be further determined. The risk factors of mucosal membrane pressure injury involve multiple aspects, and some risk factors have only been explored in few studies and need to be further verified, in order to detect the risk group of mucosal membrane pressure injury early and take targeted preventive measures.
IMPLICATIONS FOR CLINICAL PRACTICE
We synthesized the current research status of mucosal membrane pressure injury in critically ill patients, which can provide a valuable reference for the clinical staff to develop preventive and management measures for such patients.
Topics: Humans; Pressure Ulcer; Critical Illness; Intensive Care Units; Risk Factors
PubMed: 37918080
DOI: 10.1016/j.iccn.2023.103560 -
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 -
Clinical Interventions in Aging 2009With our aging population, chronic diseases that compromise skin integrity such as diabetes, peripheral vascular disease (venous hypertension, arterial insufficiency)... (Review)
Review
With our aging population, chronic diseases that compromise skin integrity such as diabetes, peripheral vascular disease (venous hypertension, arterial insufficiency) are becoming increasingly common. Skin breakdown with ulcer and chronic wound formation is a frequent consequence of these diseases. Types of ulcers include pressure ulcers, vascular ulcers (arterial and venous hypertension), and neuropathic ulcers. Treatment of these ulcers involves recognizing the four stages of healing: coagulation, inflammation, proliferation, and maturation. Chronic wounds are frequently stalled in the inflammatory stage. Moving past the inflammation stage requires considering the bacterial burden, necrotic tissue, and moisture balance of the wound being treated. Bacterial overgrowth or infection needs to be treated with topical or systemic agents. In most cases, necrotic tissue needs to be debrided and moisture balance needs to be addressed by wetting dry tissue and drying wet tissue. Special dressings have been developed to accomplish these tasks. They include films, hydrocolloids, hydrogel dressings, foams, hydrofibers, composite and alginate dressings.
Topics: Aged; Bandages; Debridement; Female; Humans; Male; Middle Aged; Pressure Ulcer; Wound Healing
PubMed: 19554098
DOI: 10.2147/cia.s4726 -
International Wound Journal May 2022The aim of this national cross-sectional study was to explore the prevalence of pressure injuries and incidence of hospital-acquired pressure injuries, and the relating...
The aim of this national cross-sectional study was to explore the prevalence of pressure injuries and incidence of hospital-acquired pressure injuries, and the relating factors in somatic-specialised inpatient care in Finland. The study was conducted in 16 (out of 21) Finnish health care organisations offering specialised health care services. Data were collected in 2018 and 2019 from adult patients (N = 5902) in inpatient, emergency follow-up, and rehabilitation units. Pressure injury prevalence (all stages/categories) was 12.7%, and the incidence of hospital-acquired pressure injuries was 10%. Of the participants, 2.6% had at least one pressure injury at admission. The risk of hospital-acquired pressure injuries was increased for medical patients with a higher age, the inability to move independently, mode of arrival, being underweight, and the absence of a skin assessment or pressure injury risk assessment at admission. For surgical patients, the risk was associated with the inability to move independently, mode of arrival, and lack of skin assessment at admission, while being overweight protected the patients. Overall, medical patients were in greater risk of hospital-acquired pressure injuries than the surgical patients. An assessment of the pressure injury risk and skin status should be carried out more systematically in Finnish acute care hospitals.
Topics: Adult; Cross-Sectional Studies; Humans; Incidence; Inpatients; Pressure Ulcer; Prevalence; Risk Factors
PubMed: 34605185
DOI: 10.1111/iwj.13692 -
Ostomy/wound Management Sep 2009Pressure ulcers are serious health problems. Although a vast amount of literature addresses prevention and treatment strategies, conceptual difficulties persist... (Review)
Review
Pressure ulcers are serious health problems. Although a vast amount of literature addresses prevention and treatment strategies, conceptual difficulties persist regarding pressure ulcer definitions, classifications, and distinction from other tissue lesions. Based on a review of terminologies as well as current state of knowledge on pathophysiology and etiology, questions as to what pressure ulcers are and what they are not are addressed. Because pressure forces seem to play a minor role in the development of superficial ulcers, the authors suggest these types of wounds no longer be termed pressure ulcers. A more general term such as decubitus ulcer may be a more appropriate way to characterize wounds that emerge as a result of compressive forces, shearing forces, and/or friction in patients dependent on skilled care. For clinical practice, a two-category classification is proposed: superficial ulcers predominantly caused by friction and deep ulcers predominantly caused by pressure. This simple classification could enhance diagnostic accuracy and reliability. Multidisciplinary communication and research is needed to develop valid and reliable definitions and classifications for pressure ulcer-like wounds.
Topics: Humans; Pressure Ulcer
PubMed: 19797800
DOI: No ID Found -
International Wound Journal May 2022Pressure ulcers (PUs) have a profound impact on individuals, with studies demonstrating that compared with similarly aged persons, those living with a PU have a... (Randomized Controlled Trial)
Randomized Controlled Trial
Pressure ulcers (PUs) have a profound impact on individuals, with studies demonstrating that compared with similarly aged persons, those living with a PU have a significantly lower quality of life. The aim of this study was to explore the impact of the Shanley Pressure Ulcer Prevention Programme (SPUPP) on older persons' knowledge of, and attitudes and behaviours towards, PU prevention. This was a multi-centre, open-label, randomised controlled trial. The population of interest was older persons living in the community who attended either a day care centre or a retirement group and were deemed to be at risk of PUs due to reduced mobility. Stratified random sampling was used to randomise based on days of attendance at day care centre/retirement group. Pretest and post-test were applied to the intervention and control groups. The SPUPP is a multimedia programme delivered using electronic media, hard copy materials, activities, and patient diaries and addresses the key tenets of PU prevention as described by the SKIN bundle. The programme contains five separate sessions delivered over 5 weeks. The impact of the SPUPP was assessed using the patient knowledge of and attitude and behaviour towards PU prevention instrument (KPUP). A total of 64 persons, 32 in each group, took part in the study. Of these, 75% (n = 48) were female, with a mean age of 81.9 years (SD: 5.56 years). Further, 68.8% (n = 44) were either overweight or obese and 40.6% (n = 26) were usually incontinent of urine. There were no differences between the intervention and control groups in mean scores during the pretest stage. However, at post-test, the mean scores for the intervention group were higher than the control group, 16.87 (SD: 1.88) versus 12.41 (SD: 3.21), respectively. For the post-test stage, mean differences between the two groups in favour of the intervention group (∆ = 4.46) were statistically significant, as t = 6.76, P = .0001, and equal variances were not assumed. The SPUPP impacted positively on knowledge scores of the participants and positively influenced attitudes and behaviours towards PU prevention. Thus, this research provides information regarding the potential to enhance patient involvement in PU prevention.
Topics: Aged; Aged, 80 and over; Attitude; Female; Humans; Male; Pressure Ulcer; Quality of Life; Skin Care; Suppuration
PubMed: 34382318
DOI: 10.1111/iwj.13671 -
Acta Medica Portuguesa 2006Despite improved awareness and quality of care among health care personnel, pressure ulcers prevalence remains high especially in the inpatient setting. Pressure ulcers... (Review)
Review
Despite improved awareness and quality of care among health care personnel, pressure ulcers prevalence remains high especially in the inpatient setting. Pressure ulcers are associated with increased morbidity and mortality, affecting the quality of life of patients and their caregivers, and significantly increasing direct and indirect healthcare costs. Early risk assessment for developing a pressure ulcer is essential to decide on the appropriate preventive measures and for initiation of a tailored therapeutic approach. Interventions include strategies to reduce extrinsic and intrinsic risk factors associated with tissue ischemia, optimization of patient's nutritional status, and local wound care. This revision intends to review current evidence-based therapeutic interventions in pressure ulcer care, and support implementation of management protocols in an inpatient ward.
Topics: Anti-Bacterial Agents; Bandages; Evidence-Based Medicine; Humans; Nutrition Assessment; Pressure Ulcer; Skin Diseases, Bacterial
PubMed: 16987441
DOI: No ID Found -
Revista Latino-americana de Enfermagem Aug 2018to identify existing instruments in the scientific literature about the care of pressure injuries in pediatric and hebiatric patients. (Review)
Review
OBJECTIVE
to identify existing instruments in the scientific literature about the care of pressure injuries in pediatric and hebiatric patients.
METHOD
an integrative review that selected 32 articles from the PubMed/Medline, LILACS, Scopus and CINAHL databases using the descriptors pressure ulcer, decubitus ulcer, pediatrics, adolescent and protocols and their equivalent terms in Portuguese and Spanish. Inclusion criteria: research articles in full, in Portuguese, English or Spanish without any temporal cut-off. The descriptive analysis was adopted to categorize the instruments found into the three domains of care: evaluative, preventive and curative.
RESULTS
25 instruments for the care of pressure injuries in pediatric and hebiatric patients were found, with an emphasis on the Braden Q Scale being the most commonly used to assess pressure injury risk, and the protocols containing pressure injury staging guidelines developed by the National Pressure Ulcer Advisory Panel (NPUAP) and the European Pressure Ulcer Advisory Panel (EPUAP).
CONCLUSION
the scientific literature has valid and reliable instruments that can be used in nursing care practice aimed at the evaluative, preventive and curative care of pressure injuries in pediatric and hebiatric patients.
Topics: Adolescent; Adolescent Medicine; Child; Clinical Protocols; Humans; Pediatrics; Pressure Ulcer; Young Adult
PubMed: 30110107
DOI: 10.1590/1518-8345.2289.3034