Open AccessJournal Article
Pressure ulcers: prevention, evaluation, and management.
Daniel Bluestein,Ashkan Javaheri +1 more
Reads0
Chats0
TLDR
Treatment involves management of local and distant infections, removal of necrotic tissue, maintenance of a moist environment for wound healing, and possibly surgery, and systemic antibiotics are used in patients with advancing cellulitis, osteomyelitis, or systemic infection.Abstract:
A pressure ulcer is a localized injury to the skin or underlying tissue, usually over a bony prominence, as a result of unrelieved pressure. Predisposing factors are classified as intrinsic (e.g., limited mobility, poor nutrition, comorbidities, aging skin) or extrinsic (e.g., pressure, friction, shear, moisture). Prevention includes identifying at-risk persons and implementing specific prevention measures, such as following a patient repositioning schedule; keeping the head of the bed at the lowest safe elevation to prevent shear; using pressure-reducing surfaces; and assessing nutrition and providing supplementation, if needed. When an ulcer occurs, documentation of each ulcer (i.e., size, location, eschar and granulation tissue, exudate, odor, sinus tracts, undermining, and infection) and appropriate staging (I through IV) are essential to the wound assessment. Treatment involves management of local and distant infections, removal of necrotic tissue, maintenance of a moist environment for wound healing, and possibly surgery. Debridement is indicated when necrotic tissue is present. Urgent sharp debridement should be performed if advancing cellulitis or sepsis occurs. Mechanical, enzymatic, and autolytic debridement methods are nonurgent treatments. Wound cleansing, preferably with normal saline and appropriate dressings, is a mainstay of treatment for clean ulcers and after debridement. Bacterial load can be managed with cleansing. Topical antibiotics should be considered if there is no improvement in healing after 14 days. Systemic antibiotics are used in patients with advancing cellulitis, osteomyelitis, or systemic infection.read more
Citations
More filters
Journal ArticleDOI
Interrater reliability: the kappa statistic
TL;DR: While the kappa is one of the most commonly used statistics to test interrater reliability, it has limitations and levels for both kappa and percent agreement that should be demanded in healthcare studies are suggested.
Journal ArticleDOI
The global burden of unsafe medical care: analytic modelling of observational studies
Ashish K. Jha,Itziar Larizgoitia,Carmen Audera-Lopez,Nittita Prasopa-Plaizier,Hugh Waters,David W. Bates +5 more
TL;DR: Early evidence is provided that adverse events due to medical care represent a major source of morbidity and mortality globally, and the importance of critically evaluating the quality and safety of the care provided once a person accesses health services is suggested.
Journal ArticleDOI
Bacterial Contribution in Chronicity of Wounds.
TL;DR: In this paper, the authors investigated the bacterial diversity in chronic wounds and found that Staphylococcus, Pseudomonas, Peptoniphilus, Enterobacter, Stenotrophomonas and Serratia were most frequently found in chronic wound.
Journal Article
Prevention and treatment of pressure ulcers
Chantal Dangoisse,M. Ledoux +1 more
TL;DR: Preventing pressure ulcers is best achieved by identification of high risk patients, alleviation of causative and predisposing factors and early detection of ischemic skin changes.
Journal ArticleDOI
Review of the Current Management of Pressure Ulcers.
TL;DR: Despite an increased number of therapies available on the market, none has demonstrated any clear benefit over the others and pressure ulcer treatment remains frustrating and time-consuming.
References
More filters
Journal ArticleDOI
Vacuum-assisted closure: a new method for wound control and treatment: clinical experience.
TL;DR: A new subatmospheric pressure technique is presented: vacuum-assisted closure, which removes chronic edema, leading to increased localized blood flow, and the applied forces result in the enhanced formation of granulation tissue.
Journal ArticleDOI
Preventing Pressure Ulcers: A Systematic Review
TL;DR: Given current evidence, using support surfaces, repositioning the patient, optimizing nutritional status, and moisturizing sacral skin are appropriate strategies to prevent pressure ulcers.
Journal ArticleDOI
Risk assessment scales for pressure ulcer prevention: a systematic review
Pedro L. Pancorbo-Hidalgo,Francisco Pedro García-Fernández,Isabel Ma Lopez-Medina,Carmen Álvarez-Nieto +3 more
TL;DR: There is no evidence that the use of risk assessment scales decreases pressure ulcers incidence, and both the Braden and Norton Scales are more accurate than nurses' clinical judgement in predicting pressure ulcer risk.