Assessment and Management of Chronic Pressure Ulcers in the Elderly

Antibiotic Resistance in Nursing Homes

“…The reported prevalence of pressure ulcers, has varied from 1,6 to up of 20% in different institutions (Michocki RJ & Lamy PP, 1976;Spector WD & Al, 1988;Branders GH & Al, 1990;Young JB & Dobrzanski S, 1992;Nicolle LE & Al, 1994a;Berlowitz DR & Al, 1996;Coleman EA & Al, 2002;Zulkowski K & Al, 2005), with an incidence as high as 10 to 30% patient per year (Berlowitz DR & Wilking SVB, 1989;Branders GH & Al, 1990), and as low as 3,4 to 4,8 episodes per 100000 resident days (Nicolle LE & Al, 1994b). Pressure ulcers are associated with increased mortality (Branders GH & Al, 1990;Livesley NJ & Chow A, 2002;Garcia AD & Thomas DR, 2006). Infected ulcers are reported to occur from 0,1 to 0,3 episodes per 1000 resident days (Farber BF & Al, 1984;Scheckler W & Peterson P, 1986) or 1,4 per 1000 ulcer days (Nicolle LE & Al, 1994b).…”

“…Medical factors predisposing to pressure ulcers have been delineated (Berlowitz DR & Wilking SVB, 1989;Garcia AD & Thomas DR, 2006) and include immobility, pressure, friction, shear, moisture, steroids, incontinence, sensory impairment, malnutrition and infections; reduced nursing time can also increase the risk of developing pressure ulcers. Several of these factors may be partially preventable (i.e.…”

Adverse outcomes after major surgery in patients with pressure ulcer: A nationwide population-based retrospective cohort study

“…Limited mobility due to spinal cord injury, cerebrovascular accident or hip fracture was an important contributing factor in pressure ulcer [4,5]. Diabetes, congestive heart failure, renal dysfunction, chronic obstructive pulmonary disease, progressive neurologic disorder, malnutrition and aging skin were also considered as medical comorbidities associated with pressure ulcer [4,5].…”

“…Diabetes, congestive heart failure, renal dysfunction, chronic obstructive pulmonary disease, progressive neurologic disorder, malnutrition and aging skin were also considered as medical comorbidities associated with pressure ulcer [4,5]. The influences of extrinsic pressure, friction, shear stress and excessive moisture contribute to tissue hypoxia and poor wound healing followed by tissue necrosis [5].…”

“…Diabetes, congestive heart failure, renal dysfunction, chronic obstructive pulmonary disease, progressive neurologic disorder, malnutrition and aging skin were also considered as medical comorbidities associated with pressure ulcer [4,5]. The influences of extrinsic pressure, friction, shear stress and excessive moisture contribute to tissue hypoxia and poor wound healing followed by tissue necrosis [5]. Pressure ulcers may lead to patient distress, poor quality of life and recurrent severe infection; these often increase hospital stay length [3,6], mortality rates [7], and need for long-term health care [3].…”