Neonatal pressure ulcers: prevention and treatment

Abstract

Health professionals should be prepared to respond to the needs of hospitalized neonates. The health team must consider multiple situations, where the neonate is at risk of having an adverse effect. One of the main interventions that health professionals must practice when interacting with hospitalized newborns is skin care. Neonates often suffer from diaper rash or intravenous drugs extravasation. Recently, hospitalized neonates and especially those in an unstable clinical situation are also at a risk of developing pressure ulcers. The presence of a pressure ulcer in a neonate can lead to serious problems to survival (eg, sepsis, clinical instability). This is the reason why, with this literature review, we attempt to answer questions from health professionals caring for neonates about the prevention and treatment of pressure ulcers.

Cord Blood Platelet Gel as a Treatment of Occipital Pressure Injuries in Newborns: Report of Two Cases

“…Immobility, sedation, hypotension, hypoxemia, mechanical ventilation, and extracorporeal membrane oxygenation are risk factors for occipital PU. Postural changes are recommended for occipital PU prevention and treatment every two hours, and therapeutic surfaces are suggested [ 1 , 23 ].…”

“…Pressure ulcers (PU) are rarely reported in the neonatal population, with an estimated incidence in infants admitted to Neonatal Intensive Care Units (NICU) between 3.7% and 21.6% and a prevalence of 23% [ 1 ].…”

“…Endotracheal tube, non-invasive ventilation, vascular catheter, immobilization, hypotension, hypoxemia, prolonged NICU hospitalization, low birth weight, and prematurity represent risk factors for PU [ 1 , 2 , 3 ].…”

“…However, most of the available products to treat PU are contra-indicated in newborns because of the risk of absorption and toxicity. Therefore, only a few products are available for the treatment of neonatal PU [ 1 ].…”

Efectividad de las medidas y estrategias de prevención de úlceras por presión en neonatos

“…En los RN a término este proceso comienza inmediatamente después del parto, con la adaptación de la piel del neonato al ambiente seco en comparación con el medio intrauterino, y finaliza en el primer año de vida. Sin embargo, en los RN prematuros el proceso no se inicia, equiparándose a los RN a término, hasta pasadas 2-3 semanas posparto, o más tardío si el neonato nace entre las 23-25 semanas de gestación 1,5,6 .…”