New concepts in the prevention of pressure sores

Bogie, Kath M.; Powell, Heather L.; Ho, Chester

doi:10.1016/b978-0-444-52137-8.00014-0

Cited by 7 publications

(4 citation statements)

References 72 publications

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“…Clinical surveys identify the sacral area as the most common site for PUs associated with prolonged supine position (bedrest). Compressive loads applied by the heavy pelvis and shear loads caused by static or dynamic frictional forces (such as when a patient slides downwards in the bed because of gravity or during repositioning) subject the soft tissues around the sacrum to sustained deformations, which may lead to a PU [ 2 , 3 , 7 , 9 ]. PU is a problem that has always plagued critically ill patients in the bedridden elderly ICU, and it is also a problem that medical staff pay close attention to.…”

Section: Resultsmentioning

confidence: 99%

“…PU was caused by local tissue hand pressure for a long time, nutritional imbalance, blocked blood circulation, and persistent tissue hypoxia [ 1 , 2 ]. PU is the most common complication in the daily nursing work of medical staff [ 3 ]. Patients who are stationary, such as those who are paralysed, unconscious, or under anesthesia during a surgical procedure, endure prolonged bodyweight-related compressive, tensional, and shear loads at the body-support contact areas, which, over time, may lead to the onset of PUs [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Application of Self-Adhesive Soft Silicone Common Foam Dressing in Reducing Intraoperative Pressure Ulcers in Elderly ICU Patients

Wang

Gan

Zhou

et al. 2021

Computational and Mathematical Methods in Medicine

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Pressure ulcer (PU), also called pressure injury, is localized damage to the skin and underlying soft tissues, usually over bony prominences, as a result of sustained mechanical loads applied to the tissues. However, in many situations, complete off-loading of sacral PUs is not possible. Minimising the exposure of wounds and their surroundings to elevated mechanical loads is crucial for healing. We for the first time reported the application of Meipicang in the prevention and treatment of intraoperative pressure ulcers in elderly ICU patients with severe illness. We found that the pressure ulcer risk score ( 20.15 ± 2.17 ) in the dressing group after intervention was higher than that ( 17.42 ± 3.62 ) in the regular group. The incidence of pressure sores in the dressing group was 3.77% lower than the 18.88% in the regular group. The psychological concern score ( 31.41 ± 3.15 ) of the dressing group was higher than that ( 26.92 ± 3.43 ) of the regular group. The trust score ( 29.57 ± 2.61 ) of the dressing group was higher than the score ( 24.28 ± 2.29 ) of the regular group. The score of physiological problems in the dressing group ( 34.69 ± 3.82 ) is higher than that in the regular group ( 29.88 ± 3.54 ). The skin complication rate of the dressing group was 5.56% lower than that of the regular group (22.64%). The comfort score (92.46 ± 4.15) of the dressing group was higher than that ( 80.59 ± 5.43 ) of the regular group. The nursing satisfaction score ( 94.53 ± 3.72 ) of the dressing group was higher than that ( 81.79 ± 4.61 ) of the regular group. To conclude, in this study, we found that the Meipicang dressing can reduce the incidence of pressure ulcers in ICU patients with severe ICU and improve the comfort and nursing satisfaction of elderly ICU patients with severe ICU, which is worthy of promotion.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Application of Self-Adhesive Soft Silicone Common Foam Dressing in Reducing Intraoperative Pressure Ulcers in Elderly ICU Patients

Wang

Gan

Zhou

et al. 2021

Computational and Mathematical Methods in Medicine

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“…13 Interface pressure mapping is a useful tool for assessment of ischial tuberosity pressure, and changes after therapeutic interventions. 4,20 In our retrospective study, however, the mapping system was used for clinical purpose only, that is, to assist with individualized wheelchair cushion prescriptions in the seating clinic. The switch from a contoured foam to an air-filled cushion can be considered as an indirect sign of improvement, as it might indicate a better pressure redistribution of ischial pressure in two patients.…”

Section: Discussionmentioning

confidence: 99%

Lipofilling (fat grafting) in the secondary prevention of ischial tuberosity and pelvic pressure ulcers

Prévinaire

Opsomer

et al. 2015

Spinal Cord

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Study Design: Retrospective study. Objectives: Lipofilling was proposed to adult chronic spinal cord injury patients with history of ischial tuberosity pressure ulcers surgery, at risk of recurrence of pressure ulcers due to unsatisfactory adipose tissue thickness. Setting: Fondation Hopale, Berck, France. Methods: The three staged (Coleman) procedure for fat grafting consisted of water-jet assisted liposuction (Harvest-Jet), decantation, and reinjection of the autologous fat in three-dimensional plan. Results: Ten consecutive patients (eight paraplegics and two tetraplegics) benefited from bilateral ischial lipofilling, with additional lipofilling of the sacrum (three patients) and the trochanters (two patients). All patients attended the seating clinic with pressure mapping before and after lipofilling for appropriate cushion prescription. Mean follow-up time was 16 months (4-24 months). Complications were limited to stage I (two patients) and stage II (one patient) pressure ulcers, due to negligence. Excellent results with minimal fat wasting (between 10% and 25%) underneath the ischial tuberosity were seen in eight patients, with significant improvement of adipose tissue thickness. Total fat waste was seen in two patients, one of whom following dramatic weight loss. Results were always good in the sacrum and trochanteric areas. Lipofilling allowed longer sitting times (three patients), improved skin quality (nine patients), improved quality of life (six patients), 'a better feeling of positioning in their wheelchair' (four patients), and decrease in pelvic pain (three patients). Discussion and Conclusion: Pelvic lipofilling is safe, cost-effective, and can now be considered in the primary prevention of pelvic pressure ulcers in patients with insufficient adipose tissue.

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“…Les úlceres afecten les persones que les pateixen de forma distinta i afecten àmbits diversos: (1) socials (estigmatització i aïllament social per pèrdua d'independència, impediment per assistir al lloc de treball); (2) personals (disminució de la qualitat de vida, empitjorament de la imatge personal, depressió); i (3) de salut (disminució de la salut física general, dolor, empitjorament de la malaltia subjacent, allargament del procés de recuperació o fins i tot la mort per infecció fatal). (Davies, K. et al, 1991;Essex, HN et al, 2009;Bogie et al, 2012).…”

Section: Com Afecten Les úLceres Per Pressió a Les Persones En Cadiraunclassified

Identificació de criteris de disseny i selecció de coixins antiescares, a partir d'aspectes funcionals dels coixins i les característiques particulars i preferències dels usuaris

Guillem¹

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A Pili, per tot.Trenta-sis persones en cadira de rodes han participat en aquest estudi que ha inclòs la valoració de vint-i-cinc coixins. El principal criteri per a la inclusió d'usuaris en l'estudi ha estat el nivell de risc de desenvolupar úlceres per pressió. Per a la inclusió dels coixins s'ha buscat la representativitat del mercat i la inclusió de tipologies diferents.Des del punt de vista de l'opinió dels usuaris aquest treball d'investigació ha permès identificar els factors de qualitat percebuda (F1. Estabilitat, F3. Encaixament, F4. Col·lapse, i calcular el pes d'ells sobre els factors globals de bondat i evolució dels coixins. Per altra banda, la comparació dels valors de pressió obtinguts amb les persones en cadira de rodes i els mesurats amb el maniquí constata una clara divergència en el comportament. També s'han definit criteris de disseny i valors límit, admissibles i recomanables, per a un conjunt de variables i la seua relació amb els factors de qualitat i les variables subjectives.Els resultats d'aquest treball suporten la importància d'una aproximació global als coixins, que incloga els processos de disseny, desenvolupament i prescripció, on els usuaris siguen molt més protagonistes del que ho han estat fins ara. SummaryWheelchair users represent around 1% of the population. This group is characterised through the number of hours spent each day in a seated position. This can lead to health problems linked mainly to the development of pressure ulcers. In addition, the position in the wheelchair is critical in order to be able to perform different activities comfortably. The aim of the cushions, integrated in the whole seating system, is to contribute to the prevention, positioning and comfort of the person in a wheelchair.Incorporating the user adequately into the assessment, prescription and development of new cushions is a key aspect, clearly identified in the bibliography, which requires the use of innovation models to produce this incorporation systematically. This research paper adopts the cause-effect model, successfully used in other fields such as the car or shoe making industries, but to date not used in the field of tissue management cushions.The use of this model has allowed for the identification of different links between the consequences of the interaction person-cushion (developed perception of the user) with the cushion and person characteristics, as well as with the physiological and biomechanical response resulting from this interaction. This was a necessary step to obtain design and selection criteria for the cushions. The physiological and biomechanical variables which have been analysed are pressure and microclimate. To study the consequences of this interaction we have considered the user perception obtained by means of a questionnaire.Thirty-six wheelchair users have participated in this study which includes the assessment of twenty-five cushions. The main criteria for the inclusion of users in the study has been the risk level of risk of developing pressure ulcers. The in...

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New concepts in the prevention of pressure sores

Cited by 7 publications

References 72 publications

Application of Self-Adhesive Soft Silicone Common Foam Dressing in Reducing Intraoperative Pressure Ulcers in Elderly ICU Patients

Application of Self-Adhesive Soft Silicone Common Foam Dressing in Reducing Intraoperative Pressure Ulcers in Elderly ICU Patients

Lipofilling (fat grafting) in the secondary prevention of ischial tuberosity and pelvic pressure ulcers

Identificació de criteris de disseny i selecció de coixins antiescares, a partir d'aspectes funcionals dels coixins i les característiques particulars i preferències dels usuaris

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