Prevention of Pressure Ulcers in the Acute Care Setting: New Innovations and Technologies

Tran, Jacquelynn P.; McLaughlin, Jillian M.; Li, Ramon T.; Phillips, Linda G.

doi:10.1097/prs.0000000000002644

Cited by 23 publications

(20 citation statements)

References 45 publications

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“…There are some clinical differences between PU and ASF. According to Delmore et al [1], PU presents as round, reddish lesions at bony prominences, whereas the lesions of ASF are described as pear-, butterfly-, or horseshoe-shaped, or sometimes as irregularly-shaped red/yellow/black ulcers, similar in appearance to abrasions that may occur suddenly (Table 1) [1,9]. The patient in our case had a pear-shaped ulcer on his left buttock with black lesions on the occiput, elbow, back, and ankle, which occurred at multiple sites simultaneously.…”

Section: Discussionmentioning

confidence: 99%

A case of acute skin failure misdiagnosed as a pressure ulcer, leading to a legal dispute

Kim

Shin

Jung³

et al. 2019

Arch Plast Surg

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It is difficult to differentiate acute skin failure (ASF) from pressure ulcer (PU). ASF is defined as unavoidable injury resulting from hypoperfusion caused by severe dysfunction of another organ system. We describe a case of ASF mistaken as PU that resulted in a legal dispute. A 74-year-old male patient was admitted to our intensive care unit with sepsis due to bacterial pneumonia. Despite the use of air cushions and regular position changes, skin ulcerations occurred over his occiput, back, buttock, elbow, and ankle. After improvement in his general condition, he was transferred to the department of plastic and reconstructive surgery. Debridement was performed immediately, followed by conservative treatment (including a vacuum-assisted closure device) for 6 weeks. The buttock and occiput wounds were treated surgically. Despite complete healing, his caregivers sued the hospital for failing to prevent PU formation. ASF is a pressure-related injury resulting from hemodynamic instability due to organ system failure. Unlike PU, ASF may occur despite the implementation of all appropriate preventive measures. Furthermore, misdiagnosis of ASF as PU can lead to litigation. Therefore, it is critical for the proper diagnosis to be made quickly, and for physicians to explain that ASF occurs despite proper preventative treatment.

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Section: Discussionmentioning

confidence: 99%

A case of acute skin failure misdiagnosed as a pressure ulcer, leading to a legal dispute

Kim

Shin

Jung³

et al. 2019

Arch Plast Surg

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“…PUs are described as “localized injury to the skin and/or underlying tissue, usually over a bony prominence, as a result of pressure or pressure in combination with shear.” [ 5 ] Pressure, shear, friction, and microclimate interact as extrinsic factors in the development of PUs. [ 13 , 14 ] Thus, how to relieve these extrinsic factors in advance is a key point in preventing PUs. Although a large number of studies in developed countries have assessed prophylactic and pressure-reducing measures, the PU rates continue to escalate at an alarming rate.…”

Section: Discussionmentioning

confidence: 99%

Application of gluteus maximus fasciocutaneous V-Y advancement flap combined with resection in sacrococcygeal pressure ulcers

Liu

Lu²,

Zhang

et al. 2017

Medicine

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Background:Traditional gluteus maximus myocutaneous flaps have generally been used to fill tissue defects after resection of sacrococcygeal pressure ulcers. However, postoperative complications were gradually revealed as increasing operations were performed. This study aimed to introduce the innovative application of gluteus maximus fasciocutaneous V-Y advancement flaps for repairing tissue defects and to comparatively analyze the differences between the innovative and traditional flaps.Methods:A total of 32 cases were included in this study. All the PU lesions were removed by resection. Sixteen cases used the gluteus maximus myocutaneous flaps, and the remaining 16 cases used gluteus maximus fasciocutaneous V-Y advancement flaps to fill the tissue defects after surgery. Comparative analysis between the gluteus maximus myocutaneous flaps and gluteus maximus fasciocutaneous V-Y advancement flaps was used to evaluate the 2 flaps based on the mean operating time, postoperative infection, paresthesia, appearance of flaps, and recurrence.Results:The gluteus maximus fasciocutaneous V-Y advancement flaps required a reduced operating time and a more simple operation compared with the gluteus maximus myocutaneous flaps. Although the infectious risk of the gluteus maximus fasciocutaneous V-Y advancement flaps was reduced compared with the gluteus maximus myocutaneous flaps, the gluteus maximus myocutaneous flaps have a better appearance compared with the gluteus maximus fasciocutaneous V-Y advancement flaps. Most importantly, no flap necrosis was noted, and the recurrence rate during follow-up was reduced in cases using the gluteus maximus fasciocutaneous V-Y advancement flaps.Conclusion:The combined application of gluteus maximus fasciocutaneous V-Y advancement flaps with surgical resection can reduce the postoperative complications and aid in the treatment of sacrococcygeal pressure ulcers.

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“…These include behavioural and educational interventions [68][69][70]; electrical stimulation [71][72][73]; and nutritional support [74]. Others have more broadly assessed a range of interventions for treatment [75,76] or prevention [77,78] of PUs within a single review.…”

Section: 'Empty' Reviewsmentioning

confidence: 99%

“…The methodological quality of the studies included in some of these reviews was assessed using a variety of methods, with some reviews not providing any quality assessment at all [69,78]. A further limitation included restrictions on publication language [69,70,[72][73][74][75][76][77].…”

Section: 'Empty' Reviewsmentioning

confidence: 99%

Interventions for pressure ulcers: a summary of evidence for prevention and treatment

Atkinson

Cullum

2018

Spinal Cord

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Prevention of Pressure Ulcers in the Acute Care Setting: New Innovations and Technologies

Cited by 23 publications

References 45 publications

A case of acute skin failure misdiagnosed as a pressure ulcer, leading to a legal dispute

A case of acute skin failure misdiagnosed as a pressure ulcer, leading to a legal dispute

Application of gluteus maximus fasciocutaneous V-Y advancement flap combined with resection in sacrococcygeal pressure ulcers

Interventions for pressure ulcers: a summary of evidence for prevention and treatment

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