Repositioning for pressure injury prevention in adults

Abstract

6. Art. No.: CD009958. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.

International consensus on pressure injury preventative interventions by risk level for critically ill patients: A modified Delphi study

“…Likewise, within intensive care, Manzano et al 67 found no difference in PI incidence between 2‐hourly and 4‐hourly repositioning on an alternating pressure air mattress. While 2‐hourly repositioning has been acknowledged as the standard of care, 68 wide study variations in repositioning frequency and mattress combinations, with conflicting results, means that optimal repositioning frequency remains unknown 69 …”

“…While 2-hourly repositioning has been acknowledged as the standard of care, 68 wide study variations in repositioning frequency and mattress combinations, with conflicting results, means that optimal repositioning frequency remains unknown. 69 While the evidence surrounding repositioning is conflicting, repositioning itself has a strong theoretical justification. 68,69 Generally, PI occurs due to unrelieved pressure forces on body tissues, such as tissue between a bony prominence and a mattress surface; 60,70 however, repositioning the body to relieve that pressure subsequently relieves the PI development forces on the affected tissue.…”

“…69 While the evidence surrounding repositioning is conflicting, repositioning itself has a strong theoretical justification. 68,69 Generally, PI occurs due to unrelieved pressure forces on body tissues, such as tissue between a bony prominence and a mattress surface; 60,70 however, repositioning the body to relieve that pressure subsequently relieves the PI development forces on the affected tissue. 19,69 In our study, the expert panel established a minimum repositioning frequency of 4-hourly for critically ill people at low-risk, increasing to 2-hourly for people at moderate-and high-risk.…”

“…68,69 Generally, PI occurs due to unrelieved pressure forces on body tissues, such as tissue between a bony prominence and a mattress surface; 60,70 however, repositioning the body to relieve that pressure subsequently relieves the PI development forces on the affected tissue. 19,69 In our study, the expert panel established a minimum repositioning frequency of 4-hourly for critically ill people at low-risk, increasing to 2-hourly for people at moderate-and high-risk. These results further highlight the concept that as risk level increases, intervention use or intensity should also increase; 23 a theory which underpins this study.…”

Keystone Flap for Reconstruction of Sacral and Ischial Pressure Injury

“…1,3 Pressure injury has become a significant health issue because of its high cost of treatment, debilitating effect on the patients, and the high recurrence rate despite the preventive measures and treatment. 4,5,6 Pressure injury affects 2.5 million individuals resulting in 60,000 deaths in the US and impacts 700,000 individuals with 29,000 deaths in the UK. 5 The cost of pressure injury care in the UK was estimated at between £1.4 billion and £2.1 billion annually and 9.1 to 11.6 billion dollars annually in the US.…”