Review of Evidenced-Based Practice for the Prevention of Pressure Sores in Burn Patients

Abstract

Pressure ulcers represent a complex clinical problem, with a reported incidence of 2.7% to 29.5% in hospitalized patients and an etiology that is multifactorial. The prevention of pressure sores in the burn patient population is clearly an area of practice in need of guidelines for care. A multidisciplinary group of advanced burn care professionals have compiled, critiqued, and summarized herein the current evidence of practice in nursing, nutrition, and rehabilitation as it pertains to the prevention of pressure sores after burn injuries. A broad overview of risk factors and assessment scales is described, and current intervention practices and recommendations for care are provided based, whenever possible, on research findings. In addition, research questions are generated in an attempt to move the specialty of burns toward the formal investigation of pressure sores with the ultimate goal being the development of evidence-based practice guidelines.

Low-echoic lesions underneath the skin in subjects with spinal-cord injury

“…Furthermore, pressure ulcers present a significant burden on the national health system; healing one pressure ulcer costs as much as $70 000. 1,2 Pressure ulcers occur almost exclusively over bony prominences that have been subjected to excessive pressure for a length of time, and inevitably resolve once the pressure is removed. Therefore, it is likely that ischemia because of supracapillary pressure is a prime factor in the development of pressure ulcers.…”

Pressure Ulcers and Prolonged Hospital Stay in Hip Fracture Patients Affected by Time-to-Surgery

“…Protein energy malnutrition is seen more often in elderly patients with hip fractures compared with age-matched control subjects [37][38][39][40]. Protein malnutrition is an important determinant of pressure ulcers and infectious complications [33,41]. Any intervention aimed at restoring protein and energy balances may result in reduced complication rates.…”

“…In view of the complex nature of the process of pressure ulcer development, a great number of potential risk factors have been identified [32] and this has led to difficulties in developing a simple and reliable risk assessment model [33]. To reduce the incidence of pressure ulcers, patients at risk should be placed on low-pressure support systems from arrival at hospital until mobility is restored [8,34,35] However, the clinical and economic effect of these support systems has yet to be proven in properly designed clinical trials [36].…”

Effective research without walls – Reflections on an international partnership

“…In the USA it is estimated that wound management costs the health service in excess of $50 billion per year (Driver, Fabbi, Lavery, & Gibbons, 2010;Gordon, Gottschlich, Helvig, Marvin, & Richard, 2004;Hess, 2004) in Australia the cost of wound care to the health service has been estimated to be $2.6Billion a year with this being the second most frequently billed item in general practice (Wound Management Innovation Co-operative Research Centre, 2010).…”