Review of the Current Management of Pressure Ulcers

Boyko, Tatiana; Longaker, Michael T.; Yang, George P.

doi:10.1089/wound.2016.0697

Cited by 210 publications

(188 citation statements)

References 51 publications

Supporting

Mentioning

144

Contrasting

Unclassified

Order By: Relevance

“…Disability was considered to be a dependent risk factor. This outcome was consistent with several previous studies (Boyko et al., ; Coleman, Nixon, et al., ). The association between disability and PI may be explained through the following mechanisms.…”

Section: Discussionsupporting

confidence: 93%

“…In America, the fastest growing segment of population is individuals who are over 65 years of age (Boyko, Longaker, & Yang, ). Additionally, the percentage of older people in South Korea is projected to rise from 9–38% by 2050 (Kim et al., ).…”

Section: Introductionmentioning

confidence: 99%

“…In America, the fastest growing segment of population is individuals who are over 65 years of age (Boyko, Longaker, & Yang, 2016).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prevalence of pressure injury among Chinese community‐dwelling older people and its risk factors: A national survey based on Chinese Longitudinal Healthy Longevity Survey

Cai

Zha

Yuan

et al. 2019

Journal of Advanced Nursing

View full text Add to dashboard Cite

Aim To investigate the distribution of pressure injuries among older adults in China and to identify the associated risk factors. Design Cross‐sectional study. Methods The identified subjects were collected from 2012 wave of a national Chinese Longitudinal Healthy Longevity Survey. Older people were defined as being 65 years of age or older. We used chi‐square test and binary logistic regression to investigate the risk factors of pressure injury development. Results A total of 55 older people were documented as suffering from pressure injuries among 6,961 older Chinese adults, with a prevalence of 0.8%. In the group of disability, the prevalence of pressure injuries from high to low was 3.6% in the highly limited group, 0.4% in the moderately limited group, and 0.3% in the not limited group. The prevalence of pressure injury among older people with stroke, cancer, and dementia were 2%, 4.2%, and 6.6%, respectively. According to the final binary logistic regression analysis, age, disability, incontinence, cancer, and dementia emerged as important risk factors for pressure injury development. Conclusion Pressure injury among Chinese community‐dwelling aged people was shown to be associated with age, disability, incontinence, cancer, and dementia. As the development of pressure injury may distinctly increase the burden on individuals and healthcare systems, the social and related institutions should actively prevent and control the disease. Impact The results of this study will improve the identification of pressure injury among older Chinese people and contribute to the development of effective pressure injury risk management interventions.

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prevalence of pressure injury among Chinese community‐dwelling older people and its risk factors: A national survey based on Chinese Longitudinal Healthy Longevity Survey

Cai

Zha

Yuan

et al. 2019

Journal of Advanced Nursing

View full text Add to dashboard Cite

show abstract

“…Pressure ulcers arising from malnutrition, immobility, and decreased sensation affect 2.5 million people, cost $11.6 billion per year (adding an estimated $43,180 per hospital stay), and contribute to 60,000 deaths annually. 17,18 Despite this, pressure ulcers are thought to be largely preventable. 16 Delirium can affect >50% of surgical patients, 19 costs upwards of $152 billion annually (adding an estimated $64,421 per patient), 20 is strongly predicted by cognitive impairment (relative risk 3.5 to 4.2), 17 can result in persistent and sometimes permanent cognitive decline, 17 and has been associated with a 7.35-fold increase in 5-year mortality (95% CI 1.49 to 36.18).…”

Section: Discussionmentioning

confidence: 99%

Enhancing the American College of Surgeons NSQIP Surgical Risk Calculator to Predict Geriatric Outcomes

Hornor

Zhou

et al. 2020

Journal of the American College of Surgeons

View full text Add to dashboard Cite

BACKGROUND: The American College of Surgeons (ACS) NSQIP Surgical Risk Calculator (SRC) plays an important role in risk prediction and decision-making. We sought to enhance the existing ACS NSQIP SRC with functionality to predict geriatric-specific outcomes and assess the predictive value of geriatric-specific risk factors by comparing performance in outcomes prediction using the traditional ACS NSQIP SRC with models that also included geriatric risk factors. STUDY DESIGN: Data were collected from 21 ACS NSQIP Geriatric Surgery Pilot Project hospitals between 2014 and 2017. Hierarchical regression models predicted 4 postoperative geriatric outcomes (ie pressure ulcer, delirium, new mobility aid use, and functional decline) using the traditional 21-variable ACS NSQIP SRC models and 27-variable models that included 6 geriatric risk factors (ie living situation, fall history, mobility aid use, cognitive impairment, surrogate-signed consent, and palliative care on admission). RESULTS:Data from 38,048 patients 65 years or older undergoing 197 unique operations across 10 surgical subspecialties were used. Stable model discrimination and calibration between developmental and validation datasets confirmed predictive validity. Models with and without geriatric risk factors demonstrated excellent performance (C statistic >0.8) with inclusion of geriatric risk factors improving performance. Of the 21 ACS NSQIP variables, CPT code, COPD, age, functional dependence, sex, disseminated cancer, diabetes, and sepsis were the strongest risk predictors, and impaired cognition, fall history, and mobility aid use were the strongest geriatric predictors. CONCLUSIONS: The ACS NSQIP SRC can predict 4 unique outcomes germane to geriatric surgical patients, with improvement of predictive capability after accounting for geriatric risk factors. Augmentation of ACS NSQIP SRC can enhance shared decision-making to improve the quality of surgical care in older adults. (J Am Coll Surg 2020;230:88e100. Ó

show abstract

“…While pressure is the main cause, they are also affected by friction, shearing forces, and moisture . Common risk factors include age >65, impaired circulation/tissue perfusion, immobilization, undernutrition, decreased sensation, and incontinence …”

Section: Introductionmentioning

confidence: 99%

Noninvasive staging of pressure ulcers using photoacoustic imaging

Hariri

Chen

Moore

et al. 2019

Wound Repair Regeneration

View full text Add to dashboard Cite

Ulcers including pressure ulcers and diabetic foot ulcers damage the skin and underlying tissue in people with compromised blood circulation. They are classified into four stages of severity and span from mild reddening of the skin to tissue damage and muscle/bone infections. Here, we used photoacoustic imaging as a noninvasive method for detecting early tissue damage that cannot be visually observed while also staging the disease using quantitative image analysis. We used a mouse model of pressure ulcers by implanting subdermal magnets in the dorsal flank and periodically applying an external magnet to the healed implant site. The magnet-induced pressure was applied in cycles, and the extent of ulceration was dictated by the number of cycles. We used both laser-and lightemitting diode (LED)-based photoacoustic imaging tools with 690 nm excitation to evaluate the change in photoacoustic signal and depth of injury. Using laser-based photoacoustic imaging system, we found a 4.4-fold increase in the photoacoustic intensity in stage I vs. baseline (no pressure). We also evaluated the depth of injury using photoacoustics. We measured a photoacoustic ulcer depth of 0.38 AE 0.09 mm, 0.74 AE 0.11 mm, 1.63 AE 0.4 mm, and 2.7 AE 0.31 mm (n = 4) for stages I-IV, respectively. The photoacoustic depth differences between each stage were significant (p < 0.05). We also used an LED-based photoacoustic imaging system to detect early stage (stage I) pressure ulcers and observed a 2.5-fold increase in photoacoustic signal. Importantly, we confirmed the capacity of this technique to detect dysregulated skin even before stage I ulcers have erupted. We also observed significant changes in photoacoustic intensity during healing suggesting that this approach can monitor therapy. These findings were confirmed with histology. These results suggest that this photoacoustic-based approach might have clinical value for monitoring skin diseases including pressure ulcers.

show abstract

Review of the Current Management of Pressure Ulcers

Cited by 210 publications

References 51 publications

Prevalence of pressure injury among Chinese community‐dwelling older people and its risk factors: A national survey based on Chinese Longitudinal Healthy Longevity Survey

Prevalence of pressure injury among Chinese community‐dwelling older people and its risk factors: A national survey based on Chinese Longitudinal Healthy Longevity Survey

Enhancing the American College of Surgeons NSQIP Surgical Risk Calculator to Predict Geriatric Outcomes

Noninvasive staging of pressure ulcers using photoacoustic imaging

Contact Info

Product

Resources

About