Underpads in the Prevention of Decubiti

Lowthian, Peter

doi:10.1007/978-1-349-02492-6_18

Cited by 19 publications

(7 citation statements)

References 3 publications

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“…However, whether incontinence is an independent predictor for pressure sore development remains unclear. While one study demonstrated a fivefold increase in the incidence of pressure sores among incontinent patients, 24 another study found that incontinence failed to add any discriminatory information above that contained in measures of patient mobility and activity 25 . Allman et al 1 could demonstrate no association between urinary incontinence and pressure sores at an acute care hospital.…”

Section: Discussionmentioning

confidence: 98%

Risk Factors for Pressure Sores

Berlowitz

Wilking

1989

J American Geriatrics Society

249

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The purpose of this study was to identify prospectively risk factors for pressure sores and to compare these results with a cross-sectional analysis in the same population. Medical records on all admissions to a chronic care hospital over a 13-month period were reviewed. Data on potential risk factors were abstracted from the initial history, physical examination, nursing assessment, and laboratory studies. Pressure sore status on admission and at three weeks was determined from a standardized from completed on all patients with a score. The cross-sectional analysis was performed by comparing patients with and without a pressure sore at the time of admission. The cohort analysis used patients initially without a pressure sore and monitored for a new sore at three weeks. Factors associated with pressure sores on univariate testing were entered into a stepwise logistic regression model. One hundred of the 301 admissions presented with a pressure sore. Factors significantly associated with the presence of a sore were altered level of consciousness (OR = 4.1), bed- or chair-bound (OR = 2.4), impaired nutritional intake (OR = 1.9), and hypoalbuminemia (OR = 1.8 for 10 mg/mL decrease). Of the 185 patients without a pressure sore, 20 (10.8%) developed a sore. Factors significantly associated with the development of a new pressure sore were a history of cerebrovascular accident (OR = 5.0), bed- or chair-bound (OR = 3.8), and impaired nutritional intake (OR = 2.8). Neither urinary nor fecal incontinence, nor the presence of hypoalbuminemia, was associated with sore development. We have prospectively identified risk factors for pressure sores.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Discussionmentioning

confidence: 98%

Risk Factors for Pressure Sores

Berlowitz

Wilking

1989

J American Geriatrics Society

249

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“…Sources of moisture include sweat, wound drainage, urine, and feces. Several studies indicated that incontinence increases the risk of pressure ulcer development fivefold, 57 but the studies did not distinguish between fecal and urinary incontinence. When urinary incontinence was looked at separately, it had no independent association with pressure ulcers.…”

Section: S Provide Good Skin Carementioning

confidence: 99%

Prevention and treatment of pressure ulcers: what works? what doesn't?

Thomas¹

2001

Cleveland Clinic Journal of Medicine

116

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Although no gold standard for preventing or treating pressure ulcers has been established, data from clinical trials indicate specific efforts are worthwhile. Preventive strategies include recognizing risk, decreasing the effects of pressure, assessing nutritional status, avoiding excessive bed rest, and preserving the integrity of the skin. Treatment principles include assessing the severity of the wound; reducing pressure, friction, and shear forces; optimizing wound care; removing necrotic debris; managing bacterial contamination; and correcting nutritional deficits. s KEY POINTS Pressure ulcers are often blamed on poor nursing care in long-term care facilities, but the incidence is actually higher in acute care hospitals. The most important reversible host factor contributing to wound healing is nutritional status. Several studies suggest that dietary protein, in particular, is important in healing pressure ulcers. Surgical closure of pressure ulcers results in more rapid resolution of the wound. The chief problems are frequent recurrence and inability of frail patients to tolerate the procedure. Any therapy that dehydrates the wound, such as dry gauze, heat lamps, air exposure, or liquid antacids, is detrimental to chronic wound healing The most common complications are increased mortality, osteomyelitis, and sepsis.

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“…However, the relationship between incontinence and pressure sores is not so obvious as is often presumed. Some researchers have con®rmed the ®ndings of Norton et al (Lowthian, 1976;Goldstone & Goldstone, 1982), but others have not found a relationship between pressure sores and incontinence (Berlowitz & Wilking, 1989;Van Marum et al, 1992). Claessens (1973) and Welten (1983) thought it was not incontinence that fostered the occurrence of sores, but rather a poor general condition that caused both pressure sores and incontinence.…”

Section: Factors That Determine the In¯uence Of Shearing Forcementioning

confidence: 99%

The risk of pressure sores: a conceptual scheme

Defloor

1999

Journal of Clinical Nursing

162

139

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Based on a review of the literature related to the prediction and prevention of pressure sores, a conceptual scheme on pressure sores in introduced. The article highlights the four elements of the scheme: pressure, shearing force, tissue tolerance for pressure and tissue tolerance for oxygen. Factors influencing pressure and shearing forces, the pressure distribution capacity of tissue, the oxygen need of tissue and oxygen supply to tissue are discussed.

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Underpads in the Prevention of Decubiti

Cited by 19 publications

References 3 publications

Risk Factors for Pressure Sores

Risk Factors for Pressure Sores

Prevention and treatment of pressure ulcers: what works? what doesn't?

The risk of pressure sores: a conceptual scheme

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