Aetiology, risk factors and treatment of typical and atypical pressure ulcers in patients with traumatic brain injury: A narrative review

Abstract

Pressure ulcers are one of the leading complications in bedridden patients that result in multiple burdens on healthcare systems and patients (11 billion dollars/year). The prevalence of pressure ulcers in traumatic brain injury patients is 1.5‐fold compared with the other bedridden patients. Moreover, critical traumatic brain injury patients who are admitted to the intensive care unit experience severe pressure ulcers and further complications. The motor/sensory disabilities and low supplementation and oxygenation to the pressured side were the main mechanisms of the typical pressure ulcers. Intellectual evaluation is the first essential step to prevent the development of pressure ulcers in high‐risk patients. Till now, different scales, including Injury Scale Score and Braden Scale Score, have been provided to assess the pressure ulcer. Since low stages of pressure ulcers heal rapidly, traumatic brain injury patients require a periodical assessment to prevent further developments timely. Alongside different procedures provided to prevent and treat any pressure ulcer, traumatic brain injury patients required additional specific protections. For the first line, fast and efficient rehabilitation repairs motor/sensory disabilities and decreases the chance of pressure ulcer. Our review indicated that pressure ulcer in traumatic brain injury had several complex mechanisms that demand special care. Therefore, further studies are required to address these mechanisms and prevent their progression to typical and atypical pressure ulcers.

Prognóstico clínico de pacientes com traumatismo cranioncefálico em Unidades de Terapia Intensiva

“…O estudo enfatiza a importância de cuidados específicos e avaliação periódica para prevenir e tratar essas úlceras. A implementação de protocolos de reabilitação rápida e eficiente pode ajudar a reparar deficiências motoras e sensoriais, reduzindo a incidência de úlceras por pressão e melhorando os desfechos clínicos desses pacientes (Dehghani;Pourmontaseri, 2024). De acordo com Barea-Mendoza et al (2023), a combinação da Escala de Coma de Glasgow com a avaliação pupilar (GCS-P) apresenta uma capacidade superior para prever a mortalidade hospitalar em pacientes com traumatismo cranioencefálico grave, quando comparada à GCS tradicional.…”