Guidelines for the treatment of pressure ulcers

Whitney, Jo Anne D.; Phillips, Linda G.; Aslam, Rummana; Barbul, Adrian; Gottrup, Finn; Gould, Lisa; Robson, Martin C.; Rodeheaver, George T.; Thomas, David; Stotts, Nancy A.

doi:10.1111/j.1524-475x.2006.00175.x

Cited by 195 publications

(162 citation statements)

References 158 publications

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“…What is required to be done when the patient is admitted to the service is to provide for the planning, follow-up, and continuity of the care in whom a pressure ulcer risk assessment will be made. Risk assessment scales that are reliable, valid, and that completely reveal the situation of the patient are of great importance, in particular for increasing the quality of care of the patient and for creating care standards (1)(2)(3)(4)(5)23).…”

Section: Discussionmentioning

confidence: 99%

“…This condition usually develops in the areas over bony prominences of the body depending on the exposure to constant pressure, peeling, and friction of the skin or combinations of these (1)(2)(3). The back of the head, shoulder head, elbow, lower back, hips, pelvic bone, ankle, and heel are the parts of the body where pressure ulcers are widely seen (4).…”

Section: Introductionmentioning

confidence: 99%

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Is Braden Scale Reliable and Sufficient to Evaluate the Risk of Pressure Ulcer Occurrence in Level 3 Intensive Care Unit Patients?

Gül¹,

Köprülü²,

Haspolat³

et al. 2016

JAREM

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Objective: To prevent pressure ulcer, detecting risk factors and planning how to act with respect to patients provide to find solution. Thus, Braden Scale is the most common tool that is used in Turkey. This study aimed to measure Braden Scale effectiveness at detecting the risk groups of level 3 intensive care unit patients.Methods: This prospective, single-center study includes 206 level 3 intensive care unit patients whose risk factors were standardized as much as possible in the intensive care unit between January 2014 and May 2015. Routine clinical care was applied to the patients whose risk groups were determined by Braden Scale, and the patients were divided into two groups depending on the presence of a pressure ulcer before discharging from the hospital. Demographic findings, hospitalization duration, mental status, Apache II score, expected/actual mortality, blood albumin levels, and Braden Scale score were compared. Results:Comparison of the groups showed that patients' age, length of stay in intensive care unit, mental status, and blood albumin levels are significantly different between patients with and without pressure ulcers. Furthermore, scores of patients with pressure ulcers were not significantly different from those of patients without pressure ulcers. Data also illustrated that pressure ulcers occurred in no risk patients with the ratio of 7.14%; in low-risk patients with the ratio of 27.8%; in moderate-risk patients with the ratio of 29.73%; in high-risk patients with the ratio of 17.72%.Conclusion: Data evaluation demonstrates that Braden Scale is not effective to detect the risk factors, and parameters related to pressure ulcer development are not sufficiently represented by Braden Scale. Modification of an existing scale or a new risk assessment scale that includes all other risk parameters and that is more suitable for the patients of our country is required. (JAREM 2016; 6: 98-104)

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Is Braden Scale Reliable and Sufficient to Evaluate the Risk of Pressure Ulcer Occurrence in Level 3 Intensive Care Unit Patients?

Gül¹,

Köprülü²,

Haspolat³

et al. 2016

JAREM

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“…The patient's life expectancy increased along with the development of physical medicine and rehabilitation, allowing a better management of urinary and sphincter disorders. 1,2 Pressure ulcers (PUs) are now the most common complication for patients with SCI, 3,4 despite the large number of recommendations available 5,6 for information and prevention, and the technological progresses made for preventing and treating PU. PU has become the second cause of rehospitalization after an SCI, 7 with estimated annual costs amounting to 1.4 billion dollars in the United States.…”

Section: Introductionmentioning

confidence: 99%

Pressure ulcer risk factors in persons with SCI: part I: acute and rehabilitation stages

Gélis

Dupeyron

Legros³

et al. 2008

Spinal Cord

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Background: Pressure ulcers (PUs) are a common complication following a spinal-cord injury (SCI). Good prevention requires identifying the individuals at risk for developing PUs. Risk assessment scales used nowadays were designed on pathophysiological concepts and are not SCI-specific. Recently, an epidemiological approach to PU risk factors has been proposed to design an SCI-specific assessment tool. The first results seem quite disappointing, probably becuase of the level of evidence of the risk factors used. Objective: To determine PU risk factors correlated to the patients with SCI, medical care management during the acute as well as in the rehabilitation and chronic stages. This first part focuses on identifying the risk factors during the acute and rehabilitation stages. Materials and methods: Systematic review of the literature. Results: Six studies met our inclusion criteria. The risk factors during the acute stage of an SCI are essentially linked to care management and treatment modalities. There is insufficient evidence to make a recommendation on medical risk factors, except for low blood pressure on admission to the Emergency Room, with a moderate level of evidence. Regarding the rehabilitation stage, no study was deemed relevant. Discussion and conclusions: Additional observational studies are needed, for both the acute and rehabilitation stages, to improve this level of evidence. However, this systematic review unveiled the need for a carefully assessed t care management and the related practices, especially during the acute stage of an SCI.

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“…17 Difficult-to-heal wounds affect tens of millions of people worldwide. In the U.S., studies have shown that approximately 2.5 million people have venous ulcers, 18,19 while pressure ulcers afflict an additional 1.3-3 million people, 20 including an estimated 10%-18% of those in acute care and up to 28% of those in extended care facilities. 21 Approximately 15% of the 16 million U.S. adults with diabetes will develop serious foot ulcers within their lifetime.…”

Section: Introductionmentioning

confidence: 99%

Optimizing Wound Bed Preparation With Collagenase Enzymatic Debridement

McCallon

Weir

Lantis

2014

Journal of the American College of Clinical Wound Specialists

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Difficult-to-heal and chronic wounds affect tens of millions of people worldwide. In the U.S. alone, the direct cost for their treatment exceeds $25 billion. Yet despite advances in wound research and treatment that have markedly improved patient care, wound healing is often delayed for weeks or months. For venous and diabetic ulcers, complete wound closure is achieved in as few as 25%-50% of chronic or hard-to-heal wounds. Wound bed preparation and the consistent application of appropriate and effective debridement techniques are recommended for the optimized treatment of chronic wounds. The TIME paradigm (Tissue, Inflammation/infection, Moisture balance and Edge of wound) provides a model to remove barriers to healing and optimize the healing process. While we often think of debridement as an episodic event that occurs in specific care giver/patient interface. There is the possibility of a maintenance debridement in which the chronic application of a medication can assist in both the macroscopic and microscopic debridement of a wound. We review the various debridement therapies available to clinicians in the United States, and explore the characteristics and capabilities of clostridial collagenase ointment (CCO), a type of enzymatic debridement, that potentially allows for epithelialization while debriding. It appears that in the case of CCO it may exert this influences by removal of the necrotic plug while promoting granulation and sustaining epithelialization. It is also easily combined with other methods of debridement, is selective to necrotic tissue, and has been safely used in various populations. We review the body of evidence has indicated that this concept of maintenance debridement, especially when combined episodic debridement may add a cost an efficacious, safe and cost-effective choice for debridement of cutaneous ulcers and burn wounds and it will likely play an expanding role in all phases of wound bed preparation.

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Guidelines for the treatment of pressure ulcers

Cited by 195 publications

References 158 publications

Is Braden Scale Reliable and Sufficient to Evaluate the Risk of Pressure Ulcer Occurrence in Level 3 Intensive Care Unit Patients?

Is Braden Scale Reliable and Sufficient to Evaluate the Risk of Pressure Ulcer Occurrence in Level 3 Intensive Care Unit Patients?

Pressure ulcer risk factors in persons with SCI: part I: acute and rehabilitation stages

Optimizing Wound Bed Preparation With Collagenase Enzymatic Debridement

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