Medical Aspects of the Decubitus Ulcer

Andersen, Klaus Ejner; Kvorning, Sven Ancher

doi:10.1111/j.1365-4362.1982.tb02095.x

Cited by 41 publications

(15 citation statements)

References 14 publications

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“…Repeatedly, increasing age has been correlated with higher risk of pressure sores (Andersen & Kvorning, 1982;Gerson, 1975;Gosnell, 1973;Manley, 1978;Seiler & Stahelin, 1985). In elderly surgical patients, the incidence of pressure sores ranged from 20 to 66% (Roberts & Goldstone, 1979;Versluysen, 1986).…”

mentioning

confidence: 99%

Factors that contribute to pressure sores in surgical patients

Kemp

Keithley²,

Smith³

et al. 1990

Research in Nursing & Health

134

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In this prospective study examination was made of whether (a) time on the operating table, (b) proportion of intraoperative diastolic hypotensive episodes, (c) age, (d) preoperative serum albumin, (e) preoperative total protein levels, and (f) preoperative Braden scores could identify those patients who do and do not develop pressure sores during elective surgery. The stratified sample consisted of 125 adult patients. Fifteen patients (12%) developed a total of 23 pressure sores. A discriminant function using time on the operating table, extracorporeal circulation, and age emerged as the best predictor correctly classifying 12 of 15 patients who developed pressure sores and 83 of 110 patients who remained pressure sore free.

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mentioning

confidence: 99%

Factors that contribute to pressure sores in surgical patients

Kemp

Keithley²,

Smith³

et al. 1990

Research in Nursing & Health

134

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“…Additional well-recognized intrinsic and extrinsic risk factors which predispose the development of pressure sores are fecal and urinary incontinence, altered consciousness, impaired nutritional intake, dehydration, hypoalbuminemia, hypoxemia and the presence of moisture and constant pressure on skin areas at risk [2,3,4,9,32,36,39]. In this context it is important to recognize that the influence of these factors varies from patient to patient.…”

Section: Discussionmentioning

confidence: 97%

“…Patient groups at risk of developing pressure sores are patients aged 70 years and over, immobilized and paraplegic patients, trauma patients and patients being underweight [4,5,30,39,44]. Additional well-recognized intrinsic and extrinsic risk factors which predispose the development of pressure sores are fecal and urinary incontinence, altered consciousness, impaired nutritional intake, dehydration, hypoalbuminemia, hypoxemia and the presence of moisture and constant pressure on skin areas at risk [2,3,4,9,32,36,39].…”

Section: Discussionmentioning

confidence: 98%

Pressure sores: epidemiology, medico-legal implications and forensic argumentation concerning causality

Tsokos

Heinemann

Püschel

2000

International Journal of Legal Medicine

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The aim of the present investigation was to identify the frequency and grading of pressure sores in a large series of unselected consecutive deceased subjects before cremation and to discuss aspects of the forensic argumentation concerning causality. A total of 10,222 corpses were examined prospectively over a 1-year-period (1998) for the occurrence, localization and grading of pressure sores. Epidemiological aspects (e.g. age, sex, underlying and contributing causes of death, place of death etc.) were taken from the death certificate. The mean prevalence of pressure sores was 11.2% (87.1% isolated sores; predominant localization of advanced grades on the sacrum in 69.6%). There was a positive correlation between the prevalence of sores and advanced age resulting in a clear female predominance in the age group of 80 years and over because of differences in life expectancy. A significant correlation was found between the prevalence of pressure sores and certain underlying diseases, e.g. trauma, senile dementia, neurological diseases, apoplexy and marasmus. Pressure sores of all grades were more frequently found in the deceased when a senior citizen's or nursing home was given on the death certificate as the domicile in the last period of life. The forensic argumentation for the causal relationship of a pressure sore as the focus of fatal infectious complications or septicemia has to be based on the results of clinical expertises and forensic investigations (evaluation of the institutional documentation of the patient's course, autopsy findings, histology, immunohistochemistry). The vast majority of physicians seem to pay only little attention to the potentially fatal outcome of pressure sores and fatalities associated with this condition are clearly underreported. From the point of view of social medicine, the prevalence of pressure sores in a defined population can be seen as a parameter for the quality of nursing and medical care. In bringing these fatalities to light, the field of legal medicine contributes to a general quality control of standards of nursing and medical care.

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“…The protein intake of four of the seven subjects was 0.9–1.0 g/kg per day, which was lower than the 1.2 g/kg per day recommended for the elderly or the 1.2–1.5 g/kg per day recommended for patients with pressure ulcers (Agency for Health Care Policy and Research, 1994). Latent factors of delayed healing in elderly people (Anderson & Kvorning, 1982; Bergstrom & Braden, 1992; Robert, 2001), such as protein or zinc deficiency, during the granulation period of a wound causes a decrease in fibroblast function and collagen synthesis (Rijswijk & Polansky, 1994). Therefore, the nutrition of the present subjects was inadequate for wound repair, and thus the healing of the pressure ulcers was delayed.…”

Section: Discussionmentioning

confidence: 99%

Healing process of pressure ulcers after a change in the nutrition regimen of bedridden elderly: A case series

Omote

Sugama

Sanada

et al. 2005

Japan Journal Nursing Sci

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Aim: The aim of the present study was to describe the healing process of pressure ulcers after a change in the nutrition regimen of seven bedridden elderly patients. Methods: The healing process of pressure ulcers was described and monitored for 4 weeks prior to and 4 weeks following a change in the nutrition regimen in the seven subjects, who were in long-term care facilities, while controlling for other factors related to pressure ulcer healing. Changes in the nutrition regimen included increased caloric intake, supplements, or tube feeding. The healing process was measured qualitatively using wound sketches and quantitatively using wound surface area and DESIGN score. Results: Pressure ulcers were predominantly stage III (n = 4) and located in the truncal area (n = 6). There were qualitative differences in the healing process before and after the nutrition regimen change. Most notably, in six cases there was early granulation tissue at the wound edge at week 2 after the change, the color of the granulation tissue improved at week 3, and there was a decrease in wound depth at week 4. Conclusions: Based on this description of the process of healing of full-thickness pressure ulcers in seven elderly subjects, it is suggested that a qualitative assessment of improvement in the wound can be made from the appearance of the granulation tissue following a change in nutrition.

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Medical Aspects of the Decubitus Ulcer

Cited by 41 publications

References 14 publications

Factors that contribute to pressure sores in surgical patients

Factors that contribute to pressure sores in surgical patients

Pressure sores: epidemiology, medico-legal implications and forensic argumentation concerning causality

Healing process of pressure ulcers after a change in the nutrition regimen of bedridden elderly: A case series

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