Patient-Reported Pressure Ulcer Pain: A Mixed-Methods Systematic Review

Gorecki, Claudia; Closs, S. José; Nixon, Jane; Briggs, Michelle

doi:10.1016/j.jpainsymman.2010.11.016

Cited by 114 publications

(99 citation statements)

References 21 publications

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“…Our work builds on previous research 15,32,36,42 through adapted methods, a comprehensive search of the literature, and strict eligibility criteria applied, including only studies that had used multivariate statistical methods. We also undertook a thorough quality assessment, with consideration of study attrition, participation and confounding factors as a means of highlighting study bias and limitations.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of risk factors for the development and recurrence of pressure ulcers in people with spinal cord injuries

2013

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Study design: A systematic review was undertaken, based upon methods recommended for effectiveness questions but adapted to identify observational risk factor (RF) studies. Objectives: The literature identifies many RFs for pressure ulcer (PU) recurrence and development; however, RFs independently predictive of PU development in adults with spinal cord injury (SCI) have not been determined. A systematic review was undertaken to identify RFs for PUs for people with SCI. Setting: Acute hospital, community and rehabilitation settings. Methods: Electronic searches of MEDLINE, EMbase and Cochrane databases from 1980 to 2011 were completed. Retrieved studies were assessed for eligibility and quality criteria applied by two independent reviewers. Identified RFs were categorised into themes and compared and contrasted with RFs identified for the general PU population. Results: The five studies included 18 RFs. These were classified into six themes: sociodemographic, neurological, functional, clinical, biological and medical care management. RFs for both the general and SCI-specific populations were similar, however, clinical, functional and hospital management emerged as specific RF domains for the SCI population. Conclusion: We identified SCI-specific RFs for the development and recurrence of PUs. However, these findings are based on a small number of studies; highlighting the need for further confirmatory work to reduce PU development and recurrence, and provide a foundation for SCI risk assessment development.

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Section: Discussionmentioning

confidence: 99%

A systematic review of risk factors for the development and recurrence of pressure ulcers in people with spinal cord injuries

2013

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“…Although PUs do occur in all age groups it is especially a condition of the aged [11]. PUs are associated with pain, reduced quality of life [12] and PU treatment is burdensome and expensive. Among 15 selected common skin conditions in the latest Global Burden of Disease report PUs were regarded as the most severe dermatological diseases contributing to a substantial health loss [13].…”

Section: Introductionmentioning

confidence: 99%

Skin response to sustained loading: A clinical explorative study

Kottner

Dobos

Andruck

et al. 2015

Journal of Tissue Viability

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“…11,12 Similar to VAP, pressure ulcers have been linked to increased length of stay, 13 high costs, 14,15 and pain. 16 Support surfaces are often used to prevent skin breakdown, including low-tech foam mattresses and high-tech alternating pressure mattresses or low-air-loss beds. 17 In addition to distributing a patient's weight, low-air-loss supports tend to control the microclimate of the patient's skin.…”

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confidence: 99%

Interface Pressure at Different Degrees of Backrest Elevation With Various Types of Pressure-Redistribution Surfaces

Lippoldt

Pernicka

Staudinger

2014

American Journal of Critical Care

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Background Increased elevation of the head of the bed is linked to a higher risk for sacral pressure ulcers. A semirecumbent position of at least 30° is recommended for the prevention of ventilator-associated pneumonia in patients treated with mechanical ventilation. Therefore, prevention of pressure ulcers and prevention of pneumonia seem to demand contradictory, possibly incompatible, positioning. Objectives To measure pressure at the interface between sacral skin and the supporting surface in healthy volunteers at different degrees of upright position with different types of mattresses. Methods An open, prospective, randomized crossover trial was conducted with 20 healthy volunteers. Interface pressure was measured by using a pressure mapping device with the participant in a supine position at 0, 10°, 30°, and 45° elevation and in the reverse Trendelenburg position at 10° and 30°. Four types of mattresses were examined: 2 different foam mattresses and 2 air suspension beds, 1 of the latter with low-air-loss technology. Results Peak sacral interface pressures increased significantly only at 45° of backrest elevation (P < .001). A mattress system with low-air-loss technology significantly reduced peak interface pressures at all angles (P < .001).The reverse Trendelenburg position led to lower peak pressures for all positions (P = .01). Conclusions Backrest elevation up to 30° might be a compromise between the seemingly incompatible demands of skin integrity and the prevention of ventilator-associated pneumonia. The reverse Trendelenburg position and a mattress system with low-air-loss technology could be additional useful tools to help prevent skin breakdown at the sacrum.

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Patient-Reported Pressure Ulcer Pain: A Mixed-Methods Systematic Review

Abstract: A biopsychosocial model of pain experienced from PUs is presented. Improved communication of pain experienced between the individual and health care professionals is needed to promote more effective PU pain management in the future.

Cited by 114 publications

References 21 publications

A systematic review of risk factors for the development and recurrence of pressure ulcers in people with spinal cord injuries

A systematic review of risk factors for the development and recurrence of pressure ulcers in people with spinal cord injuries

Skin response to sustained loading: A clinical explorative study

Interface Pressure at Different Degrees of Backrest Elevation With Various Types of Pressure-Redistribution Surfaces

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