Pressure Induced Deep Tissue Injury Explained

Oomens, Cwj Cees; Bader, DL Dan; Loerakker, Sandra; Baaijens, Fpt Frank

doi:10.1007/s10439-014-1202-6

Cited by 169 publications

(143 citation statements)

References 26 publications

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“…Waiting at the ED on a trolley may lead to increased risk for developing pressure ulcer. Research has informed us that cellular damage and thus the potential development of pressure ulcers can occur within a few minutes [16]. …”

Section: Discussionmentioning

confidence: 99%

“…A high number of these patients are in a fragile situation, with high age and suffering from multi-diseases leading to a complex situation. Also, recent biomedical research reveals that a direct deformation of tissue results from high strain, and is a process that leads to the first signs of cell damage within minutes [16]. Subsequently, patients in the ambulance or at the ED are exposed to high pressure ulcer risk [17–19].…”

Section: Introductionmentioning

confidence: 99%

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Heel pressure ulcer, prevention and predictors during the care delivery chain – when and where to take action? A descriptive and explorative study

Athlin

Engström

Gunningberg

et al. 2016

Scand J Trauma Resusc Emerg Med

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BackgroundHazardous healthcare settings, for example acute care, need to focus more on preventing adverse events and preventive actions across the care delivery chain (i.e pre-hospital and emergency care, and further at the hospital ward) should be more studied. Pressure ulcer prevalence is still at unreasonably high levels, causing increased healthcare costs and suffering for patients. Recent biomedical research reveals that the first signs of cell damage could arise within minutes. However, few studies have investigated optimal pressure ulcer prevention in the initial stage of the care process, e.g. in the ambulance care or at the emergency department. The aim of the study was to describe heel pressure ulcer prevalence and nursing actions in relation to pressure ulcer prevention during the care delivery chain, for older patients with neurological symptoms or reduced general condition. Another aim was to investigate early predictors for the development of heel pressure ulcer during the care delivery chain.MethodsExisting data collected from a multi-centre randomized controlled trial investigating the effect of using a heel prevention boot to reduce the incidence of heel pressure ulcer across the care delivery chain was used. Totally 183 patients participated. The settings for the study were five ambulance stations, two emergency departments and 16 wards at two hospitals in Sweden.ResultsA total of 39 individual patients (21 %) developed heel pressure ulcer at different stages across the care delivery chain. Findings revealed that 47–64 % of the patients were assessed as being at risk for developing heel pressure ulcer. Preventive action was taken. However, all patients who developed pressure ulcer during the care delivery chain did not receive adequate pressure ulcer prevention actions during their hospital stay.Discussion and ConclusionsIn the ambulance and at the emergency department, skin inspection seems to be appropriate for preventing pressure ulcer. However, carrying out risk assessment with a validated instrument is of significant importance at the ward level. This would also be an appropriate level of resource use. Context-specific actions for pressure ulcer prevention should be incorporated into the care of the patient from the very beginning of the care delivery chain.Trial registration ISRCTN85296908.Electronic supplementary materialThe online version of this article (doi:10.1186/s13049-016-0326-0) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Heel pressure ulcer, prevention and predictors during the care delivery chain – when and where to take action? A descriptive and explorative study

Athlin

Engström

Gunningberg

et al. 2016

Scand J Trauma Resusc Emerg Med

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“…31 Pressure and shear forces applied to the wound can also lead to direct deformational damage to the wound as well as capillary closure leading to cellular disruption and microvascular damage arising from ischemia-reperfusion injury. 32 Scarring and the eventual mechanical properties of the healed wound are influenced by the extrinsic mechanical forces that are applied to the wound during proliferation and remodeling. 33,34 When appropriately applied extrinsic mechanical forces can lead to enhanced healing and potentially less scarring.…”

Section: Factors Affecting Wound Healingmentioning

confidence: 99%

Review of near-infrared methods for wound assessment

Sowa

Kuo²,

et al. 2016

J. Biomed. Opt

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Vous avez des questions? Nous pouvons vous aider. Pour communiquer directement avec un auteur, consultez la première page de la revue dans laquelle son article a été publié afin de trouver ses coordonnées. Si vous n'arrivez pas à les repérer, communiquez avec nous à PublicationsArchive-ArchivesPublications@nrc-cnrc.gc.ca. Questions? Contact the NRC Publications Archive team atPublicationsArchive-ArchivesPublications@nrc-cnrc.gc.ca. If you wish to email the authors directly, please see the first page of the publication for their contact information. NRC Publications Archive Archives des publications du CNRCThis publication could be one of several versions: author's original, accepted manuscript or the publisher's version. / La version de cette publication peut être l'une des suivantes : la version prépublication de l'auteur, la version acceptée du manuscrit ou la version de l'éditeur. NRC Publications Record / Notice d'Archives des publications de CNRC:http://nparc.cisti-icist.nrc-cnrc.gc.ca/eng/view/object/?id=f622d2fd-d6fd-477b-9502-e09dd5a4b2d2 http://nparc.cisti-icist.nrc-cnrc.gc.ca/fra/voir/objet/?id=f622d2fd-d6fd-477b-9502-e09dd5a4b2d2Review of near-infrared methods for wound assessment Abstract. Wound management is a challenging and costly problem that is growing in importance as people are living longer. Instrumental methods are increasingly being relied upon to provide objective measures of wound assessment to help guide management. Technologies that employ near-infrared (NIR) light form a prominent contingent among the existing and emerging technologies. We review some of these technologies. Some are already established, such as indocyanine green fluorescence angiography, while we also speculate on others that have the potential to be clinically relevant to wound monitoring and assessment. These various NIR-based technologies address clinical wound management needs along the entire healing trajectory of a wound.

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“…Also it occurs due to a subject's physiological parameters such as body weight, height. Pressure ulcers mostly develop at bony areas (43% at sacrum, 11% at heel) compared to soft muscular area ) [9], [10]. Figure 1 shows the frequency of pressure ulcer occurrence in the human body.…”

Section: Introductionmentioning

confidence: 99%

Modelling of pressure ulcer (PU) risk prediction system

Mishu

Schroeder

2015

2015 Science and Information Conference (SAI)

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Abstract-Human skin deformation occurs due to external loading. As a result, blood flow in soft tissue becomes low and also the oxygenation decreases. Tissue under continuous loading results in tissue necrosis and leads to pressure ulcer (PU), also known as bedsore, decubitus ulcer, and ischemia. The amount of external load applied to the body support surface is associated with a subject's BMI (body mass index). Therefore interface pressure (IP) at the skin and the surface is the result of a subject's physical and support surface properties. Interface pressure increases, the blood flow decreases and a subject starts developing stage-1 pressure ulcer. Previous research suggests that interface pressure of 32 mmHg (4.26 kPa) can cause PU, but there is no strong evidence to show at what time that pressure is reached. Also interface pressure changes from subject to subject due to their body compositions. Three risk assessment scales are available to predict overall risk of PU formation. But none of these scales take interaction of body support surface materials into account. Also these do not provide any information at which area a subject is at risk of PU formation. In this work a study is presented where external load at different bony areas are measured using 11 volunteers. By measuring the external load for 11 subjects (age:33 ± 7 yrs and BMI:25.04 ± 3.01 kg/m 2 ) at different bony areas, the relationship with the total body weight was identified. A mathematical model is proposed to predict the risk of PU formation combining the Waterlow risk assessment scales for bony areas and a graphic user interface to predict this is discussed.

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Pressure Induced Deep Tissue Injury Explained

Cited by 169 publications

References 26 publications

Heel pressure ulcer, prevention and predictors during the care delivery chain – when and where to take action? A descriptive and explorative study

Heel pressure ulcer, prevention and predictors during the care delivery chain – when and where to take action? A descriptive and explorative study

Review of near-infrared methods for wound assessment

Modelling of pressure ulcer (PU) risk prediction system

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