Pressure Ulcer Incidence and Progression in Critically Ill Subjects

Black, Joyce; Berke, Christine; Urzendowski, Gail

doi:10.1097/won.0b013e3182514c50

Cited by 32 publications

(19 citation statements)

References 19 publications

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“…In particular, clinical pain is not simply the consequence of a “switching on” of the “pain system” in the periphery by a particular pathology, but it instead reflects to a substantial extent the state of excitability of the central nociceptive circuits 17 ) . In previous research, mattress comfort was investigated by analyzing sensations related to body pressure distribution, but the results showed high variability 3 , 18 , 19 , 20 , 21 ) . In this study, we analyzed body pressure distribution and subjective sensation according to the environment in a static supine position.…”

Section: Discussionmentioning

confidence: 99%

Differences in the body pressure-related sensory changes between the floor and mattress in a static supine position for physiotherapy research: a randomized controlled pilot trial

Lee

Kim

et al. 2016

J Phys Ther Sci

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[Purpose] This study was performed to investigate the difference in body pressure–related sensory changes between the floor and mattress in a static supine position for physiotherapy research. [Subjects and Methods] To analyze body pressure, the Body Pressure Measurement System was used. Body pressure sensors were attached to mattresses and the floor beneath the subjects. The level of pain was evaluated using pain score tools before the static supine position was adopted, at 1, 5, 10, and 15 min, and in total for specific body points. [Results] In analysis of digitized images, there was no significant difference observed between floor and mattress body pressure values at the start position. However, the head pressure intensity was significantly higher than that of the other body parts. In analysis of pain scores, all body part pain scores except those for both legs were significantly higher for the floor than for the mattress. Furthermore, the pain scores of the floor group were significantly increased at minute 1 compared with those of the mattress group. [Conclusion] These results suggest that properties that change in a time-dependent manner and postural changes need to be carefully considered when applying physical therapy.

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Section: Discussionmentioning

confidence: 99%

Differences in the body pressure-related sensory changes between the floor and mattress in a static supine position for physiotherapy research: a randomized controlled pilot trial

Lee

Kim

et al. 2016

J Phys Ther Sci

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“…Patient repositioning devices aim to facilitate repositioning to relieve or redistribute pressure (NPUAP, EPUAP & PPPIA, 2014). To date, most trials evaluated the effectiveness of repositioning aides and support surfaces on PU incidence or pressure reduction, in addition to health economic analyses (Black, Berke, & Urzendowski, 2012;Brown et al, 2016;Catz, Zifroni, & Philo, 2005;Edger, 2017;García Molina et al, 2012;K. D. Hall & Clark, 2016;Powers, 2016;Serraes & Beeckman, 2016;van Leen, Hovius, Neyens, Halfens, & Schols, 2011;Yi, Kim, Yoo, Kim, & Kwon, 2009).…”

Section: Introductionmentioning

confidence: 99%

PROTECT – Trial: A cluster RCT to study the effectiveness of a repositioning aid and tailored repositioning to increase repositioning compliance

Meyer

Hecke

Verhaeghe

et al. 2019

Journal of Advanced Nursing

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Aim To study the effectiveness of tailored repositioning and a turning and repositioning system on: (a) nurses’ compliance to repositioning frequencies; (b) body posture of patients after repositioning; (c) incidence of pressure ulcers and incontinence‐associated dermatitis; (d) nurses’ and patients’ preferences, comfort and acceptability; and (e) budget impact. Background Patient‐tailored systematic repositioning is key in pressure ulcer prevention. To date, a clinical decision‐making tool is lacking and compliance to pressure ulcer prevention guidelines is low. Research concerning commercially available turning and repositioning systems is lacking. Design Multicentre, cluster, three‐arm, randomized, controlled pragmatic trial. Methods Two hundred and twenty‐seven patients at risk of pressure ulcer development were recruited at 29 wards in 16 hospitals between February 2016 and December 2017. Wards were randomly assigned to two experimental groups and one control group. Results Nurses’ compliance to repositioning frequencies increased significantly in the experimental groups when patients were cared for in bed (94.6% vs. 69% and 84.9% vs. 71.4%). Applying the turning and repositioning system was associated with significantly more correctly positioned patients (30–45° tilted side‐lying position) (69.6% vs. 34.6%). Few pressure ulcers and incontinence‐associated dermatitis incidents occurred. Both patients and nurses were positive about the intervention. Higher labour costs related to repositioning in bed were found in the control group. Conclusion This was the first study investigating the effect of tailored repositioning and the use of a repositioning aid to increase nurses’ compliance to repositioning. The results were in favour of the interventions yet demonstrating the importance of follow‐up and education. Trial registration This study is registered at https://clinicaltrials.gov/NCT02690753;NCT02690753.

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“…Four studies confirmed the efficacy of active and reactive support surfaces in reducing PI incidence, 14,15,17,18 and one study demonstrated the efficacy of an active support surface after 14 days 21 . Three studies did not find evidence that active and reactive support surface use reduced PI incidence (Table 2).…”

Section: Resultsmentioning

confidence: 93%

“…Research was carried out in China, Turkey, the US, Spain, Brazil, Greece, and Belgium and sample sizes ranged from 52 to 1,654 participants. Five studies examined reactive support surfaces, including VEF, 14–16 static air, 19 and low air loss 17 . Meanwhile, three studies examined an active support surface (an alternating low-pressure air mattress; Table 1).…”

Section: Resultsmentioning

confidence: 99%

Reducing the Incidence and Prevalence of Pressure Injury in Adult ICU Patients with Support Surface Use: A Systematic Review

Bambi

Yusuf

Irwan

2022

Adv Skin Wound Care

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GENERAL PURPOSE To provide information on the effectiveness of active and reactive support surfaces in reducing the incidence and prevalence of pressure injuries (PIs) in adult ICU patients. TARGET AUDIENCE This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES After participating in this educational activity, the participant will: 1. Distinguish features of active and reactive support surfaces used in the ICU.2. Compare the PI incidence in patients using a variety of support surfaces.3. Synthesize recommendations for the use of support surfaces to reduce the risk of PI in adult ICU patients. OBJECTIVE To identify and analyze scientific evidence on the effectiveness of active and reactive support surfaces in reducing the incidence and prevalence of pressure injury (PI) in adult ICU patients. DATA SOURCES PubMed, ProQuest, ScienceDirect, Wiley Online Library, ClinicalKey for Nursing, Cochrane Library, and secondary searches. STUDY SELECTION Studies were included if they related to support surfaces, involved adult ICU patients aged ≥18 years, and the primary outcome measured was incidence or prevalence of PI. The initial search resulted in 8,357 articles; after exclusions, 31 complete texts were assessed for feasibility. A total of eight articles were included in this review. A bias risk assessment was performed using the Cochrane Risk of Bias Assessment Tool. DATA EXTRACTION Data were extracted by one reviewer and summarized in a table of study results that was examined and verified by two other reviewers. DATA SYNTHESIS Reactive (constant low pressure) support surfaces included viscoelastic foam mattresses, static air mattresses, and low-air-loss mattresses, whereas the active support surface consisted of alternating-pressure air mattresses. Alternating pressure mattress and viscoelastic foam mattress use both resulted in significantly lower PI incidence. CONCLUSION Support surface use is limited, and no particular type is proven to be superior to others. Clinicians should select support surfaces based on their therapeutic features and how well they meet the patient’s particular needs.

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Pressure Ulcer Incidence and Progression in Critically Ill Subjects

Cited by 32 publications

References 19 publications

Differences in the body pressure-related sensory changes between the floor and mattress in a static supine position for physiotherapy research: a randomized controlled pilot trial

Differences in the body pressure-related sensory changes between the floor and mattress in a static supine position for physiotherapy research: a randomized controlled pilot trial

PROTECT – Trial: A cluster RCT to study the effectiveness of a repositioning aid and tailored repositioning to increase repositioning compliance

Reducing the Incidence and Prevalence of Pressure Injury in Adult ICU Patients with Support Surface Use: A Systematic Review

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