Pressure Ulcers in Neonates and Children

Baharestani, Mona Mylene; Ratliff, Catherine R.

doi:10.1097/01.asw.0000266646.43159.99

Cited by 152 publications

(155 citation statements)

References 43 publications

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“…30,31 In addition, NPWT is also used in the management of Stage III and Stage IV pressure ulcers. Medical device-related pressure ulcers is a challenge in neonates and children and strategies to prevent these injuries include protection of underlying skin, frequent assessments of skin located under the device, and frequent rotation of devices, if possible.…”

Section: Wound Management Issues In Pediatricsmentioning

confidence: 99%

Dressings and Products in Pediatric Wound Care

King

Stellar

Blevins

et al. 2014

Advances in Wound Care

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Significance: The increasing complexity of medical and surgical care provided to pediatric patients has resulted in a population at significant risk for complications such as pressure ulcers, nonhealing surgical wounds, and moistureassociated skin damage. Wound care practices for neonatal and pediatric patients, including the choice of specific dressings or other wound care products, are currently based on a combination of provider experience and preference and a small number of published clinical guidelines based on expert opinion; rigorous evidence-based clinical guidelines for wound management in these populations is lacking. Recent Advances: Advances in the understanding of the pathophysiology of wound healing have contributed to an ever-increasing number of specialized wound care products, most of which are predominantly marketed to adult patients and that have not been evaluated for safety and efficacy in the neonatal and pediatric populations. This review aims to discuss the available data on the use of both more traditional wound care products and newer wound care technologies in these populations, including medical-grade honey, nanocrystalline silver, and soft silicone-based adhesive technology. Critical Issues: Evidence-based wound care practices and demonstration of the safety, efficacy, and appropriate utilization of available wound care dressings and products in the neonatal and pediatric populations should be established to address specific concerns regarding wound management in these populations. Future Directions: The creation and implementation of evidence-based guidelines for the treatment of common wounds in the neonatal and pediatric populations is essential. In addition to an evaluation of currently marketed wound care dressings and products used in the adult population, newer wound care technologies should also be evaluated for use in neonates and children. In addition, further investigation of the specific pathophysiology of wound healing in neonates and children is indicated to promote the development of wound care dressings and products with specific applications in these populations. SCOPE AND SIGNIFICANCEGiven the lack of consensus on the optimal strategies for common wound care management issues in the neonatal and pediatric populations and the large number of wound care products on the market today, it can be challenging to make informed decisions regarding wound care in these populations. A comprehensive review of the literature on the following specific areas of focus: pressure ulcers, surgical wounds, epidermal stripping, intravenous extravasation injuries, moisture-associated skin damage (MASD), and use of negative-pressure wound therapy (NPWT) is presented, along with management recommendations based on the clinical experience of the authors.

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Section: Wound Management Issues In Pediatricsmentioning

confidence: 99%

Dressings and Products in Pediatric Wound Care

King

Stellar

Blevins

et al. 2014

Advances in Wound Care

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“…3,16,17,[25][26][27] These data highlight the need to apply measures to prevent and treat PUs, especially in NBs, with clinical devices admitted to the NICU. …”

Section: Neonatal Risk Factors and Most Frequent Locationsmentioning

confidence: 99%

“…Although, due to the characteristics of neonatal patients, there are risk factors with greater strength related to the development of PUs. The main risk factors at neonatal age are the use of therapeutic and diagnostic devices (50-90% of the PUs in neonates), 3,16 presence of endotracheal tube, use of noninvasive mechanical ventilation, hypotension and hypoxemia, prolonged stay in the neonatal intensive care unit (NICU), low birth weight (<2500 g) and prematurity (<37 weeks of GA). [16][17][18][19][20][21] The most frequent locations of PUs in neonates are the occipital region and ears, [22][23][24] as well as anatomical areas where therapeutic or diagnostic systems are at risk, such as fingers and feet (pulse oximetry sensor), skin support areas (vascular catheters), thorax (electrodes), ear lobe (capnaptic clamp sensor), nasal septum, back of the neck, nostrils and cheeks (continuous positive airway pressure interface, both binaural cannulae and face mask).…”

Section: Neonatal Risk Factors and Most Frequent Locationsmentioning

confidence: 99%

“…Most of the prevention and treatment protocols available for neonatal population are based on adult clinical practice, regardless of the anatomical and physiological difference between adults and neonates. 3 It is necessary to implement preventive and treatment measures adapted to the neonatal age. But first, we must explain which characteristics make NBs vulnerable to the presence of PUs.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Neonatal pressure ulcers: prevention and treatment

García-Molina¹,

Alfaro-López²,

García-Rodríguez³

et al. 2017

RRN

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Health professionals should be prepared to respond to the needs of hospitalized neonates. The health team must consider multiple situations, where the neonate is at risk of having an adverse effect. One of the main interventions that health professionals must practice when interacting with hospitalized newborns is skin care. Neonates often suffer from diaper rash or intravenous drugs extravasation. Recently, hospitalized neonates and especially those in an unstable clinical situation are also at a risk of developing pressure ulcers. The presence of a pressure ulcer in a neonate can lead to serious problems to survival (eg, sepsis, clinical instability). This is the reason why, with this literature review, we attempt to answer questions from health professionals caring for neonates about the prevention and treatment of pressure ulcers.

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“…Elsevier does not grant permission for this article to be further copied/distributed or hosted elsewhere without the express permission from Elsevier. 8 from pressure points (Baharestani andRatcliff, 2007 andSchindler et al, 2011).…”

Section: What Are Evidence-based Practices For the Treatment Of A Ktu?mentioning

confidence: 99%