Review articles : Pressure sores: methods used for the assessment of patient support surfaces

Abstract

In the seriously ill, the paralysed and the elderly patient, many factors such as poor skin blood flow, malnutrition and immobility predispose to a high incidence of decubitus ulcers or pressure sores. The development of a sore is a complex process, but skin distortion and localized pressure are considered important precipitating factors. Over the last two decades manufacturers have produced a large variety of support surfaces claiming to be effective in prevention as well as treatment of sores. However, a review of available literature shows that none of the test methods used by different investigators has provided a comprehensive means of determining which device is appropriate for a particular patient. Many elderly, paralysed or seriously ill patients spend long periods of time in bed. They are prone to a high incidence of pressure sores due to factors such as malnutrition, immobility, elevated temperature and poor skin perfusion. The aetiology of a sore is complex and not yet fully understood, but it is widely accepted that the tissue damage is caused by prolonged localized pressure' 1 and skin distortion.2 2 The magnitude, duration and direction of pressure are considered to be the main causative factors leading to skin lesion. 3,4 Several names have been used to describe the damaged area, for example, decubitus ulcer, bed sore, trophic ulcer and distortion sore.

The effects of the support panel of compression leggings on the provision of low pressure for foot progression angle correction

“…The area with the highest-pressure value was the GA, with 12.70 and 12.55 mmHg in the NLs and CLs, respectively, which were lower than the blood flow-based threshold of 30 mmHg and the perception-based threshold of 17 mmHg reported in previous studies. [32][33][34][37][38][39][40]…”

Nursing challenges with a severely injured patient in critical care

“…The patient had been considered high risk for PU development using a Waterlow score assessment (Waterlow, ; Wellard and Lo, ) on admission to ICU. For many patients, this would indicate supplying a pressure relieving air filled mattress in order to reduce PU risk, as basic hospital mattresses have minimal pressure relieving properties (Rithalia and Kenney, ). However, an air mattress cannot provide accurate spinal alignment and thus would have negative clinical implications for spinal injured patients (Ferrell et al ., ), therefore this was not a clinical option.…”

Pressure sore prevention in the critically ill: what you don't know, what you should know and why it's important

“…Curiously though, one issue that has not been addressed, and one in which no national consensus exists, is the optimal time cycle. Although it has been suggested that an optimal time cycle in sleeping healthy volunteers should be at 5-minute intervals (Rithalia, 1991), no data exists that suggest that this is of any benefit to the critically ill. The time cycle and inflation pressures of the cells are of extreme importance as it can have tremendous impact on tissue interface pressures.…”