Review on Pressure Sores

Kiran Madhusudhan; Pujita B

Review on Pressure Sores

Kiran Madhusudhan, Pujita B

Abstract

Pressure sore is a localised injury to the skin and underlying tissue caused due to unrelieved pressure on pressure points or bony prominences. The predisposing factors causing pressure ulcers are both intrinsic and extrinsic. Patients who are generally at risk, are those confined to bed or chair and unable to move without help. According to NPUAP (National pressure ulcer advisory panel), pressure ulcers can be categorised into four stages, and an unstageable category also exists. Staging helps to select the mode of treatment. Diagnosis is mainly by MRI, bone scan, bone biopsy and blood culture, if necessary. As the cost of treatment and complications due to pressure sores increase with the period of stay, it is better to adopt preventive methods strictly to “at risk” patients. Prevention includes, identification of “at risk” patients using the three risk assessment scales and follow interventions to reduce the risks. Goals of treatment consist of resolution of infection, promotion of wound healing and effective infection control and in advanced stages, use of newer approaches like negative pressure wound therapy (VAC
therapy-vacuum-assisted closure) and surgery.

Keywords

pressure sore, capillary pressure, intrinsic and extrinsic risk factors, staging, sepsis, osteomyelitis, negative pressure therapy (VAC), risk assessment scales

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References

Severens JL, Habraken JM, Duivenvoorden S, Frederiks CM. The cost of illness of pressure ulcers in The Netherlands. Adv Skin Wound Care. 2002;15:72–77.

Allman RM. Pressure ulcer prevalence, incidence, risk factors, and impact. Clin Geriatr Med. 1997;13:421–437.

Bluestein D, Javaheri A. Pressure ulcers: prevention, evaluation and management. Am Fam Physician. 2008;78(10):1186–1196.

Sen CK, Gordillo GM, Roy S, Kirsner R, Lambert L, Hunt TK. Human skin wounds: a major and snowballing threat to public health and the economy. Wound Repair Regen. 2009;17(6):763–71.

Niezgoda JA, Eastman SM. The effective management of pressure ulcers. Adv Skin Wound Care. 2006;19:3–14.

Agarwal K, Chauhan N. Pressure ulcers: back to the basics. Indian J Plast Surg. 2012 May-Aug;45(2):244–54.

Pancorbo-Hidalgo PL, Garcia-Fernandez FP, Lopez-Medina IM, Alvarez-Nieto C. Risk assessment scales for pressure ulcer prevention: a systematic review. J Adv Nurs. 2006;54(1):94–110.

Christian N. Kirman. Pressure ulcers and wound care. Medscape reference drugs, diseases and procedures. Updated: Apr 01, 2015.

Parish LC, Witcowski JA. The infected decubitus ulcer. Int J Dermatol. 1989;28:643–647.

Darouiche RO, Landon GC, Kilma M, Musher DM, Markowski J. Osteomyelitis associated with pressure sores. Arch Intern Med. 1994;154(7):753–8.

Bryan CS, Dew CE, Reynolds KL. Bacteremia associated with decubitus ulcers. Arch Intern Med. 1983;143(11):2093–5.

Wall BM, Mangold T, Huch KM, Corbett C, Cooke CR. Bacteremia in the chronic spinal cord injury population: risk factors for mortality. J Spinal Cord Med. 2003;26(3):248–523.

Huang AB, Schweitzer ME, Hume E, Batte WG. Osteomyelitis of the pelvis/hips in paralyzed patients: accuracy and clinical utility of MRI. J Comput Assist Tomogr. 1998;22(3):437–43.

Kranke P, Bennett M, Roecki-Wiedmann I, Debus S. Hyperbaric oxygen therapy for chronic wounds. Cochrane Database Syst Rev. 2004;(2):CD004123.

Healthwise Staff Sep 9, 2014 Complication of pressure sores. British Colombia, Health Link BC. Available at Healthwise.org.

Livesley NJ, Chow AW. Infected pressure ulcers in elderly individuals. Clin Infect Dis. 2002 Dec 1;35(11):1390–1396.

Moody BL, Fanale JE, Thompson M, Vaillancourt D, Symonds G, Bonasoro C. Impact of staff education pressure development in elderly hospitalized patients. Arch Intern Med. 1998;148:2241–2243.

Agency for health care policy and research. Treatment of pressure ulcers. Rockville, MD: U.S. Department of Health and Human services; 1994. AHCPR Publication on 95-0652. Available at http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat2. Chapter 5124. Accessed Dec 17, 2007.

Thomas DR. Prevention and treatment of pressure ulcers. J Am Med Dir Assoc. 2006;7(1):46–59.

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