Pressure Ulcers - Research Paper Example

Pressure Ulcers Pressure Ulcers From Nixon, J et al (2006) Pressure ulcers are damages to the skin and underlying tissue due to pressure, friction, shear or a combination of these factors. Support surfaces such as mattress overlays, replacement mattresses, pressure relieving beds, cushions, or repositioning patients manually are methods used to relieve pressure. Patients with limited mobility are provided with mattress overlays and replacement mattresses to reduce the chance of developing pressure ulcers.

A study was conducted to determine the effectiveness of replacement mattresses and mattress overlay in preventing ulcers, affecting the healing process, and patient acceptability. The study was carried out in eleven hospitals, and target participants were aged at least 55 years. They were admitted to vascular, medical, orthopedic, or elderly people wards. Participants had been admitted within the previous 24 hours, and had to stay for at least seven days with limited mobility. Patients with grade 1 or 2 pressure ulcers were also eligible for the study.

Patients were selected randomly, and the selection was minimized to centers, specialty, and type of admission. Alternating pressure overlays or alternating pressure mattresses were allocated to participants. The endpoint was the development of grade 2 or higher grade ulcers. 6155 patients were assessed for eligibility and 1971 patients were randomized for the study. 207 (10.5%) patients developed 305 new ulcers, mostly grade 2, and eight patients developed grade 3 ulcers. One hundred and six patients in the overly group and one hundred and one patients in mattress group developed new ulcers.

There was less significance of developed ulcers between the two groups within 30 days. Twenty patients in the overlay group and 19 patients in the mattress group healed their ulcers. The results indicated little difference in the development and healing of ulcers between the two groups. From Linda, R. J et al, (2003) The study aimed at determining the superiority of a viscoelastic polymer mattress against a standard hospital mattress in the prevention of pressure ulcers. The cost effectiveness of the energy absorbing mattress was also compared to that of a standard hospital mattress.

Participants were chosen randomly in three hospitals in the United Kingdom. Eligible participants had to be admitted in the elderly acute care, orthopedic, or rehabilitation wards. A total of 1168 patients who were at a risk of developing pressure ulcers participated. The median age of participants was 83 years and had the risk of developing ulcers with a 15 to 20 waterlow score. Participants were allocated the CONFOR-Med mattress/cushion combination or standard mattress/cushion combination during admission.

A standard nursing care was given to all participants, and daily observations were conducted. There was a 19.9 to 26.3 decrease in blanching erythema incidences and a no significant decrease in nonblanching erythema in participants with the experimental mattresses. Patients on standard mattresses had a 95 percent confidence interval for developing blanching and nonblanching erythema. Participants with both types of erythema were less mobile than those with normal skin conditions. However, the difference in mobility in participants with similar pressure ulcers was not attributed to differences in mattresses.

Pressure ulcers occurred in participants using both types of mattresses. However, there was a significant reduction of blanching erythema in patients using the experimental mattresses. From Shahin, Dassen, and Halfens (2009) Patients undergoing acute and long-term care develop pressure ulcers and the study was to assess the development of pressure ulcers in intensive care patients. Factors related to pressure ulcers and, the course of pressure ulcers was also studied. The study was conducted in the cardiological and surgical intensive care and nephrological intensive care on a general and university hospital respectively.

One hundred and twenty-one patients participated. Eligible patients were those admitted in the adult intensive care wards in the hospital, and patients less than 18 years old did not participate. Patients were assessed upon admission, upon discharge or death, or after spending two weeks in intensive care. A questionnaire was issued for data collection, and the EPUAP grading system was used. The participating group consisted of 56.2 percent males and 43.8 percent females. A 4.5 percent of neprological patients and 2.

9 percent of surgical patients developed pressure ulcers and the highest grade was 2. None of the cardiologic patients developed pressure ulcers. 19 percent of the ulcers developed within two weeks, and 25 percent new ulcers developed in patients who stayed for less than one week. Patients who stayed for more than one week and less than two weeks developed 75 percent new pressure ulcers. Foam mattresses, standard mattresses and alternating air mattresses were used by 43%, 23%, and 33% of the patients respectively.

Hydrocolloid dressing was commonly used for patients with pressure ulcers. The low percentages of pressure ulcers were attributed to the short stay of patients in the ICU wards. Most ulcers developed on the sacrum, heel, and ischium body parts of the patients. References Linda, J., Reynolds, T. M., Park, C. S., Rithalia, S., Gonsalkorale, M., Birch, J. B., Torgerson, D., and Iglesias, C. M. (2003). Randomized Clinical Trial Comparing 2 Support Surfaces: Results of the Prevention of Pressure Ulcers Study.

Advances in Skin & Wound Care,16, 317-327. Nixon, J., Cranny, G., Iglesias, C., Andrea, E. N., Hawkins, K., Philips, A Torgesson, D., Mason, S., Cullum, N., and PRESSURE Trial Group. (2006) Randomised, controlled trial of alternating pressure mattresses compared with alternating pressure overlays for the prevention of pressure ulcers: PRESSURE (pressure relieving support surfaces) trial. BMJ, 332, 1413. Shahin, E.S., Dassen, T., and Halfens, R.J. (2009). Incidence, prevention and treatment of pressure ulcers in intensive care patients: a longitudinal study.

International Journal of Nursing Studies, 46, 413–421.