Prophylaxis and treatment of pressure ulcers in the intensive care units (literature review)

L.O. Maltseva, N.F. Mosensev, О.A. Mishchenko, V.M. Lisnichaya, Ye.F. Sakovych

Abstract


Review objective: from the position of the International National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel, Pan Pacific Pressure Injury Alliance, there are presented the issues of terminology, statistics, risk factors, international classification, main directions of prevention, differential diagnostis, examinationof the skin and paperwork management, aggressive medical therapy of pressure ulcers. Pressure ulcers are localized damages to the skin and/or subjacent tissues, usually at the sites of the bony prominences, as a result of a pressure or pressure combined with friction, dislocation, scratching or skin deflection. Statistics. In the USA, pressure ulcers are annually developed in 2.5 million of patients (from 2.3 up to 18 % in urgent patients); 60,000 patients die every year due to complications of pressure ulcers; implementation of programs on pressure ulcers prevention is associated with 50% reduction in their number. There are presented risk factors for the development of pressure ulcers. International classification of pressure ulcers is set forth; 4 categories of complexity are identified, measures are established to ensure the process reversibility. Principles of differential diagnosis, examinationof the skin and paperwork management are set forth. To predict the risk of pressure ulcers, there is used Braden scale, which includes the following factors: sensory perception, skin humidity, activity, mobility, nutrition, friction and slip followed by evaluation of the scores. Pressure Ulcer Scale for Healing (PUSH Toll, 2008) is designed to predict the dynamics and outcome of pressure ulcers. There are presented key issues of aggressive medical therapy depending on the outcome of the pressure ulcers category; there is presented SPECIAL rule; re­commendations of the Institute for Clinical Systems Improvement working group. There is published practical guidance of American Physical Therapy Association, the leading ideology of which is the choice of treatment strategy depending on the stage of the wounds and the purpose of therapy; the effectiveness increases with the inclusion in the complex of aggressive medical therapy of sessions of hyperbaric oxygenation, electrotherapy, vacuum therapy of wounds, electrical stimulation, topical use of recombinant growth factor. Particular attention is paid to such positions of nutrition intervention as: initial assessment of nutritional status, determination of calorie insufficiency, use of adequate doses of protein, adequate prescription of liquid, vitamins, microelements.

Keywords


resuscitation and intensive care unit; pressure ulcer; prevention; aggressive medical therapy

References


Dorner B., Posthauer M.E., Thomas D. The role of nutrition in pressure ulcer prevention and treatment: National Pressure Ulcer Advisory Panel While Paper. 2009 NPUAP.

European Pressure Ulcer Advisory Panel (EPUAP) and National Pressure Ulcer Advisory Panel (NPUAP). Treatment of pressure ulcers: Quick Reference Guide. International Guideline Washington, 2009. DC: National Pressure Ulcer Advisory Pa­nel, 2009. International Guideline Treatment of Pressure Ulcers: Quick Reference Guide.

Institute for Clinical Systems Improvement (ICSI) Pressure Ulcer Prevention and treatment protocol health care protocol, Bloomington (M, N): Institute for Clinical Systems Improvement (ICS). — 2012 Jan. — 88 p. [112 references].

Kirman Ch.N., Gaibel J. Pressure Ulcers and Wound care Treatment and Management. Medscape ACP, 2015.

New 2014 Ulcer Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline.

Prevention and Treatment of Pressure Ulcers: EPUAP Clinical Practice Guideline, 2014.1. Dorner B., Posthauer M.E., Thomas D. The role of nutrition in pressure ulcer prevention and treatment: National Pressure Ulcer Advisory Panel While Paper. 2009 NPUAP.

European Pressure Ulcer Advisory Panel (EPUAP) and National Pressure Ulcer Advisory Panel (NPUAP). Treatment of pressure ulcers: Quick Reference Guide. International Guideline Washington, 2009. DC: National Pressure Ulcer Advisory Pa­nel, 2009. International Guideline Treatment of Pressure Ulcers: Quick Reference Guide.

Institute for Clinical Systems Improvement (ICSI) Pressure Ulcer Prevention and treatment protocol health care protocol, Bloomington (M, N): Institute for Clinical Systems Improvement (ICS). — 2012 Jan. — 88 p. [112 references].

Kirman Ch.N., Gaibel J. Pressure Ulcers and Wound care Treatment and Management. Medscape ACP, 2015.

New 2014 Ulcer Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline.

Prevention and Treatment of Pressure Ulcers: EPUAP Clinical Practice Guideline, 2014.




DOI: https://doi.org/10.22141/2224-0586.3.82.2017.102331

Refbacks

  • There are currently no refbacks.


Copyright (c) 2017 EMERGENCY MEDICINE

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

 

© Publishing House Zaslavsky, 1997-2017

 

 Яндекс.МетрикаSeo анализ сайта Рейтинг@Mail.ru