PRESSURE-ULCER

Pressure-Ulcer

Pressure-Ulcer

Introduction

A Pressure-Ulcer is also described as a bedsore, decubitus ulcer, or pressure sore is the deterioration of skin and underlying tissue caused by unrelieved pressure. The severity ranges from reddening of the skin to a large open wound. Healthy individuals continually shift their weight when sitting or lying down, but individuals who are debilitated are unable to change position, and consequently an adequate blood supply does not get to the compressed skin. If left untreated, Pressure-Ulcers may become infected and painful, further limiting movement. Without treatment, Pressure-Ulcer infections rapidly spread into the underlying muscle, sometimes to the bone.

Development Of Pressure-Ulcers

Over time, pressure causes a growing discomfort that prompts a person to change position before tissue ischemia occurs. In ulcer formation, an inverse relationship exists between time and pressure. Typically, low pressure for long periods is far more damaging than high pressure for short periods. For example, a pressure of 70 mm Hg sustained for 2 hours or longer almost always causes irreversible tissue damage, whereas a pressure of 240 mm Hg can be endured for a short time with little or no tissue damage. Furthermore, after the time-pressure threshold for damage passes, damage continues even after the pressure stops. Although Pressure-Ulcers can result from one period of sustained pressure, they're more likely to result from repeated ischemic events without adequate time between events for recovery. (Nickoley , 2007)

Risk Factors

The risk factors related to Pressure-Ulcers comprise immobility, advancing age, infection, poor nutrition, incontinence, and low blood pressure. High-risk patients should be assessed frequently for Pressure-Ulcers.

Age

The risk of developing Pressure-Ulcers increases with age as aging affects all aspects of healing.

Immobility

Immobility may be the most advanced risk factor for development of Pressure-Ulcers. The patient's ability to move in response to pressure sensations as well as the frequency with which his position is changed should always be considered in risk assessment. Bar-iatric patients are especially at risk.

Incontinence

Incontinence increases a patient's exposure to moisture and, over time, increases his risk of skin breakdown.

Infection

Although the role of infection in Pressure-Ulceration isn't fully understood, animal studies on the effects of pressure and infection indicate that compression encourages a localized increase in bacteria concentration. Bacteria injected into animals localized at the compression site resulted in necrosis at lower pressures relative to the control group. (Akyol, 2007)

Nutrition

Proper nutrition is vitally important to tissue integrity. A tough association is there between Pressure-Ulceration and poor nutrition. Don't overlook the importance of nutrition during treatment.

Albumin Acumen

Increased protein is required for the body to heal itself. Albumin is one of the key proteins in the body. A patient's serum albumin level is an important indicator of his protein levels. A subnormal serum albumin level is a late manifestation of protein deficiency. Normal serum albumin levels range from 3.5 - 5 g/dl.

Shear

Shearing force intensifies the pressure's destructive effects. Shear is an automatic strength that in spite of vertical goes parallel, to a skin region of; profound tissues feel the brunt of the ...