PRESSURE ULCERS USING ROPER, LOGAN AND TIERNEY MODEL

Pressure Ulcers Using Roper, Logan and Tierney Model

Pressure Ulcers Using Roper, Logan and Tierney Model

Pressure ulcers, better known as pressure ulcers or bedsores, are lesions caused by many factors, such as: unrelieved pressure, friction, humidity, shear forces, temperature, age, continence and medication, anywhere in body, especially parts like bone or cartilage areas sacrum, elbows, knees and ankles. Although easily preventable and completely curable if detected early, pressure ulcers are often fatal - even under auspices of medical care - and are the major iatrogenic causes of death reported in developed countries, exceeded only by adverse drug reactions. Before 1950's, treatment was not effective until Doreen Norton showed that primary care and treatment to eliminate pressure by turning patient every two hours. (Willams 2005)

Definitions of four stages of pressure ulcers are reviewed periodically by National Pressure Ulcer Advisory Panel (NPUAP) in United States. In short, however, are:

• Stage I is most superficial, indicated by redness that does not bleach disappears after pressure is relieved. This stage is visually similar to reactive hyperemia seen in skin after prolonged application of pressure. Stage I pressure ulcers can be distinguished from reactive hyperemia in two ways: hyperemia) reaction resolves within 3 / 4 of time pressure was applied, and b) reactive hyperemia whitening when pressure is applied, while Stage I pressure ulcer. skin may be warmer or colder than normal, has the strange texture, or perhaps be painful for patient. Although easy to identify in the fair-skinned patient, ulcers in people with darker skin may appear as shades of purple or blue color, compared with lighter skin tones.

• Stage II is damage to epidermis extending to, but no deeper than dermis. At this stage, ulcer may be referred to as the blister or abrasion.

• Phase III includes entire thickness of skin and may extend into subcutaneous tissue. This layer has the relatively poor blood supply and can be difficult to cure. At this stage, may be undermining damage that makes wound much larger than it seems on surface

• Stage IV is deepest, extending into muscle, tendon or bone, even.

• Unstageable pressure ulcers are covered with dead cells, or eschar and wound exudate, so depth cannot be determined. (Ryan 2002 )

Suspected deep tissue injury: purple or maroon localized area of discolored intact skin or blood-filled blister due to damage of underlying soft tissue pressure and / or cutting. area may be preceded by tissue that is painful, firm, soft, boggy, warmer or cooler as compared to adjacent tissue.

Moreover description: Deep tissue injury may be difficult to detect in people with dark skin tones. Evolution may include the thin blister over the dark wound bed. wound may further evolve and become subject of thin scars. Evolution may be rapid exposure of additional layers of tissue even with optimal treatment. (Walsh 2003 )

With higher stages, healing time is prolonged. While about 75% of Stage II ulcers heal within eight weeks, only 62% of Stage IV pressure ulcers never heal, and ...