Conclusion and References
Conclusion
Risk assessment and prevention of a PI is an essential part of caring for a person. For persons at risk, appropriate interventions need to be in place and communicated to caregivers across the care continuum. Treating a person with a PI requires a holistic approach to provide treatment that will maintain health and quality of life.
Key Takeaways
- Pressure Injury development is complex and treatment planning is often multifactorial, requiring an interprofessional team
- Accurate identification of the cause is required in order to develop an effective treatment plan
- Unmanaged moisture (urine, feces, body fluids) increases risk of pressure injuries
- Most pressure injuries are avoidable and can be prevented
References
Allen KJ, Leslie SW. Autonomic Dysreflexia. [Updated 2021 Aug 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482434/
Allard, J.P., Keller, H., Jeejeebhoy, K.N., Laporte, M., Duerksen, D., Gramlich, L., et al. Malnutrition at hospital admission: Contributors and impact on length of stay. A prospective cohort study from the Canadian Malnutrition Task Force. (2016) Journal of Parenteral Enteral Nutrition 40(4), 487–97
Agarwal, E., Ferguson, M., Banks, M., Batterham, M., Bauer, J., Capra, S., et al. (2013) Malnutrition and poor food intake are associated with prolonged hospital stay, frequent readmissions, and greater in-hospital mortality: Results from the Nutrition Care Day Survey 2010. Clinical Nutrition 32(5), 737–45.
Angel D.E., Lloyd, P., Carville, K., Santamaria, C.L., Hillis, S.L., Park, H., Scherubel, M. (2006) Diagnostic validity of three swab techniques for identifying chronic wound infection. Wound Repair and Regeneration 14(5), 548-57
Bamba R, Madden JJ, Hoffman AN, Kim JS, Thayer WP, Nanney LB, Spear ME. Flap Reconstruction for Pressure Ulcers: An Outcomes Analysis. Plast Reconstr Surg Glob Open. 2017 Jan 18;5(1)
Bernatchez, S.F., Mengistu, G.E., Ekholm, B.P., Sanghi, S., Theiss, S.D. (2015) Reducing friction on Skin at Risk: The Use of 3M TM Cavilon TM No Sting Barrier Film. Advances in Wound Care 4(12), 705-710
Day, D., Chakari, W., Matzen, S. H. (2018). Malignant transformation of a non-healing traumatic wound on the lower extremity: A case report. International Journal of Surgery Case Reports 53, 468-470. Doi: 10.1016/j.ijscr.2018.11.026
European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel, and Pan Pacific Pressure Injury Alliance. (2019). Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline. The International Guideline. Emily Haesler (Ed.). EPUAP/NPIAP/PPPIA.
Fletcher, J. (2017). An Overview of Pressure Ulcer Risk Assessment Tools. Wounds UK, 13(1), 18-26.
Gefen, A., Levine, J. (2007) The false premise in measuring body-support interface pressures for preventing serious pressure ulcers. Journal of Medical Engineering & Technology 31(5), 375-80
Hatzenbuehler J, Pulling TJ. Diagnosis and management of osteomyelitis. Am Fam Physician. 2011 Nov 1;84(9):1027-33
Ireton, J.E., Unger, J.G, Rohrich, R.J. (2013) The Role of Wound Healing and Its Everyday Application in Plastic Surgery: A Practical Perspective and Systematic Review. Plastic and Reconstructive Surgery Global Open 1(1), e10-e19.
Klassen, M., Schipper, D., Masen, M. (2016) Influence of the relative humidity and the temperature on the in-vivo friction behaviour of human skin. Biotribiology 6, 21-28
Lustig, M., Levy, A., Kopplin, K., Ovadia-Blechman, Z., Gefen, A. (2018) Beware of the toilet: the risk for a deep tissue injury during toilet sitting. Journal of Tissue Viability 27(1), 23-31.
Mackay E. Malnutrition and wound healing. (2019) Wound Care Canada 17(3), 32-36.
McNichol, L., Mackey, D., Watts, C., Zuecca, N. (2020). Choosing a Support Surface for Pressure Injury Prevention and Treatment. Nursing 2020 Wolters Kluwer Health Inc. 50(2), 41-44. DOI-10.1097/01.NURSE.0000651620.87023.d5
Mhatre P, Huang M, Cohler M. Autonomic dysreflexia with negative-pressure wound therapy: a report of two cases. PM R. 2013 Mar;5(3):238-41
Moulin D, Boulanger A, Clark AJ, Clarke H, Dao T, Finley GA, Furlan A, Gilron I, Gordon A, Morley-Forster PK, Sessle BJ, Squire P, Stinson J, Taenzer P, Velly A, Ware MA, Weinberg EL, Williamson OD; Canadian Pain Society. Pharmacological management of chronic neuropathic pain: revised consensus statement from the Canadian Pain Society. Pain Res Manag. 2014 Nov-Dec;19(6):328-35.
Mu A, Weinberg E, Moulin DE, Clarke H. Pharmacologic management of chronic neuropathic pain: Review of the Canadian Pain Society consensus statement. Can Fam Physician. 2017 Nov;63(11):844-852.
Ness, S.J., Hickling, D.F., Bell, J.J., Collins, P.F. (2018) The pressures of obesity: The relationship between obesity, malnutrition and pressure injuries in hospital inpatients. Clinical Nutrition 37(5), 1569–74
Norton, Linda BScOT, OT Reg(ONT), MScCH; Coutts, Patricia RN, IIWCC; Sibbald, R. Gary MD, MEd, BSc, FRCPC(Med)(Derm), MACP, FAAD, MAPWCA Beds, Advances in Skin & Wound Care: July 2011 – Volume 24 – Issue 7 – p 324-332
Okan, D., Woo, K., Ayello, E.A., Sibbald, R.G. (2007). The Role of Moisture Balance in Wound Healing. Advances in Skin & Wound Care 20, 39-53.
Padula WV, Delarmente BA. The national cost of hospital-acquired pressure injuries in the United States. Int Wound J. 2019 Jun;16(3):634-640.
Posthauer, M.E., Banks, M., Dorner, B., Schols, J. (2015) The role of nutrition for pressure ulcer management. National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel, and Pan Pacific Pressure Injury Alliance white paper. Advances in Skin and Wound Care 28(4), 175–88
Registered Nurses’ Association of Ontario (2016). Assessment and Management of Pressure Injuries for the Interprofessional Team, Third Edition. Toronto, ON: Registered Nurses’ Association of Ontario.
Schryvers OI, Stranc MF, Nance PW. Surgical treatment of pressure ulcers: 20-year experience. Arch Phys Med Rehabil 2000;81:1556-62
SCIRE at https://scireproject.com/
Sibbald, R. G., Elliott, J. A., Persaud-Jaimangal, R., Goodman, L., Armstrong, D. G., Harley, C., Coelho, S., Xi, N., Evans, R., Mayer, D. O., Zhao, X., Heil, J., Kotru, B., Delmore, B., LeBlanc, K., Ayello, E. A., Smart, H., Tariq, G., Alavi, A., & Somayaji, R. (2021). Wound Bed Preparation 2021. Advances in Skin & Wound Care, 34(4), 183–195.
Türk EE, Tsokos M, Delling G. Autopsy-based assessment of extent and type of osteomyelitis in advanced-grade sacral decubitus ulcers: a histopathologic study. Arch Pathol Lab Med. 2003 Dec;127(12):1599-602
White J. Consensus statement: ASPEN – Characteristics recommended for the identification and documentation of adult malnutrition (undernutrition). (2016) Journal of Academy Nutrition and Dietetics. 112(5), 730–38
Darren Wong, Paul Holtom, Brad Spellberg, Osteomyelitis Complicating Sacral Pressure Ulcers: Whether or Not to Treat With Antibiotic Therapy, Clinical Infectious Diseases, Volume 68, Issue 2, 15 January 2019, Pages 338–342