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Pressure injuries Pressure Ulcer

Pressure injuries are not only an issue for people in a nursing home under long-term care.

Pressure Wound injuries (PIs) are damage to the skin caused by sustained pressure compounded by friction, shear, moisture and physiological factors. Incidence of pressure Wound injuries may be more common in long-term care facilities due to a higher concentration of higher-risk individuals. However, almost anybody could be at risk for pressure injuries. PI’s are massive complications in care that can result in infections, loss of function, and even death; never mind the increased costs, potential lawsuits and fines the facility may face.

Hospital-acquired pressure injuries (HAPrI’s) occur in 5-15% of hospitalized patients with higher concentrations in intensive and critical care units. Patients are regularly screened for increasing risk factors since many HAPrI’s are considered mostly preventable events. Not all pressure injuries are avoidable, as skin is susceptible to failure just like any other organ system.

Individuals at higher risk for developing pressure injuries are people of advanced age, limited mobility, poor circulation, decreased sensation and frequent incontinence. The time and amount of pressure loaded on soft tissue is also a huge contributing factor. A high load could cause damage in a short period of time but a lighter load over an extended period is equally as problematic.

Prevention, early detection and changes in treatment plans are an essential part in keeping pressure injuries from occurring or progressing to disastrous consequences. Physical turning and body positioning frequencies may need to be adjusted. The use of technology like hover mats and limiting the time that people sit up in bed with the head of the bed inclined greater than 30 degrees will help prevent shearing forces on fragile bottoms. Utilizing services like physical and occupational therapy to improve functional mobility status should be encouraged for those at higher risk for pressure injury breakdown.

Community-acquired pressure injuries will continue to be a factor requiring daily skin inspection for individuals with limited mobility and sensation. Wheelchair-bound or limited mobility individuals are encouraged to use pressure-relieving seat cushions and to change positions regularly. People with diabetes need to be careful with new shoes causing pressure and friction issues. New shoes or devices wear time should be progressed slowly with vigorous skin inspection to quickly identify issues as the nature of diabetes will prolong or prevent healing. The same advice would be given to sensorily challenged people and the use of braces or compression garments, as they may limit circulation causing skin breakdown.
Frequent skin inspection and adjusting accordingly, along with maintaining proper hygiene, hydration and nutrition are key to preventing issues. Once a pressure injury occurs, treatment by wound certified specialists will prevent delayed healing due to inadequate wound knowledge. If slow healing pressure injuries are an issue for you, contact info@humanbiosciences to help determine how using Human BioSciences Kollagen™ Products Skintemp II® collagen sheets and Medifil® collagen particles may be beneficial to expedite healing.

References

  1. https://cdn.ymaws.com/npiap.com/resource/resmgr/pdsi/2021_iwj_our_contemporary_un.pdf
  2. Mondragon N, Zito PM. Pressure Injury. [Updated 2022 Aug 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557868/
  3. Alderden, J., Drake, K.P., Wilson, A. et al. Hospital acquired pressure injury prediction in surgical critical care patients. BMC Med Inform Decis Mak 21, 12 (2021). https://doi.org/10.1186/s12911-020-01371-z
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