Bedsore: Epidemiology; Risk Factors; Classification; Assessment Scales and Management
Bedsore is a very important problem in bedridden patients. It affects patients’ lives and imposes substantial costs to society. Its incidence approaches 38% and its annual prevalence is estimated to be 14.8% in patients who are admitted in hospitals.
The National Pressure Ulcer Advisory Panel (NPUAP) and the European Pressure Ulcer Advisory Panel (EPUAP) define bedsore as “a localized injury to skin and/or its underlying tissues as a result of pressure, shear or a combination of those and usually present over a bony prominence.
Proposed mechanisms for the development of pressure ulcers include friction or shear force over the skin. Several scales have been introduced in clinical studies in order to assess the risk for development of bedsores. Four of the most important scales are Braden scale, Norton scale, Waterlow scale and Cubbin & Jackson scale.
Based on literature review it seems that, using appropriate dressings, repositioning the patient, optimizing nutritional status, and moisturizing sacral skin are best ways for management and prevention of pressure ulcers.
Gordana Repić, Sunčica Ivanović. Pressure ulcers and their imapct on the quality of life. Acta Medica Medianae. 2014; 53(4):75-80.
Agrawal K, Chauhan N. Pressure ulcers: Back to the basics. Indian J Plast Surg. 2012; 45(2): 244-54.
Cox J. Predictors of pressure ulcers in adult critical care patients. Am J Crit Care. 2011; 20(5):364-75.
Källman U, Lindgren M. Predictive validity of 4 risk assessment scales for prediction of pressure ulcer in a hospital setting. Adv Skin Wound Care. 2014; 27(2):70-6.
Bergstrom N, Allman RM, Alvarez OM, Bennett MA, Carlson CE, Frantz RA, et al. Pressure Ulcer Treatment. Clinical Practice Guideline. Quick Reference Guide for Clinicians, No. 15. Rockville, MD: U.S. Department of Health and Human Services; 1994. Accessed at www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/archive.html on 17 May 2013.
Lyder CH. Pressure ulcer prevention and management. JAMA. 2003; 289(2): 223-6.
European Pressure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel. Prevention and treatment of pressure ulcers: quick reference guide. Washington DC: National Pressure Ulcer Advisory Panel; 2009.
Cuddigan J, Ayello EA, Sussman C, Baranoski S. Pressure ulcers in America: prevalence, incidence, and implications for the future. An executive summary of the National Pressure Ulcer Advisory Panel monograph. Adv Skin Wound Care. 2001; 14(4):208-15.
Leblebici B, Turhan N, Adam M, Akman MN. Clinical and epidemiologic evaluation of pressure ulcers in patients at a university hospital in Turkey. J Wound Ostomy Continence Nurs.2007; 34(4): 407-11.
Amlung SR, Miller WL, Bosley LM. The 1999 national pressure ulcer prevalence survey: a bench marking approach. Adv Skin Wound Care. 2001; 14(6): 297-301.
Richards JS, Waites K, Chen YY, Kogos K, Schumitt MM. The epidemiology of secondary conditions following spinal cord injury. Top Spinal Cord Inj Rehabil. 2004; 10(1):15-29.
Crenshaw RP, Vistnes LM. A decade of pressure sore research: 1977–1987. J Rehabil Res Dev. 1989; 26(1): 63-74.
Stausberg J, Kiefer E. Classification of pressure ulcers: a systematic literature review. Stud Health Technol Inform. 2009; 146: 511-5.
DeLisa JA, Mikulic MA. Pressure Ulcers. What do we do if preventive management fails? Pressure Ulcers. 1985; 77(6):209–12.
Orsted HL, Ohura T, Harding K. Pressure ulcer prevention: pressure, shear, friction and microclimate in context. A consensus document.International review. London: Wounds International, 2010.
Clark M, Romanelli M, Reger SI, Ranganathan VK, Black J, Dealey C. Pressure ulcer prevention: pressure, shear, friction and microclimate in context.A consensus document: International review. London: Wounds International, 2010. P:19-25.
Gerhardt LC, Strässle V, Lenz A, Spencer ND, Derler S. Influence of epidermal hydration on the friction of human skin against textiles. J R Soc Interface. 2008; 5(28): 1317- 28.
Smith ME, Totten A, Hickam DH, Fu R, Wasson N, Rahman B, et al. Pressure Ulcer Treatment Strategies A Systematic Comparative Effectiveness Review. Ann Intern Med. 2013; 159(1): 39-50.
Tayyib N, Coyer F, Lewis P. Pressure ulcers in the adult intensive care unit: a literature review of patient risk factors and risk assessment scales. Journal of Nursing Education and Practice. 2013; 3(11): 28-42.
Pancorbo-Hidalgo P L, Garcia-Fernandez F P, Soldevilla-Agreda J J, Martinez-Cuervo F. [Pressure ulcers risk assessment: clinical practice in Spain and a meta-analysis of scales effectiveness]. Gerokomos 2008; 19(2): 84-98.
Jastremski CA. Pressure relief bedding to prevent pressure ulcer development in critical care. J Crit Care. 2002; 17(2): 122-5.
Bluestein D, Javaheri A. Pressure Ulcers: Prevention, Evaluation, and Management. AmericanFamily Physician. 2008; 78(10): 1186-94.