Clinical Presentation and Integrated Management of Pressure Injuries in the Emergency Hospital Setting: A Plastic Surgeon’s Perspective

Healthcare, 2024 · DOI: https://doi.org/10.3390/healthcare12242583 · Published: December 22, 2024

Simple Explanation

Pressure injuries, also known as bedsores, are lesions of the skin and underlying tissue caused by prolonged pressure, leading to ischemia, inflammation, and tissue anoxia. These sores commonly occur in acutely hospitalized or long-term care patients, especially older adults, critically ill individuals, and those with spinal cord injuries. The study reviews a 2-year retrospective analysis of patients admitted to an emergency hospital, focusing on the clinical characteristics, risk factors, and management of pressure injuries examined by plastic surgeons.

Study Duration

2 Years

Participants

176 patients with clinically diagnosed pressure ulcers

Evidence Level

Retrospective study

Key Findings

1
The study included 176 patients with clinically diagnosed pressure ulcers, with 28.52% of cases as stage III and 35.57% as stage IV.
2
Common sites included the sacrum (40.94%), ischium (15.1%), and heel (14.43%).
3
The median patient age was 76 years, with 47.15% between 60 and 80 years and 36.93% ≥80 years, often presenting with comorbidities such as cardiovascular disease (71.59%).

Research Summary

Pressure injuries are a significant challenge in healthcare, leading to complications like infections, increased care needs, and prolonged rehabilitation, impacting patients physically and psychologically. The study, conducted in an emergency hospital, focused on deep pressure ulcers and found a high prevalence of stage III and IV injuries, commonly located on the sacrum, ischium, and heel. The management of these injuries includes relieving pressure, debridement, infection control, and surgical interventions, tailored to the wound characteristics and patient conditions.

Practical Implications

Tailored Treatment Plans

Treatment plans should be customized based on the severity and location of the pressure ulcer, patient's overall health, and presence of comorbidities.

Multidisciplinary Approach

A multidisciplinary approach involving surgeons, internists, dietitians, and nurses is crucial for successful management and prevention of pressure ulcers.

Focus on Prevention

Emphasizing preventive measures, such as frequent repositioning, proper nutrition, and specialized bedding, can significantly reduce the incidence of pressure injuries.

Study Limitations

1
Monocentric nature of the study
2
Lack of follow-up data
3
The strategies implemented to prevent bed sores prior to diagnosis, as well as the measures taken to limit the progression of pressure injuries once they developed, were not included in the study.

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