Follow-up of Geriatric Patients with Pressure Ulcers by Plastic, Reconstructive and Aesthetic Surgery in Intensive Care Conditions

Year 2022, Volume: 12 Issue: 1, 107 - 112, 30.03.2022

Anvar Ahmedov Yeşim Ahmedov

https://doi.org/10.33808/clinexphealthsci.831458

Cited By: 1

Abstract

Objective: The aim of this study was to define the Follow-up results and the observation of relationship between the clinical features and wound
conditions of geriatric patients with pressure ulcers treated in the intensive care unit by Plastic, Reconstructive and Aesthetic Surgery (PRAS)
Methods: The research was carried out at Evliya Çelebi Training and Research Hospital of Kütahya University of Health Sciences between
January 2018 and January 2020. All pressure ulcers on set of our patients was observed during hospitalization. Study was conducted on 215
patients hospitalized in neurology and general intensive care units. Ulcer diagnosis was performed by European Pressure Ulcer Advisory Panel
(EPUAP) and National Pressure Ulcer Advisory Panel (NPUAP). Patient data were collected and evaluated by surgical care nurse and PRC surgeon
together during the visit. The confidentiality and personal rights of each patient were respected.
Results: There were 215 patients with pressure injuries, 45.6% were hospitalized in the neurology intensive care unit and 42.5% were with the
diagnosis of cerebrovascular disease, 41.6% of patients state of consciousness was evaluated as confused. Gender prevalence were 52.2% were
female with mean age 72.5 ± 2.4. There are 43.2% of the ulcers were in the sacral area, 52% were in stage 2, all patients had fecal / urinary
incontinence.
Conclusion: Awareness and education of the care professionals working in intensive care units in terms of preventive measures can save
patients from pressure ulcers and avoid patients from the difficult and risky surgical interventions.

Keywords

Geriatrics, Intensive care, pressure ulcer

References

• References: 1. National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel, Pan Pacific Pressure Injury Alliance, In: Haesler, E. (Ed.), Prevention an Treatment of Pressure Ulcers: Clinical Practice https://www.epuap.org/wp-content/uploads/2016/10/quick-reference-guide-digital-npuap-epuap-pppia-jan2016.pdf. (Accessed: 30.10.2019).
• 2. Gencer ZE, Ozkan O. Pressure Ulcers Surveillance Report. Journal of the Turkish Society of Intensive Care 2015; 13: 26-30.( DOI: https://doi.org/10.4274/tybdd.8130010).
• 3. Kiraner E, Terzi B, Uzun Ekinci A, Tunali B. Characteristics of patients with pressure wound in the intensive care unit. Journal of Intensive Care Nursing 2016; 20(2): 78–82. (In Turkish).
• 4. Katran HB. The research on the incidence of pressure sores in a surgical intensive care unit and the risk factors affecting the development of pressure sores. Journal of Academic Research in Nursing 2015; 1(1): 9–13. ( DOI: https://doi.org/10.5222/jaren.2015.008).
• 5. Çelik S, Dirimeşe E, Taşdemir N et al. Prevention and Management of Nurses'. Pressure Injury. Bakırköy Medical Journal 2017; 13: 134-139. (DOI: https://doi.org/10.5350/BTDMJB201713305).
• 6. Tavakolli K, Rutkowski S, Cope C, Hassall M. Recurrence rates of ischial sores in paraplegics and tetraplegics treated with hamstring flaps: an 8-year study. Br J Plast Surg 1999; 52: 476-9. (PMID: 10673925).
• 7. Grewal PS; Sawant NH, Deaney CN, Gibson KM et al. Pressure sore prevention in hospital patients: a clinicalaudit. J Wound Care 1999; 8: 129-31. (PMID:10362991).
• 8. Shipperley T. Guidelines for pressure ulcer prevention and management, Nurs Times 2000; 96: 11-2. (PMID:10827728).
• 9. Dansereau JG, Conway H. Closure of decubiti in paraplegics. Report on 2000 cases. Plast Reconstr Surg 1964; 33: 474-7. (PMID: 14147519).
• 10. Ercocen AR, Yilmaz S, Can Z, Emiroglu M, Yormuk E. Surgical treatment of pressure sores: Evaluation of 108 cases. Turkish Plastic Surgery Journal 2000; 8: 82-9. (In Turkish).
• 11. Lepistö M, Erikson E, Hietanen H, Asko-Seljavaara S. Patient with Pressure Ulcers in Finnnish Hospitals. International Journal of Practice 2001; 7: 280-287. (DOI: https://doi.org/10.1046/j.1440-172x.2001.00290.x).
• 12. Ulker Efteli E, Gunes U. The Effect of Perfusion Values on Pressure Wound Development. Anatolian Journal of Nursing and Health Sciences 2014; 17 (3): 140-143. (In Turkish).
• 13. Neloska L, Damevska K, Nikolchev A, Pavleska L, Petreska-Zovic B, Kostov M. The association between malnutrition and pressure ulcers in elderly in long-term care facility. Macedonian Journal of Medical Sciences 2016; 4 (3): 423–426. (PMID: 27703567).
• 14. Chiari P, Forni C, Guberti M, Gazineo D, Ronzoni S, D’Alessandro F. Predictive factors for pressure ulcers in an older adult population hospitalized for hip fractures. A prognostic cohort study. Plos One 2017; 9(12): 1-12. (PMID: 28068425).
• 15. Karadağ A. Pressure ulcers: Evaluation, prevention and treatment. CU Journal of Nursing School 2003; 7 (2): 41-48. (In Turkish).
• 16. Jaul E, Menzel J. Pressure Ulcers in the Elderly, as a Public Health Problem. Journal of General Practice 2014; 2 (5): 1-3. (DOI: 10.4172/2329-9126.1000174).
• 17. Hyun S, Li X, Vermillion B et al. Body Mass Index and Pressure Ulcers: Improved Predictability of Pressure Ulcers in Intensive Care Patients. Am J Crit Care 2014; 23(6): 495–500. (PMID: 25352673).
• 18. Borghardt AT, Prado TN do, Bicudo SDS, Castro DS de, Oliveira Bringuente ME de. Pressure ulcers in critically ill patients: incidence and associated factors. Rev Bras Enferm 2016; 69 (3): 432–436. (DOI: http://dx.doi.org/10.1590/0034-7167.2016690307i).
• 19. Montalcini T, Moraca M, Ferro Y et al. Nutritional parameters predicting pressure ulcers and short-term mortality in patients with minimal conscious state as a result of traumatic and non-traumaticac quired brain injury. Journal of Translational Medicine 2015; 13 (1): 1–8. (PMID: 26376778).
• 20. Hanönü S. Determination of Prevalence of Pressure Ulcers Due to Medical Devices in Intensive Care Units, M.Sc. Thesis, Gazi University Institute of Health Sciences Ankara 2014; 35-44. (In Turkish).
• 21. Neiva GP, Carnevalli JR, Cataldi RL, Furtado DM, Fabri RL, Silva PS. Hematological change parameters in patients with pressure ulcer at long-term care hospital. Einstein 2014; 12 (3): 305-308. (PMID: 25295450).
• 22. Yamamoto Y, Tsutsumida A, Murazumi M, Sugihara TC. Long term outcome of pressure sores treated with flap coverage. Plast Reconstr Surg 1997; 100: 1212-7. (PMID: 9326782).
• 23. Çizmeci O, Emekli U. Pressure Wounds. Turkey Journal of Physical Medicine and Rehabilitation 1999; 3:50-7. (In Turkish).
• 24. Foster RD, Anthony JP, Mathes SJ, Hoffman WY, Young D, Eshima I. Flap selection as a determinant of success in pressure sore coverage. Arch Surg 1997; 132: 868-73. (PMID: 9267271).