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Current Treatment Approaches in Pressure Ulcers

Year 2011, Volume: 1 Issue: 4, 118 - 125, 01.12.2011
https://doi.org/10.5505/sakaryamj.2011.24633

Abstract

Prevelance of pressure ulcer is reported as %8-11 among the hospitalized patients. Pressure ulcers are caused by mechanical pressure, traction and friction on the skin and underlying tissue. Old age, poor nourishment, moist skin, infection and metabolic disorders (such as diabet, renal insufficiency ) are the contrıbuting factors. Once a pressure ulcer has developed, the treatment is long and expensive. Relief of pressure and reduction of risk factors are important in the prevention and treatment. Treatment principles include assessing the severity of the wound; reducing pressure, friction, and shear forces, optimizing wound care, removing necrotic debris, correcting nutritional deficits, using support surfaces and special beds, electrotheraphy, and surgery.

References

  • Salcido R, Hart D, Smith AM. The Prevention and Management of Pressure Ulcers. In: Braddom RL (ed), Physical Medicine & Rehabilitation. Philadelphia,WB Saunders Company 1996. p.630- 647.
  • Knudsen CW, Tonseth KA. Pressure ulcers-prophylaxis and treatment. Tidsskr Nor Legeforen, 2011;131:464-7.
  • Alman RM, Laprade CA, Noel LB, Walker JM, Moorer CA, Dear MR, et al. Pressure sores among hospitalized patients. Ann Intern Med 1986;105:337-42.
  • Yarkony GM, Kirk PM, Carlson C, Roth EJ, Lovell L, Heinemann A, et al. Classification of pressure ulcers. Arch Dermatol 1990 Sep;126(9):1218-25.
  • Nola GT, Vistnes LM. Differential response of skin and muscle in the experimental production of pressure sores. Plast Reconstr Surg 1980;66:728-33.
  • Hanson D, Langemo DK, Anderson J, Thompson P, Hunter S. Friction and shear considerations in pressure ulcer development. Adv Skn Wound Care. 2010 Jan;23(1):21-4.
  • Sivrioğlu K, Özcan O. Basınç Yaraları. Oğuz H, Dursun E, Dursun N editörler. Tıbbi Rehabilitasyon. Ankara: Nobel Tıp Kitabevleri; 2004.s:711-22.
  • Doley J. Nutrition management of pressure ulcers. Nutr Clin Prac. 2010 Feb;25(1):50-60.
  • Anthony D, Reynolds T, Russell L. An investigation into the use of serum albumin in pressure sore prediction. J Adv Nurs 2000;32 (2):359-65.
  • Kirazlı Y. Bası Yarası. Beyazova M, Gökçe-Kutsal Y editörler. Fiziksel Tıp ve Rehabilitasyon. 1. Baskı. Ankara: Güneş Kitabevi; 2000.s:1260-82.
  • Susan L, Garber TA (çeviren Uğurlu H, Sallı A.) Bası Yaraları. In Garrison SJ (ed), Kavuncu V (çeviri editörü). Fiziksel Tıp ve Rahabilitasyon El Kitabı. 2. Baskı. Ankara, Güneş Kitabevi; 2005. s:241-60.
  • Reddy M, Gill SS, Rochon PA. Preventing pressure ulcers: a systematic review. JAMA 2006;296(8):974-84.
  • Yücel A. Cilt Hastalıkları ve Yara Bakımı. Aydemir E H, Altındaş M, editör. İ.U.Cerrahpaşa Tıp Fak. Sürekli Tıp Eğitimi Etkinlikleri Sempozyum dizisi İstanbul : 2001.s.131-150.
  • Bourdel-Marchasson I, Barateau M, Rondeau V, Dequae- Merchadou L, Salles-Montaudon N, Emeriau JP, et al. GAGE Group. A multi-center trial of the effects of oral nutritional supplementation in critically ill older inpatients. Nutrition 2000;16:1-5.
  • Vanderwee K, Grypdonck MH, DeFloor T. Effectiveness of an alternating pressure air mattress for the prevention of pressure ulcers. Age Ageing 2005;34:261-67.
  • Nixon J, Cranny G, Iglesias C, Nelson EA, Hawkins K, Phillips A, et al. Randomised, controlled trial of alternating pressure mattresses compared with alternating pressure overlays for the prevention of pressure ulcers: PRESSURE (pressure relieving support surfaces) trial. BMJ 2006;332:1413-15.
  • National Pressure Ulcer Advisory Panel: Pressure Ulcers: Incidense, economics, risc assestment. Consensus Development Conference Statement. West Dundee, IL, S-N Publications, 1989.
  • Bryant CA, Rodeheaver GT, Reem EM, Nichter LS, Kenney JG, Edlich RF. Search for a nontoxic surgical scrub solution for periorbital lacerations. Ann Emerg Med 1984;13(5):317-21.
  • Houghton PE, Kincaid CB, Lovell M, Campbell KE, Keast DH, Woodbury MG, et al. Effect of Electrical Stimulation on Chronic Leg Ulcer Size and Appearance. Phys Ther 2003;83(1):17-28.
  • Ovington LG. Dressings and adjunctive therapies: AHCPR guidelines revisited. Ostomy/Wound Management 1999;45(1):94-106.
  • Bergstrom N, Bennett MA, Calrson CE. Clinical Practice Guideline No.15: Treatment of Pressure Ulcers. Rockville, Md: US Dept of Health and Human Services, Public Health Services, Agency for Health Care Policy and Research; 1992:55-56.
  • Ok N. Hemiplejik ve paraplejik hastalarda bası yaralarında pulse ultrason ve ultraviyole ışınları uygulamalarının konvansiyonel yara bakımı ile karşılaştırılması. Uzmanlık tezi, Bornova, 1993, s:46.
  • Baba-Akbari Sari A, Flemming K, Cullum NA, Wollina U. Therapeutic ultrasound for pressure ulcers. Cochrane Database of Systematic Reviews 2006;3.pub2.
  • Onigbinde AT, Olafimihan KF, Ojoawo A, Adedoyin RA, Omiyale O, Mothabeng J. The effect of ultaviyole radiation (type B) on decubitis ulcers. The Internet Journal of Allied Health Sciences and Practice 2010;8(1):1-6.
  • Mester E, Spiry T, Szende B. Effect of laser rays on wound healing. Bull Soc Int Chir 1973;32(2):169-73.
  • Evans D, Land L. Topical negative pressure for treating chronic wounds. In:The Cochrane Library, Issue 1, 2007. Chichester, UK: John Wiley & Sons , Ltd. Search date 2002.
  • Mao CL, Rivet AJ, Sidora T, Pasko MT. Update on pressure ulcer management and deep tissue injury. Ann Pharmacother 2010;Feb;44(2):325-32.
  • Rhodes RS, Heyneman CA, Culbertson VL, Wilson SE, Phatak HM. Topical phenytoin treatment of stage II decubitus ulcers in the elderly. Ann Pharmacother 2001;35:675-81.
  • Scevola S, Nicoletti G, Brenta F, Isernia P, Maestri M, Faga A. allogenic platelet gel in the treatment of pressure sores: a pilot study. Int Wound J 2010;7(3):184-90.
  • Arslantaş MK. İskemik yara tedavisinde eritropoietinin etkinliği. Tez. 2007, İstanbul.

Bası Yaralarında Güncel Tedavi Yaklaşımları

Year 2011, Volume: 1 Issue: 4, 118 - 125, 01.12.2011
https://doi.org/10.5505/sakaryamj.2011.24633

Abstract

Bası yarası, hastanede yatan hastaların %8-11'inde görülmektedir. Bu durum, cilt ve cilt altı dokudaki basınç, makaslama kuvveti ve sürtünmenin etkisiyle oluşmaktadır. İleri yaş, beslenme bozuklukları, nemli deri, enfeksiyon ve metabolik hastalıklar (örn; diyabet, böbrek yetmezliği) bası yarası oluşumunu kolaylaştıran diğer faktörlerdir. Bası yarası bir kez geliştikten sonra tedavisi uzun ve maliyetlidir. Önleme ve tedavi açısından basıncı azaltma ve risk faktörlerinin giderilmesi çok önemlidir. Yaranın şiddetine göre uygulanabilecek tedavi yöntemleri; basınç, friksiyon ve makaslama kuvvetinin giderilmesi, yara bakımı, nekrotik doku debridmanı, beslenmenin düzenlenmesi, destek yüzeylerin ve özel yatakların kullanılması, elektroterapi ve cerrahi tedavilerdir

References

  • Salcido R, Hart D, Smith AM. The Prevention and Management of Pressure Ulcers. In: Braddom RL (ed), Physical Medicine & Rehabilitation. Philadelphia,WB Saunders Company 1996. p.630- 647.
  • Knudsen CW, Tonseth KA. Pressure ulcers-prophylaxis and treatment. Tidsskr Nor Legeforen, 2011;131:464-7.
  • Alman RM, Laprade CA, Noel LB, Walker JM, Moorer CA, Dear MR, et al. Pressure sores among hospitalized patients. Ann Intern Med 1986;105:337-42.
  • Yarkony GM, Kirk PM, Carlson C, Roth EJ, Lovell L, Heinemann A, et al. Classification of pressure ulcers. Arch Dermatol 1990 Sep;126(9):1218-25.
  • Nola GT, Vistnes LM. Differential response of skin and muscle in the experimental production of pressure sores. Plast Reconstr Surg 1980;66:728-33.
  • Hanson D, Langemo DK, Anderson J, Thompson P, Hunter S. Friction and shear considerations in pressure ulcer development. Adv Skn Wound Care. 2010 Jan;23(1):21-4.
  • Sivrioğlu K, Özcan O. Basınç Yaraları. Oğuz H, Dursun E, Dursun N editörler. Tıbbi Rehabilitasyon. Ankara: Nobel Tıp Kitabevleri; 2004.s:711-22.
  • Doley J. Nutrition management of pressure ulcers. Nutr Clin Prac. 2010 Feb;25(1):50-60.
  • Anthony D, Reynolds T, Russell L. An investigation into the use of serum albumin in pressure sore prediction. J Adv Nurs 2000;32 (2):359-65.
  • Kirazlı Y. Bası Yarası. Beyazova M, Gökçe-Kutsal Y editörler. Fiziksel Tıp ve Rehabilitasyon. 1. Baskı. Ankara: Güneş Kitabevi; 2000.s:1260-82.
  • Susan L, Garber TA (çeviren Uğurlu H, Sallı A.) Bası Yaraları. In Garrison SJ (ed), Kavuncu V (çeviri editörü). Fiziksel Tıp ve Rahabilitasyon El Kitabı. 2. Baskı. Ankara, Güneş Kitabevi; 2005. s:241-60.
  • Reddy M, Gill SS, Rochon PA. Preventing pressure ulcers: a systematic review. JAMA 2006;296(8):974-84.
  • Yücel A. Cilt Hastalıkları ve Yara Bakımı. Aydemir E H, Altındaş M, editör. İ.U.Cerrahpaşa Tıp Fak. Sürekli Tıp Eğitimi Etkinlikleri Sempozyum dizisi İstanbul : 2001.s.131-150.
  • Bourdel-Marchasson I, Barateau M, Rondeau V, Dequae- Merchadou L, Salles-Montaudon N, Emeriau JP, et al. GAGE Group. A multi-center trial of the effects of oral nutritional supplementation in critically ill older inpatients. Nutrition 2000;16:1-5.
  • Vanderwee K, Grypdonck MH, DeFloor T. Effectiveness of an alternating pressure air mattress for the prevention of pressure ulcers. Age Ageing 2005;34:261-67.
  • Nixon J, Cranny G, Iglesias C, Nelson EA, Hawkins K, Phillips A, et al. Randomised, controlled trial of alternating pressure mattresses compared with alternating pressure overlays for the prevention of pressure ulcers: PRESSURE (pressure relieving support surfaces) trial. BMJ 2006;332:1413-15.
  • National Pressure Ulcer Advisory Panel: Pressure Ulcers: Incidense, economics, risc assestment. Consensus Development Conference Statement. West Dundee, IL, S-N Publications, 1989.
  • Bryant CA, Rodeheaver GT, Reem EM, Nichter LS, Kenney JG, Edlich RF. Search for a nontoxic surgical scrub solution for periorbital lacerations. Ann Emerg Med 1984;13(5):317-21.
  • Houghton PE, Kincaid CB, Lovell M, Campbell KE, Keast DH, Woodbury MG, et al. Effect of Electrical Stimulation on Chronic Leg Ulcer Size and Appearance. Phys Ther 2003;83(1):17-28.
  • Ovington LG. Dressings and adjunctive therapies: AHCPR guidelines revisited. Ostomy/Wound Management 1999;45(1):94-106.
  • Bergstrom N, Bennett MA, Calrson CE. Clinical Practice Guideline No.15: Treatment of Pressure Ulcers. Rockville, Md: US Dept of Health and Human Services, Public Health Services, Agency for Health Care Policy and Research; 1992:55-56.
  • Ok N. Hemiplejik ve paraplejik hastalarda bası yaralarında pulse ultrason ve ultraviyole ışınları uygulamalarının konvansiyonel yara bakımı ile karşılaştırılması. Uzmanlık tezi, Bornova, 1993, s:46.
  • Baba-Akbari Sari A, Flemming K, Cullum NA, Wollina U. Therapeutic ultrasound for pressure ulcers. Cochrane Database of Systematic Reviews 2006;3.pub2.
  • Onigbinde AT, Olafimihan KF, Ojoawo A, Adedoyin RA, Omiyale O, Mothabeng J. The effect of ultaviyole radiation (type B) on decubitis ulcers. The Internet Journal of Allied Health Sciences and Practice 2010;8(1):1-6.
  • Mester E, Spiry T, Szende B. Effect of laser rays on wound healing. Bull Soc Int Chir 1973;32(2):169-73.
  • Evans D, Land L. Topical negative pressure for treating chronic wounds. In:The Cochrane Library, Issue 1, 2007. Chichester, UK: John Wiley & Sons , Ltd. Search date 2002.
  • Mao CL, Rivet AJ, Sidora T, Pasko MT. Update on pressure ulcer management and deep tissue injury. Ann Pharmacother 2010;Feb;44(2):325-32.
  • Rhodes RS, Heyneman CA, Culbertson VL, Wilson SE, Phatak HM. Topical phenytoin treatment of stage II decubitus ulcers in the elderly. Ann Pharmacother 2001;35:675-81.
  • Scevola S, Nicoletti G, Brenta F, Isernia P, Maestri M, Faga A. allogenic platelet gel in the treatment of pressure sores: a pilot study. Int Wound J 2010;7(3):184-90.
  • Arslantaş MK. İskemik yara tedavisinde eritropoietinin etkinliği. Tez. 2007, İstanbul.
There are 30 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Gülnur Taşcı Bozbaş This is me

Gülcan Gürer This is me

Publication Date December 1, 2011
Submission Date September 7, 2015
Published in Issue Year 2011 Volume: 1 Issue: 4

Cite

AMA Bozbaş GT, Gürer G. Bası Yaralarında Güncel Tedavi Yaklaşımları. Sakarya Tıp Dergisi. December 2011;1(4):118-125. doi:10.5505/sakaryamj.2011.24633

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