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Prevention and Treatment Methods of Pressure Ulcers

Introduction

Pressure ulcers are skin injuries that occur after a prolonged absence of movement or a person’s inability to reposition themselves in order to relieve pressure from certain bone areas (Joyce et al., 2018). Many interventions concerning this disease are implemented, with some being more effective than others. Reportedly, more than 3 million people in the United States are affected by pressure ulcers in the healthcare setting (Qaseem et al., 2015).

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The leading causes of such disease in patients are immobility and continual bed rest that leads to pressure ulcers (Koh et al., 2018). Perpetual lying in the same position deprives a particular body part of oxygen and nutrient, which then causes injuries (Moore & Cowman, n.d.). Pressure damages frequently occur within health facilities due to adverse care, consequently not only drastically harming the well-being of patients but also causing significant financial troubles (Li et al., 2020). Therefore, the forestalling of pressure ulcers must be prioritized in health facilities with people who are unable to move.

Multiple interventions demonstrate to have a beneficial impact on the prevention of pressure ulcers; however, one solution must be determined to be the most effective. Therefore, a vital need to study various interventions to avoid this injury is needed. In this paper, the comparison of repositioning practices and pressure-relieving matrasses concerning pressure ulcers decrease will be discussed. This research will help with ascertaining the most suitable method for preventing pressure ulcers.

Repositioning

Patients with pressure ulcers require specific interventions in order to recover from an injury. In the management of ulcers, repositioning is an essential component on the path to recovery. The discomfort caused by oxygen deprivation causes a healthy person to reposition, although failure to do so causes wounds and further tissue damage (Moore & Cowman, n.d.). In the cases of patients’ inability to move in a timely manner, assistance is required. Therefore, each person must have consistent movement in order not to develop a pressure ulcer.

Repositioning, in the case of the pressure ulcer, is not a novel intervention, in fact, it was described in medical literature by Robert Graves in 1848 (Moore & Cowman, n.d.).

The author describes how these types of injuries can be prevented and managed through readjusting interventions. However, until these days, repositioning was not scientifically proved to be an effective way of recovering from a pressure ulcer. Thus, despite the lack of empirical research, it continues to be implemented as one of the fundamental methods in management strategies of pressure ulcers in the healthcare system.

The Singapore hospitals conducted a research and discovered that one of the most effective interventions to prevent patients from acquiring pressure ulcers inside the hospital is their repositioning every 2-4 hours (Koh et. al, 2018). Such methods distribute the bodyweight of the patient and balances the level of their nutritional status.

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Moreover, the international practice guidelines also encourage healthcare facilities to imply regular repositioning to their strategies of preventing pressure ulcers (Li et al., 2020). Consequently, such intervention is evidently a primary recommended method of treating and preventing pressure ulcers.

If talking about the frequency of repositioning, no specific recommendation was found in the research. Even though the general advice is to reposition once every 2 hours, each individual is different. Some patients can stay in the same position for hours, while others need movement more frequently than every two hours.

An example can be repositioning at night: doing it every two hours disrupts a healthy sleep and can cause further problems. In addition, people with wounds or joint conditions experience severe pain with every movement. Hence, the timing of a patient’s repositioning should be strictly individual based on a comprehensive assessment; otherwise, there is a high chance of injuring a person more severely.

On the grounds of the research can be concluded that repositioning remains a fundamental strategy for nurses to prevent pressure ulcer, however such method requires severe changes (Moore & Cowman, n.d). It must be individualized, as the research shows that repositioning every 2 hours is not a universal treatment. Thorough examination of a patient must be conducted to determine the frequency of assistive repositioning to consequently establish proper medical care.

Pressure-Relieving Mattress

Pressure-Relieving matrasses is another intervention that is used for preventing pressure ulcers, not less than repositioning. These types of mattresses have specific chambers that are automatically filled with air (Qaseem et al., 2015). The distinct feature of such mattresses is that the air pressure frequently changes, which helps with relieving pressure in the body. However, similar to rearranging, little research is available regarding the benefits of such intervention on the forestalling of pressure ulcers.

From the retrieved information, it is known that pressure-relieving mattresses supposedly lower the risk of pressure ulcers (Qaseem et al., 2015). Such mattresses are generally used in hospitals or nursing homes to accommodate the patients who face the potential risk of pressure ulcers. Mattresses with special form not only provide a soft surface to rest but also equally distribute the pressure on the area and consequently reduce it on highly vulnerable body parts.

Alternating pressure mattresses are commonly used among patients that are in grave danger of developing pressure ulcers, impaired patients – individuals with no ability to move. Such bedding aid individuals in the healing of wounds, and in the case of progressed pressure ulcers, reduce it in size over time. For that matter, in clinical treatments, pressure-relieving mattresses help with preventing pressure ulcers and recovering from it.

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Thus, the drawback of such pressure-relieving mattresses is they are too soft, which poses difficulty to move for certain people. During a prolonged period of lying on such a bedding can make patients sink in it that consequently limits their physical abilities to change positions. For impaired people, such surfaces may even possess a high risk if they are not able to reposition without supporting people. Therefore, the change in such practice is crucial; mattresses must be individually chosen according to the patients’ health conditions.

The evidence to prove the harmful features of a pressure-relieving mattress is insufficient due to the few reports with no significant research, though reportedly, not many injuries were fixated for such a support surface (Qaseem, et al., 2015). In one of the investigations, even after the conducted analysis, the significant impact of pressure-relief mattress was not confirmed (Joyce, Et al., 2018). Therefore, due to the lack of background and proven possible discomfort hospitals cannot put pressure-relieving matrasses everywhere, but individually implicate them as a part of the recovery process from pressure ulcers.

Conclusion

Concluding, prevention, and treatment of pressure ulcers requires a multidisciplinary approach with the use of different workable strategies. After analyzing the impact of repositioning and pressure-relieving mattresses on the effects of fighting pressure ulcers, it was discovered that empirical research is lacking, and no particular conclusion can be made.

However, from the collected information, one can conclude that bot interventions need a change and most importantly individual approach. As for the efficiency, periodical repositioning might show more impact in fighting pressure ulcers than pressure-relieving mattresses as any movement encourages wound healing and distribution of pressure better than any assistive surfaces. Therefore repositioning should show a better effect in preventing pressure ulcers.

References

Joyce, P., Moore, Z., & Christie, J. (2018). Organisation of health services for preventing and treating pressure ulcers. Cochrane Database of Systematic Reviews, (12). Web.

Koh, S. Y., Yeo, H. L., & Goh, M. L. (2018). Prevention of heel pressure ulcers among adult patients in orthopaedic wards: An evidence-based implementation project. International Journal of Orthopaedic and Trauma Nursing, 31, 40-47. Web.

Li, Z., Lin, F., Thalib, L., & Chaboyer, W. (2020). Global prevalence and incidence of pressure injuries in hospitalised adult patients: A systematic review and meta-analysis. International Journal of Nursing Studies, 105, 103546. Web.

Moore, Z., & Cowman, S. (n.d.). Repositioning for treating pressure ulcers. Cochrane Database of Systematic Reviews, (1). Web.

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Qaseem, A., Humphrey, L. L., Forciea, M. A., Starkey, M., & Denberg, T. D. (2015). Treatment of Pressure Ulcers: a Clinical Practice Guideline from the American College of Physicians. Annals of Internal Medicine, 162(5), 370. Web.

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