People with non‐blanchable erythema are at higher risk of pressure ulcers

Abstract

Pressure ulcers, also known as bed sores, are injury to the skin mainly caused by prolonged pressure, for example in someone who is bedridden. Pressure ulcers occur in 470 to 3,210 per 10,000 patients in hospitals in the U.K., U.S.A., and Canada. Their severity is graded from stage 1 (the least severe) to stage 4 (the most severe). For patients and carers, it is important to know what normal skin is and to regularly check skin changes over the common places where pressure ulcers may appear (e.g. the bottom, heels, and lower back). Non‐blanching erythema – skin redness that does not turn white when pressed – is an important skin change. This study, undertaken by researchers from the University of Manchester and University of Liverpool, U.K., aimed to find out whether people with non‐blanching erythema are more likely to develop pressure ulcers in future than those without non‐blanching erythema. The authors used systematic review and individual‐level data analysis methods to summarise evidence from thirteen studies (with 68,077 people), and to analyse individual‐level data of 3,223 patients. Their analysis showed that people with non‐blanchable erythema had 2.72 times the odds of developing a new pressure ulcer of Stage 2 or above within 28 days, compared with those without non‐blanchable erythema. This means that if 73 people per 1,000 without non‐blanchable erythema develop new pressure ulcers of Stage 2+ within 28 days, 176 people per 1,000 with non‐blanchable erythema will probably develop new ulcers. The authors conclude that people with non‐blanching erythema are more likely to develop new pressure ulcers of Stage 2 or above within 28 days, than people without non‐blanching erythema. It is important for medical staff to identify non‐blanchable erythema and to intervene appropriately to prevent pressure ulcers. This summary relates to the study: Nonblanchable erythema for predicting pressure ulcer development: a systematic review with an individual participant data meta‐analysis