Pressure Ulcers and Occipital Alopecia in Operation Iraqi Freedom Polytrauma Casualties

Abstract

Several of the casualties from Operation Iraqi Freedom arriving at one Veterans Administration (VA) polytrauma rehabilitation center (PRC) were noted to have occipital pressure ulcers or hair loss. The objective of this study was to determine the prevalence and severity of pressure-related injuries in VA PRC admissions. A retrospective review of admissions from active duty from 2004 to 2006 was performed. Thirty-eight percent of admissions to this VA PRC had pressure-related injuries on the day of admission. Casualties from Iraq had a higher rate of pressure ulcers (53%) than did those from elsewhere (22%). Occipital lesions constituted 50% of non-stage I pressure ulcers and were more severe than those of the sacrum or extremities. Further epidemiological research should be performed to identify risk factors for pressure injury in the military continuum of care, by linking specific military medical evacuation and treatment processes and characteristics of casualties with outcomes.