Pressure Ulcer Prevention Research Articles

The outcome and challenges of application of pressure ulcer prevention project in king Fahad Hospital Jeddah – 2023

Background: A pressure ulcer (PU), also known as bedsore, pressure injury, or decubitus ulcer, is a localized injury brought on by sustained pressure applied to the skin and underlying soft tissue over an extended length of time. 
 Aim: This study aimed to identify the outcome and challenges of the application of pressure ulcer prevention project.
 Methodology: This is a retrospective hospital-based study, which monitored the pressure ulcer prevention project's (PUPP) results from 2019 to 2021 for 3 years. Data on 21400 patients were gathered from several departments of a hospital in the northern region of Saudi Arabia. The project's main goals were the installation of a wound care team, hospital staff education, ongoing data monitoring, and follow-up visits for inpatient units.
 Results: This current study showed that the pressure ulcer prevention project was successful showing a statistically significant reduction of hospital-acquired pressure ulcers (HAPUs) from 1.97% in 2018 to 1.4% in 2019 to 0.53% in 2020 to 0.14% in 2021. 
 Conclusion: The research concluded the percentage of cases of pressure ulcers was successfully decreased by the PUPP. The project can be expanded and carried out in additional hospitals.

Automatic Controlled Pressure Sensor to Prevent Pressure Ulcer Obtained For Prolonged Hospitalization

The prototype model presented in this paper proposes a solution for evaluating and preventing pressure ulcers in long-lasting bedridden patients. The system integrates various sensors capable of monitoring critical factors such as pressure, temperature, and moisture. These sensors are embedded within the prototype bed, allowing for the collection of real-time data concerning the patient's condition and identification of potential risk factors associated with pressure ulcer development. The bed is equipped with switches that facilitate the monitoring of the patient's mobility and activities. These switches can detect movements, providing valuable information on changes in posture, frequency of turning, and overall activity level. Through data analysis, the system can assess the probability of pressure ulcer occurrence, taking into account factors such as prolonged pressure on specific areas, excessive moisture levels, or extreme temperatures. This prototype model shows significant promise in preventing pressure ulcers among long-lasting bedridden patients. Continuous monitoring of the patient's physiological parameters and activity levels enables healthcare providers to receive timely alerts and intervene appropriately to mitigate the risk of pressure ulcers. Additionally, the system can generate informative reports and offer valuable insights into the patient's condition, assisting healthcare professionals in making informed decisions regarding patient care and preventive measures. Overall, this prototype model provides a comprehensive approach to evaluating and preventing pressure ulcers in long-lasting bedridden patients. By leveraging sensor technology and real-time data analysis, it has the potential to improve patient outcomes, enhance the quality of care, and reduce the incidence of pressure ulcers in this vulnerable population.

Pressure ulcer prevention in practice.

Pressure ulcer avoidance in the context of care has the potential to improve the quality and longevity of lives for those living in residential and non-residential care home settings. This paper reports on an educational intervention in the North East of England, which focused on the initial benchmarking of self-reported knowledge levels of healthcare workers, who regularly work with people living within this context. Using a longitudinal study design, a series of three questionnaires were used to collate data from research participants. The study revealed a disparity between what healthcare workers perceived their knowledge to be versus what it was, in terms of application to practice at the front line of patient care. The study reveals that confidence levels in dealing with pressure ulceration had been significantly altered by the training session that was being implemented. It also raised concerns on the methodological approaches being used in the education and training of care staff, which should ideally lead them to be proactive with patients in their care. The study provides an insight into the need for a strategic and targeted approach to pressure ulceration avoidance education, which is tailored to individual learning needs through supervision and mentorship as part of clinical education.

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN PENGETAHUAN PERAWAT TENTANG BRADEN Q

The increasing incidence of pressure ulcers needs to be handled by health workers, especially nurses in preventing pressure ulcers in the ward. The incidence of pressure ulcers in 2020 in Lantai 1 Anak Gedung A RSCM ranged from 0-2.8% and the highest rate for the last 2 years occurred in February 2021 at 3.8%. One way to prevent pressure ulcers is to detect the risk factors that can cause pressure ulcers in children using the Braden Q scale. Good nurse knowledge is needed in conducting Braden Q scale assessments in order to get appropriate results. This study aims to determine the factors that influence the level of knowledge of nurses about braden Q on Lantai 1 Anak Gedung A RSCM. This research is a quantitative research with correlative descriptive method involving 46 respondents using the total sampling technique method. Data collection uses a questionnaire that has been tested for validity and reliability. Based on the results of the analysis, it was found that there was no significant relationship between age, education level and length of work with nurses' knowledge of the Braden Q scale. The results of this study also showed that there was more of a role for nurses who had good knowledge of the Braden Q scale. As for age, level of education, experience did not affect the level of knowledge of nurses about braden Q.

Health policy approach to the treatment and prevention of pressure ulcers

A pressure sore (decubitus) is a wound that develops on the skin and subcutaneous tissue in places exposed to pressure. Primarily occurs in elderly, non-mobile individuals, the prevention and control of which requires not only medical and nursing participation, but it also financial expenditure. In our study, after a systematic document analysis, we present the relevant results of the decubitus survey conducted among state hospitals during Q2 of 2022, focusing on the organizational and management factors of decubitus prevention and care. The national survey was comprehensive in terms of the range of institutions relevant to decubitus care. After defining the selection criteria, we got a picture of 86 institutional practices for the base year of 2019. During the review and systematization of domestic and European Union professional policy documents, regulators and strategy documents, it can be established that pressure ulcer prevention and care can be adapted to several development policy objectives, and its incidence appears as a quality indicator of the health sector. Based on the results of our national decubitus survey, it can be said that domestic good practices operate in isolation, our reporting system is inhomogeneous, and the documentation is not uniform in our institutional system. 17 of the 86 institutions have new (2021-2022) documents regulating decubitus care at the institutional level, which in 17% of the institutions are dated 2010 or earlier. The scope of revision of the regulatory documents is set at 10% of the institutions. 61 of the examined institutions (71%) operate decubitus teams, 55 institutions (64%) use prophylactic bandages. There is a lack of professional monitoring measures and quality indicators, institutional-level expenditure analyses, controlling-type feedback, which would form the basis of costing and cost-effectiveness analyses. In addition to our proposals for several organizational and managerial measures, we advocate the renewal of the relevant professional directive and the introduction of a uniform institutional reporting system as well. Orv Hetil. 2023; 164(21): 821-830.

Determining knowledge and attitudes related to pressure injury prevention among operating room nurses and associated factors

AimTo determine attitudes and levels of knowledge related to pressure injury (PI) prevention among operating room nurses and identify associated factors. MethodsThis descriptive, cross-sectional study was conducted in Turkey with a sample of 112 operating room nurses recruited by the snowball method of convenience sampling. Data were collected online via Google Forms using a nurse data collection form, the Knowledge of Operating Room Nurses about Pressure Injuries Form, and the Attitude Towards Pressure Ulcer Prevention Instrument (APuP). ResultsThe operating room nurses' mean score for PI knowledge was 52.19 ± 17.01 out of 100, and their mean total APuP score was 42.28 ± 5.19 out of 52. Knowledge about PIs was negatively associated with being male (β = −0.287, p < 0.001) and positively associated with intervening to prevent PIs during surgery (β = 0.214, p = 0.008), using international PI guidelines as a reference in the operating room (β = −0.225, p = 0.005), and APuP score (β=.415, p < 0.001). Intervening to prevent PIs during surgery (β = 0.294, p = 0.003) was a significant predictor of attitude toward PI prevention. ConclusionOur results indicate that overall, operating room nurses have insufficient knowledge but positive attitudes about PI prevention. Female gender, using international PI reference guides in the operating room, and positive attitude toward PI prevention were identified as factors associated with higher PI knowledge level, while intervening to prevent PIs during surgery was positively associated with both knowledge level and attitude toward PI prevention.

Nurse's Knowledge Regarding Pressure Ulcer Prevention among Critical Patients in Intensive Care Unit at Governmental Hospitals in Gaza Strip

This study aimed to assess nurse's knowledge of pressure ulcer prevention in governmental hospitals in the Gaza Strip. This study utilized a descriptive, cross-sectional, analytical design. The sample of the study consisted of 116 ICU nurses from five governmental hospitals. For data collection, the researcher used a self-administrated questionnaire and Observation Checklist. Results showed that the study population were males (73.3%) and 26.7% were females. Moreover, (62.1%) of the study population had less than 5 years of experience in the ICU. There were no statistical significant differences between means in knowledge related to gender, age, educational level, and hospitals. The study concluded that intensive care nurses' knowledge of pressure ulcer prevention was above moderate. The study recommended the need to provide sufficient numbers of qualified nurses in intensive care departments and urged nurses to attend training courses on safety standards for the prevention of pressure ulcers among patients.

Incidence of pressure ulcers due to prone position in patients admitted to the ICU for Covid-19

The appearance of pressure ulcers (PU) is one of the frequent complications of prone position (PP), due to prolonged pressure and shear forces. ObjectivesTo compare the incidence of pressure ulcers secondary to prone position and describe their location among four Intensive Care Units (ICU) of public hospitals. MethodsMulticenter descriptive and retrospective observational study. The population consisted of patients admitted to the ICU between February 2020 and May 2021, diagnosed with Covid-19 who required prone decubitus. The variables studied were sociodemographic, days of admission to the ICU, total hours on PP, PU prevention, location, stage, frequency of postural changes, nutrition and protein intake. Data collection was carried out through the clinical history of the different computerized databases of each hospital. Descriptive analysis and association between variables were performed using SPSS vs.20.0. ResultsA total of 574 patients were admitted for Covid-19, 43.03% were pronated. 69.6% were men, median age was 66 (IQR 55−74) and BMI 30.7 (RIC 27−34.2). Median ICU stay was 28 days (IQR 17−44.2), median hours on PD per patient 48 h (IQR 24−96). The incidence of PU occurrence was 56.3%, 76.2% of patients presented a PU, the most frequent location was the forehead (74.9%). There were significant differences between hospitals in terms of PU incidence (P = .002), location (P = .000) and median duration of hours per PD episode (P = .001). ConclusionsThe incidence of pressure ulcers due to the prone position was very high. There is great variability in the incidence of pressure ulcers between hospitals, location and average duration of hours per episode of prone position.

Effects of PechaKucha presentation about prevention of pressure injury on knowledge of elderly care department students: a randomized controlled study

Background: PechaKucha (PK) is a presentation technique that uses visual and narrative presentations consisting of 20 slides, each shown for 20 seconds. Purpose: The aim of this study was to evaluate the effects of the PK presentation on elderly care department students’ knowledge about pressure injury prevention. Methods: This study used a single-blinded randomized control trial. Elderly care department students were randomized to the PK presentation technique (intervention group) and traditional PowerPoint presentations only (control group). The sample of the study consisted of 54 (intervention group = 28, control group = 26) elderly care department students. Data was collected using the Sociodemographic Form and the Pressure Ulcer Prevention Knowledge Assessment Instrument (PUPKAI). PUPKAI was administered before the presentations (pre-test), after the presentations (post-test 1), and 4 weeks after the presentations (post-test 2). Results: Following the presentations, the intervention group's PUPKAI mean score (47.23 ± 11.62) was significantly higher than the control group's mean score (36.64 ± 12.41) (P &lt; .05). Four weeks after completing the education, the intervention group's mean PUPKAI score (43.11 ± 13.72) was significantly higher than the control group's mean score (36.46 ± 12.76) (P &lt; .05). Conclusion: The knowledge level of the elderly care department students was found to be below the satisfactory level. It was determined that the PK presentation increased the knowledge level of the students regarding pressure injury prevention.

Skin self-management of community-dwelling patients with spinal cord injury: A cross-sectional study

Backgroundcommunity-acquired pressure injury is one of the most common and troublesome complications of discharged patients with spinal cord injury. Previous studies have shown that pressure injury can not only increase the financial burden and care burden of patients, but also seriously affect their quality of life. AimTo evaluate the skin self-management of community-dwelling patients with spinal cord injury and to explore the related independent influencing factors. MethodsThis was a cross-sectional survey study. A convenience sample of 110 community-dwelling patients with spinal cord injury recruited from three rehabilitation centers in Guangzhou and Chengdu in China completed the survey from September 2020 to June 2021. They were asked about their demographic data, skin self-management, knowledge about skin self-management, attitude to skin self-management, self-efficacy, and functional independence. Univariate analysis and multiple linear regression were performed to isolate the most important relationships. ResultsThe skin self-management of community-dwelling patients with spinal cord injury was relatively low, and they also performed poorly in the three categories of: skin check, preventing pressure ulcer, and preventing wounds. Skin self-management was found to be most often associated with level of knowledge about skin self-management, higher reimbursement and self-efficacy. ConclusionCommunity-dwelling patients with spinal cord injury with lower level of knowledge about skin self-management, with lower self-efficacy, and those with higher reimbursement have worse skin self-management.

Nurses’ Knowledge of Pressure Ulcer Risk Assessment and Prevention Strategies: A Cross-Sectional Study in Nigeria

The development of PUs consequently results in significant physical, financial, and emotional burdens on the affected patients and their relatives including healthcare providers. This study aimed to assess knowledge of pressure ulcer risk assessment (PURA) and prevention strategies among nurses at University College Hospital (UCH), Ibadan, Nigeria. A cross-sectional descriptive design among 264 nurses was selected through a simple random sampling technique using a structured pre-tested questionnaire for data collection. Data were analyzed using descriptive and inferential statistics. The level of significance is set at a p-value &lt;0.05. The mean age of participants was 40.59 ± 9.88 years. Findings revealed that an average of 51.1% of respondents had adequate knowledge of PURA. However, adequate knowledge of pressure ulcer prevention strategies was recorded among just a little above average 67.8%. Analysis of Variance (ANOVA) showed no significant relationship between respondents’ level of education and their knowledge of pressure ulcer risk assessment as well as their knowledge of pressure ulcer prevention strategies (p&gt;0.05). Knowledge of pressure ulcer and prevention strategies was inadequate. Nurses need regular training programs to improve their knowledge and skills in PURA and the prevention of pressure ulcers among at-risk patients according to international best practices in order to bridge the previously identified gaps.&#x0D;

Modelling the cost-effectiveness of subepidermal moisture measurement as part of a process of assessment and intervention to prevent hospital-acquired pressure ulcers.

Skin tissue assessment is traditionally used to identify early signs of pressure damage from changes observed at the skin surface. However, the early onset of tissue damage induced by pressure and shear forces is likely to be on soft tissues beneath the surface of the skin. Subepidermal moisture (SEM) is a biophysical marker for the detection of early and deep pressure-induced tissue damage. Measurement of SEM can detect early pressure ulcers up to 5 days before visible skin changes occur. The aim of this study was to evaluate the cost-effectiveness of SEM measurement compared with visual skin assessment (VSA). A decision-tree model was developed. Outcomes are the incidence of hospital-acquired pressure ulcers, quality-adjusted life-years (QALYs) and costs to the UK National Health Service. Costs are at 2020/21 prices. The effects of parameter uncertainty are tested in univariate and probabilistic sensitivity analysis. In a representative NHS acute hospital, the incremental cost of SEM assessment as an adjunct to VSA is -£8.99 per admission, and SEM assessment is expected to reduce the incidence of hospital-acquired pressure ulcers by 21.1%, reduce NHS costs and lead to a gain of 3.634 QALYs. The probability of cost-effectiveness at a threshold of £30 000 per quality-adjusted life year is 61.84%. Pathways that include SEM assessment make it possible to implement early and anatomy-specific interventions which have the potential to improve the effectiveness of pressure ulcer prevention and reduce healthcare costs.

Effect of changing the lying posture angle by changing the bed posture on the average pressure, maximum pressure, and pressure area in the hip region.

An electric bed can easily change posture from a lying position and was effective in preventing pressure ulcer. This study aimed to identify the optimal posture for the prevention of pressure ulcers by analyzing pressure changes applied to the pelvic region. Pressure changes resulting from lateral rotations of the body using an electronic adjustable bed and changes in the posture and angles of the trunk and knees were assessed. Twelve conditions with varying angles of the trunk and knees (15-35∘ in 5∘ increments) and varying lateral angles (20-35∘ in 5∘ increments) were tested. The pressure (maximum and average) and contact area in the pelvic region of 20 individuals without disabilities were calculated. The conditions in which the average and maximum pressures did not increase according to the increase in angle were 25∘ for the upper body and knee angles and 35∘ for the side. The body pressure changed according to the posture rather than according to physical characteristics. Lateral rotation combined with changes in the angles of the trunk and knees effectively prevented pressure ulcers. Changes in the posture at various angles prevented an increased pressure on the body.

Decubitus Ulcers in Patients with Spinal Cord Injury in Different Hospitals of Lahore

BACKGROUND: Spinal cord damage is a debilitating nervous disorder that has a significant economic, social, and psychological burden on those who are affected as well as the healthcare system. The spinal cord can be damaged due to either trauma to the cord or spinal cord dysfunctions. Pressure injuries are the leading secondary complication in patients with spinal cord injuries. OBJECTIVE: The purpose of this research was to document the prevalence of decubitus ulcers in spinal cord injury patients. METHOD: It was a cross-sectional study that included a sample of 114 patients either male or female with traumatic spinal cord injury or non-traumatic spinal cord injury with age ranging from less than 12 years to greater than 89 years from various hospitals in Lahore. The sampling technique used was non-probability convenient sampling. Written consent was taken from all patients before the collection of data. Pressure ulcer assessment was done using the European pressure ulcer prevalence study questionnaire. Data were analyzed using the IBM SPSS STATISTICS-25.0 version. Categorical variables were presented as frequencies and percentages, with the use of bar charts or pie charts. RESULTS: Out of 114 patients 68 patients were male (59.6%) and 46 were female (40.4%). This study concluded that 58.9% of patients had decubitus ulcers whether severe or at stage one of PU as a secondary complication of spinal cord injury. From the total sample of 114 patients 49.9% of participants had the most severe decubitus ulcers mostly on the sacrum which can lead to infection and requires surgical interventions such as debridement. Stage 1 decubitus ulcers were seen on the elbow and back. CONCLUSION: More than half of the patients included in this study had one or more pressure ulcers that can be damaging to their health and quality of life. In developed and developing countries pressure ulcers are widespread but are preventable.&#x0D; Key Words:&#x0D; Spinal cord injury, pressure ulcer, sacrum&#x0D;

Design and Testing of Pressure Ulcers Preventive Bed for Neonates in Neonatal Intensive Care Units

In neonatal intensive care units (NICUs), preterm infants lie down immobile for long hours in a particular position, which makes them susceptible to develop pressure ulcers (PUs). These are developed due to continuous constant contact pressure generated by the self-weight of the infants with bed surfaces on their sensitive skin, which is 60% less than the thickness of an adult and hampers blood flow from the subcutaneous areas. Therefore, it is necessary to change the posture in a periodic manner. Hospitals manage the position changes by nursing staff, which is of limited effect and puts additional loads on them. Hence, in this paper, an anti-pressure ulcer bed was designed and tested to prevent pressure ulcers and also help in reducing the effort of nurses. The contact pressure of both the neonatal phantom and neonatal baby with the silicone-made bed surface was automatically varied by fluid pressure in the multi-channels based on the actuation mechanism (which rises alternately in inflated regions and falls in deflated regions), and it was measured using the force sensors. The demonstrated work was carried out in finite element modeling (FEM) using Abaqus to validate the results. We anticipate that itll reduce the risk of pressure ulcers, confirming the designed beds performance.

Outcome of Single Stage Anterior and Posterior Surgery for Tuberculous Paraplegia.

Morbidity and mortality from tuberculosis, a significant infectious illness, are expected to rise worldwide. The projected number of new cases rose from 7.5 million in 1990 to 11.9 million in 2005, a 58.6% increase in 2011. The widespread belief that TB is no longer a public health concern is unfounded; on the contrary, the link between HIV/AIDS and antibiotic resistance has further exacerbated the crisis that already existed. Similar to the nations in sub-Saharan Africa, India is now considered a Group IV country, with an annual risk of infection between 1% and 2.5%. 2. Although 60% of TB cases occur in people who are HIV-positive, only 3-5% of cases in HIV-negative individuals are skeletal. The most frequent type of articuloskeletal tuberculosis is spinal tuberculosis. 1. The goal of this study is to evaluate the neurological outcome of anterior debridement, fusion, posterior instrumentation, and early rehabilitation in individuals with spinal cord injuries. 2. The goal of this study is to determine the prevalence of pressure ulcers, hypostatic pneumonia, and urinary tract infections urinary tract infections (UTIs) among these individuals. 3. The goal of this study is to determine the frequency of graft-related problems. 4. See how well these individuals are able to keep their corrected deformities from returning. Patients who had simultaneous anterior (anterior debridement and bone grafting) and posterior (posterior instrumentation and fusion) procedures were followed prospectively. Thirty patients' films were examined. In addition, cord edema was suggested in 13 of the patients based on the presence of strong signal intensities there. Myelomalacia signs were seen in one patient, but he or she went on to make a complete neurological recovery. The average duration of operation was 355 minutes, and this included the time needed to position the patient for the two separate procedures. There was an 89.5% rate of neurological recovery with an average corrected loss of 6.98 degrees (0.20 degrees to 35.90 degrees), and the complication rate was acceptable in the group analyzed.

Review of assistive devices for the prevention of pressure ulcers: an engineering perspective

Purpose Pressure ulcers (PUs) are prevalent among immobile bed or wheelchair-reliant individuals who experience prolonged sedentary positions. Pressure relief and frequent repositioning of body posture help to mitigate complications associated with PUs. Adherence with regular repositioning is difficult to maintain due to nursing labour shortages or constraints of in-home caregivers. Manual repositioning, transferring, and lifting of immobile patients are physically demanding tasks for caregivers. This review aimed to explore and categorize these devices, discuss the significant technical challenges that need addressing, and identify potential design opportunities. Materials and Methods In this review, a literature search was conducted using PubMED, Science Direct, Google Scholar and IEEE Xplore databases including studies from 1995 until Feb 2023 with keywords such as pressure ulcer, assistive device, pressure relief, repositioning, transfer, etc. Both commercial and research-level devices were included in the search. Results 142 devices or technologies were identified and classified into four main categories that were further subcategorized. Within each category, the devices were investigated in terms of their mechanical design, actuation methods, control strategies, sensing technologies, and level of autonomy. Limitations of current technologies are design complexity, lack of patient comfort, and a lack of autonomy requiring caregivers frequent intervention. Conclusions Several devices have been developed to help with prevention and mitigation of PUs. There remain challenges that hinder the widespread accessibility and use of current technologies. Advancements in assistive technologies for pressure ulcer mitigation could lie at the intersection of robotics, sensors, perception, user-centered design, and autonomous systems. IMPLICATIONS FOR REHABILITATION Future advancements in assistive technologies for pressure ulcer mitigation could lie at the intersection of robotics, sensors, perception, user-centered design, and autonomous systems. Most existing technologies for prevention of pressure ulcers are focused on the mechanical advantage rather than user’s needs and preferences. Future designers, engineers, and product developers must be educated to conduct user needs studies concurrently with the development of technology to design the devices based on the user’s needs to ensure a balanced design outcome.

Nurses, Knowledge And Practice towards Pressure Ulcer Prevention in Governmental Hospitals in Akre District, Kurdistan Region of Iraq

A pressure ulcer is an injury to the skin and underlying tissues brought on by pressure, shear, or friction, it generally develops over a bony prominence and manifests as either an open sore or a non-healing wound. The study sought to evaluate nurses' knowledge and practices regarding pressure ulcer prevention in the Akre district of Iraq. A cross-sectional study including 114 eligible nurses from two general hospitals was undertaken from July 26 to August 28, 2022.The study's participants were chosen using a convenience sampling technique. The knowledge and practice of nurses were evaluated using a structured questionnaire that had been adopted. To evaluate connections between knowledge and practice, descriptive statistics, tables, Chi-Square tests, and Fisher's exact tests were performed using SPSS version 26. Among all nurses involved in this study, (74.6%) had acceptable cores of pressure ulcer prevention knowledge, and (75.4%) had acceptable practice. The findings of this study showed that respondents had enough information about pressure ulcer prevention, which may have contributed to their acceptable conduct (p&gt; 0.05). The working setting had a significant association with nurses’ knowledge and practices. Also, nurses’ practices were significantly associated with job satisfaction and heavy workload. Nurses’ pressure ulcer prevention knowledge and practice in this study were satisfactory. Increasing training frequency in public hospitals can help improve a thorough understanding of pressure ulcers among nurses in the Kurdistan region, Iraq

Surgical management of pressure ulcers in spinal cord injury patients.

Pressure ulcers (PU) are a common yet debilitating injury within the spinal cord injury (SCI) population. This retrospective data analysis is intended to identify the contributing factors, review the current management protocol, and risk of recurrence of PU in SCI patients at Victoria's state referral centre for traumatic spinal cord injuries. A retrospective audit of the medical records of SCI patients with pressure ulcers was conducted for the period of January 2016 to August 2021. Patients aged 18 years and older who presented for surgical management of their PU were included in the study. Among the 93 patients who met the inclusion criteria, there were a total of 195 surgeries for 129 PU. Ninety-seven percent were classified as grade of 3 or 4 and 53% had osteomyelitis on presentation. 58% were either current smokers or ex-smokers, and 19% were diabetic. Debridement alone was the most common type of surgical management (58%), followed by flap reconstruction (25%). Those who underwent flap reconstruction were admitted for 71 days longer, on average. 41% of the surgeries were associated with a post-operative complication, with the most prominent being an infection at 26%. Of the 129 PU, 11% recurred at least 4months post initial presentation. There are a multitude of a factors that impact prevalence, surgical complications, and recurrence of PU. This study provides insight into these factors to review our current practices and optimize surgical outcomes in the management of PU in the SCI population.

Intervention for Pressure Injuries Prevention in Bed Rest Patients

Pressure injuries, also known as pressure injuries or hospital-acquired pressure injuries, was damage to the integrity of the skin or soft tissue in a local area that tends to compress the bony prominences with the surface area due to a combination of prolonged pressure such as friction, shear and moisture. The main groups at risk for pressure injuries were patients with spinal cord injuries, hospitalized patients, especially those undergoing orthopedic surgery and patients admitted to the intensive care unit (ICU). The purpose was to determine the types of tools, materials, techniques and nursing interventions for the prevention of pressure injuries in bed rest patients. The research used a literature review using 3 databases, namely Science direct, Pudmed, Google Scholer with studies design included Quasi Experimental and Romdomized Controlled Trials. The study obtained 7 articles describing pressure ulcer prevention interventions such as providing bed rest, giving oral supplements, providing massage therapy and lubricating agents, providing moisturizers in the wound area and providing appropriate mattresses for bed rest patients.