Risk Of Developing Pressure Ulcers Research Articles

Polyurethane film dressings and ceramide 2-containing hydrocolloid dressing reduce the risk of pressure ulcer development in high-risk patients undergoing surgery: a matched case-control study

pBackground: Numerous clinical challenges regarding adhesive dressings have shown that using an adhesive dressing could minimize or prevent superficial skin loss in patients at risk of developing pressure ulcers. However, evidence that polyurethane film dressings and ceramide 2-containing hydrocolloid dressing can reduce the risk of pressure ulcer development in highrisk patients undergoing surgery is limited. Therefore, we assessed the effects of application of these dressings for reducing the risk of pressure ulcer development in these patients and identified other risk factors. Methods: A matched case-control study was conducted involving 254 patients at high risk for pressure ulcer development at one acute care hospital in Japan. No patients in this study had a pressure ulcer at the start of the study. Thirty-one patients developed a pressure ulcer during surgery, and these patients were defined as cases. Controls were randomly matched for sex and age (±4 years), from which 62 patients were selected. Medical records were obtained for preoperative factors, including age, sex, body mass index, diabetes mellitus, albumin, total protein, C-reactive protein, white cell count, red cell count, and hemoglobin, and for intraoperative factors, including dressing application, operation time, body position, and surgery type. The odds ratio (OR) and 95% confidence interval (CI) were determined to identify risk factors for pressure ulcer development in patients undergoing surgery. Results: By multiple logistic regression analysis, there was a significantly reduced risk of pres sure ulcer development for patients who had dressing applications as compared with those without dressing applications (OR 0.063; 95% CI 0.012–0.343; P=0.001). Prone position (OR 8.791; 95% CI 1.630–47.400; P=0.01), prolonged operation time (OR 1.684; 95% CI 1.189–2.385, P=0.003), and reduced body mass index (OR 0.774; 95% CI 0.584–0.948; P=0.02) were also significant predictive risk factors for development of a pressure ulcer. Conclusion: Application of film dressing and ceramide 2-containing hydrocolloid dressing reduced the risk of pressure ulcer development in high-risk patients undergoing surgery.

Patient perceptions of the role of nutrition for pressure ulcer prevention in hospital: an interpretive study.

The aims of this study were to explore (a) patients' perceptions of the role of nutrition in pressure ulcer prevention; and (b) patients' experiences with dieticians in the hospital setting. Interpretive qualitative study. The sample comprised 13 females and 7 males. Their mean age was 61.3 ± 12.6 years (mean ± SD), and their average hospital length of stay was 7.4 ± 13.0 days. The research setting was a public health hospital in Australia. In this interpretive study, adult medical patients at risk of pressure ulcers due to restricted mobility participated in a 20 to 30 minute interview using a semi-structured interview guide. Interview questions were grouped into 2 domains; perceptions on the role of nutrition for pressure ulcer prevention; and experiences with dieticians. Recorded interviews were transcribed and analyzed using content analysis. Within the first domain, 'patient knowledge of nutrition in pressure ulcer prevention,' there were varying patient understandings of the role of nutrition for prevention of pressure ulcers. This is reflected in 5 themes: (1) recognizing the role of diet in pressure ulcer prevention; (2) promoting skin health with good nutrition; (3) understanding the relationship between nutrition and health; (4) lacking insight into the role of nutrition in pressure ulcer prevention; and (5) acknowledging other risk factors for pressure ulcers. Within the second domain, patients described their experiences with and perceptions on dieticians. Two themes emerged, which expressed differing opinions around the role and reputation of dieticians; they were receptive of dietician input; and displaying ambivalence towards dieticians' advice. Hospital patients at risk for pressure ulcer development have variable knowledge of the preventive role of nutrition. Patients had differing perceptions of the importance and value of information provided by dieticians.

Early Assessment and Prevention of Skin Breakdown in the Post Anesthesia Care Unit (PACU)

Hospital acquired pressure ulcers significantly impact clinical and financial outcomes. Any patient going to the Operating Room (OR) can potentially be at risk for pressure ulcer development. Studies acknowledge that early identification of pressure ulcers is beneficial, providing an opportunity for early intervention. Anecdotally, routine patient turning post-operatively was performed inconsistently by our staff.

Validity of the Braden Nutrition Subscale in predicting pressure ulcer development.

The purpose of this study was to analyze the validity of the nutrition subscale from the Braden Scale for Predicting Pressure Sore Risk in hospitalized patients. A prospective, quasi-experimental, repeated-measures design guided data collection and analysis. One hundred seventy adult patients from 2 private hospitals located in urban areas in Southeastern Brazil, with a Braden Scale score of 18 or less, and who agreed to participate in the study were assessed between January and August 2006. Participants were primarily male (57.0%) and had a mean age of 67.0 ± 15.4 years (mean ± SD). Objective assessment and subjective global assessment of nutritional status were performed on admission. Every 2 days, patients deemed at potential risk for pressure ulcer development underwent evaluation of protein-energy intake, skin assessment, and repeated risk assessment for pressure ulcer development via the Braden Scale. Univariate and multivariate logistic regression analyses were used to assess the predictive power of nutritional variables related to risk for pressure ulcer development. The mean length of stay among patients was 17.8 ± 16.8 days. Multivariate regression analysis revealed that serum albumin levels (odds ratio = 5.226; P < .001) and subjective global nutritional assessment (odds ratio = 3.246; P < .001) were the best nutritional predictors of pressure ulcer development. We did not find the Braden nutrition subscale score to be predictive for pressure ulcer development in hospitalized patients. Serum albumin levels and subjective global nutritional assessment were the best nutritional predictors of pressure ulcer development.

Factors predicting the development of pressure ulcers in an at-risk population who receive standardized preventive care: secondary analyses of a multicentre randomised controlled trial.

To identify predictive factors associated with the development of pressure ulcers in patients at risk who receive standardized preventive care. Numerous studies have examined factors that predict risk for pressure ulcer development. Only a few studies identified risk factors associated with pressure ulcer development in hospitalized patients receiving standardized preventive care. Secondary analyses of data collected in a multicentre randomized controlled trial. The sample consisted of 610 consecutive patients at risk for pressure ulcer development (Braden Score <17) receiving standardized preventive care measures. Patient demographic information, data on skin and risk assessment, medical history and diagnosis were collected during 26months (December 2007-January 2010). Predictive factors were identified using multivariate statistics. Pressure ulcers in category II-IV were significantly associated with non-blanchable erythema, urogenital disorders and higher body temperature. Predictive factors significantly associated with superficial pressure ulcers were admission to an internal medicine ward, incontinence-associated dermatitis, non-blanchable erythema and a lower Braden score. Superficial sacral pressure ulcers were significantly associated with incontinence-associated dermatitis. Despite the standardized preventive measures they received, hospitalized patients with non-blanchable erythema, urogenital disorders and a higher body temperature were at increased risk for developing pressure ulcers. Improved identification of at-risk patients can be achieved by taking into account specific predictive factors. Even if preventive measures are in place, continuous assessment and tailoring of interventions is necessary in all patients at risk. Daily skin observation can be used to continuously monitor the effectiveness of the intervention.

褥瘡に対するチーム医療と形成外科治療

A refractory pressure ulcer should be treated not only by surgery but also with team medical care in order to avoid recurrence after the initial treatment. At our hospital, plastic surgeons are responsible for organizing the team care. As part of the team care strategy, physical therapists (PTs) and occupational therapists (OTs) provide education to improve the mobility of spinal-cord-injury patients, e.g., improving muscle strength of the upper extremities for adequate transfer and ability to perform wheelchair push ups. For elderly patients, nurses assess the risk of pressure ulcer development using the Braden's scale and set up a nutrition support team. Additionally, if patients have difficulty swallowing, a speech therapist treats the dysphagia. And PTs and OTs treat their impaired activities of daily living. Finally, medical social workers arrange home-health-care services when the patient returns to their home. The management of chronic wounds has progressed from merely assessing the status of the wound to understanding the underlying molecular and cellular abnormalities that prevent the wound from healing. The concept of wound bed preparation, TIME, has simultaneously evolved to provide a systematic approach to removing the barriers to natural healing and enhancing the effectiveness of advanced therapies. Wound bed preparation and the TIME framework are most likely to be successful when used alongside the wound bed preparation care cycle.

Wireless Seat Interface Pressure Mapping on a Smartphone: Feasibility Study in Users with SCI

People with spinal cord injuries (SCI) undergo seat interface pressure mapping (IPM) as part of a comprehensive evaluation for correct positioning in a wheelchair. Currently, this mapping can only be performed in the clinic setting, limiting the ability of the client to make necessary adjustment at home on a day to day basis to prevent pressure ulcers. Monitoring seating pressures at home coupled with the ability to communicate results to providers has great potential to reduce ulcer development by implementing time-sensitive changes. Five subjects with spinal cord injuries used the prototype wireless IPM system at home for 5-7 days. They were able to successfully connect to the system through the Personal Hotspot on their smartphone. They then used an app on their smartphone to view their live pressure map and were able to take several recordings throughout the day. Therapists could then view the recorded maps remotely in the clinical setting by logging into the web-based application. Single subject case series. Subjects were seen in the outpatient clinical setting for initial set-up of the prototype IMP system and again at end of study period. During data collection, they used the map in their home or other routine daily environment for 5-7 days. Adults with spinal cord injury, aged 18-80, who are wheelchair users with no active pressure ulcers on their sitting surface. Subjects used the prototype pressure mapping system at home for 5-7 days. They were required to take at least 5 recordings throughout the day. A daily log was maintained to describe length of time in chair, skin check frequency and identification of any red areas. At the end of the study they returned to answer questionnaires related to usability and satisfaction with use of the device. A therapist visually examined the subject's skin at start and end of the study period. 1.Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST)2.Psychosocial Impact of Assistive Devices Scale (PIADS)3.Qualitative report via interview from subjects regarding perception of usefulness of pressure mapping data available to them in their home environment.4.Saved pressure map files for each subject will be available for access by researcher in the secure data base designated to contain the pressure map sessions.5.Visual skin examination by research investigator at start and end of study period. Users reported satisfaction with use of the device. They were able to access the map from their smartphones to take recordings consistently. Users provided excellent and useful feedback regarding usability of the web application and placement of the pressure mat on their cushion. There were no adverse skin problems identified following use of the pressure mapping system at home. Interface pressure mapping in the home environment, with ability to view it on a smartphone, allows people who use wheelchairs and are at risk for pressure ulcer development to have access to important feedback that can help them make positioning changes. The system tested is a prototype and there are plans to incorporate the user's feedback into the next iteration of software for improved indivualized customization of the interface for each user.

A numerical study to analyse the risk for pressure ulcer development on a spine board

BackgroundSpine boards are used to immobilise accident victims suspected of having spinal injury. Guidelines about the maximum time patients remain on the board are often exceeded and on occasions may lead to pressure ulcers. Etiological research has shown that two processes ultimately lead to pressure ulcers:“Ischemic damage” which takes several hours to initiate and “deformation damage” at high strains. The latter process is very quick and the first signs of cell damage are already evident within minutes. Thus in order to minimise the risk of pressure ulcer development during prolonged loading, a new soft-layered long spine board has been designed. MethodsA subject specific numerical approach has been adopted to evaluate the prototype spine board in comparison to a conventional spine board, with reference to the estimated strains in the soft tissues adjacent to the sacrum in the supine position. The model geometry is derived from magnetic resonance images of three human volunteers in an unloaded situation. The loaded images are used to “tune” the material parameters of skin, fat and muscle. The prediction of the deformed contours on the soft-layered board is used to validate the model. FindingsComparison of the internal strains in muscle tissue near the spine showed that internal strains on the soft-layered board are reduced and maximum strains are considerably less than the threshold at which deformation damage is possible. By contrast, on the rigid spine board this threshold is exceeded in all cases. InterpretationThe prototype comfort board is able to reduce the risk for deformation damage and thus reduces the risk of developing pressure ulcers.

Pressure ulcers in the adult intensive care unit: a literature review of patient risk factors and risk assessment scales

Background : Critically ill patients are at high risk for pressure ulcer (PrU) development due to their high acuity and the invasive nature of the multiple interventions and therapies they receive. With reported incidence rates of PrU development in the adult critical care population as high as 56%, the identification of patients at high risk of PrU development is essential. This paper will explore the association between PrU development and risk factors. It will also explore PrU development and the use of risk assessment scales for critically ill patients in adult intensive care units. Method : A literature search from 2000 to 2012 using the CINHAL, Cochrane Library, EBSCOHost, Medline (via EBSCOHost), PubMed, ProQuest and Google Scholar databases was conducted. Key words used were: pressure ulcer/s; pressure sore/s; decubitus ulcer/s; bed sore/s; critical care; intensive care; critical illness; prevalence; incidence; prevention; management; risk factor; risk assessment scale. Results : Nineteen articles were included in this review; eight studies addressing PrU risk factors, eight studies addressing risk assessment scales and three studies overlapping both. Results from the studies reviewed identified 28 intrinsic and extrinsic risk factors which may lead to PrU development. Development of a risk factor prediction model in this patient population, although beneficial, appears problematic due to many issues such as diverse diagnoses and subsequent patient needs. Additionally, several risk assessment instruments have been developed for early screening of patients at higher risk of developing PrU in the ICU. No existing risk assessment scales are valid for identification high risk critically ill patient, with the majority of scales potentially over-predicting patients at risk for PrU development. Conclusion: Research studies to inform the risk factors for potential pressure ulcer development are inconsistent. Additionally, there is no consistent or clear evidence which demonstrates any scale to better or more effective than another when used to identify the patients at risk for PrU development. Furthermore robust research is needed to identify the risk factors and develop valid scales for measuring the risk of PrU development in ICU.

Nutritional Strategies for Frail Older Adults

The objectives of this continuing education article are to analyze the aging process and its effect on the nutritional status of frail older adults; determine how sarcopenia, anorexia, malnutrition, and Alzheimer disease increase the risk for pressure ulcer development and impact the healing process; and to apply evidence-based nutrition guidelines and implement practical solutions for wound healing.

Pressure Ulcer Prevalence among Hospitalized Children in Jordan = مدى حدوث التقرحات السريرية عند المرضى الأطفال المدخلين في المستشفيات في الأردن

Background: Pressure Ulcers (PUs) remain a significant and complex health problem in health care settings. It is related to human suffering, pain, disfigurement, and financial burden. Only few studies about PUs incidence and prevalence have focused on paediatric patients whereas PUs prevention and management are generally extrapolated from the adult population. Aims: Determining PUs prevalence among children in Jordan and exploring the allocation of prevention measures to at risk populations. Methods: A point prevalence survey was conducted on 784 inpatient children in university, private and governmental hospitals in Jordan. A modified European Pressure Ulcer Advisory Panel (EPUAP) PUs prevalence survey form was used. PUs were classified according to the 2009 EPUAP and the National Pressure Ulcer Advisory Panel (NPUAP) grading system. Risk of PUs development was assessed using the 2009 Glamorgan scale for risk assessment in paediatrics. Results/ Findings: The overall Pus prevalence was 8.2% (n=58) and decreased to 1.8% when Grade 1was excluded. The sacrum was the most often affected site (75.8%, n=44 of 58).For the various at risk sub groups, paediatric critical care and surgical units showed the highest PUs prevalence of 43.1% and 36.2%, respectively. Of the 400 children evaluated to be at risk of PUs development, only 10% received prevention in terms of equipment and/ or repositioning. Conclusions: The PUs prevalence among children in Jordan is comparable to that reported for other countries utilizing the same methodology. Despite relatively low PUs prevalence, few patients at risk received adequate prevention. Since PUs risk assessment scales are not frequently used in Jordan, there is a need to emphasize knowledge of prevention and interventions as a key to reducing PUs prevalence.

Development of a Pressure Ulcer Trigger Tool for the Neonatal Population

A large Midwest level IIIb neonatal intensive care unit located in a 500-bed teaching hospital implemented quarterly skin prevalence surveys to monitor prevalence of altered skin integrity including pressure ulcers, diaper dermatitis (incontinence-associated dermatitis), and skin damage as a result of intravenous therapy, adhesive, or medical devices. Pressure ulcer prevalence varied from 0% to 1% per quarter, and no pressure ulcer risk assessment tool was regularly implemented. Therefore, a working group was formed to identify a risk assessment. The Iowa Model for Evidence-Based Practice was used to guide the project. A literature review was completed to identify validated instruments, but available tools were judged lengthy for routine clinical use. Therefore, we developed a short trigger tool comprising 3 questions to identify infants at risk for pressure ulcer development.

Successful implementation of clinical practice guidelines for pressure risk management in a home nursing setting

This paper reports an initiative which promoted evidence-based practice in pressure risk assessment and management among home nursing clients in Melbourne, Australia. The aim of this study was to evaluate the introduction and uptake of the Australian Wound Management Association Guidelines for the Prediction and Prevention of Pressure Ulcers. In 2007 a pilot study was conducted. Nurse perspectives (n=21) were obtained via survey and a client profile (n=218) was generated. Audit of the uptake and continued use of the pressure risk screening tool, during the pilot study and later once implemented as standard practice organizational wide, was conducted. Nurses at the pilot site successfully implemented the practice guidelines, pressure risk screening was adopted and supporting resources were well received. Most clients were at low risk of pressure ulcer development. The pilot site maintained and extended their pilot study success, ensuring more than 90% of clients were screened for pressure risk over the 18 months which followed. All other sites performed less well initially, however subsequently improved, meeting the pilot sites success after 18 months. Two years later, the organization continues to screen more than 90% of all clients for pressure risk. Implementation of clinical practice guidelines was successful in the pilot project and pressure risk screening became a well-adopted practice. Success continued following organizational wide implementation. Pilot study findings suggest it may be prudent to monitor the pressure ulcer risk status of low risk clients so as to prevent increasing risk and pressure ulcer development among this group.

Skin inspection for evaluating the presence of risk indicators to developing pressure ulcers

Objective: The skin of patients with multisystem trauma or spinal cord injury was inspected in order to evaluate the presence of indicators of risk for pressure ulcer development associated with the Nursing Outcomes Classification (NOC) descriptor ‘Tissue Integrity: Skin and Mucosa’. Design and setting: A cross‑sectional descriptive study performed in a tertiary referral hospital integrated into the public health network of Fortaleza, Ceará state, Brazil. Subjects: Forty‑nine patients with multisystem trauma or spinal cord injury. Results: Most participants were young men with multisystem trauma. The majority used pressure redistribution devices; the most common was a pyramidal mattress. Among NOC indicators for tissue integrity, texture showed the most change, followed by tissue temperature. The sacral region showed the greatest change in colour and temperature, and the scapulas showed the greatest change in temperature. Seventy‑five percent of subjects had a final score of 5:5, indicating non‑compromised skin. Conclusion: Classification parameters were developed based on NOC indicators and their applicability in our patients was verified. Use of the NOC skin integrity outcomes may be an effective method for identifying risk indicators for pressure ulcer development.

Implementation of pressure ulcer prevention best practice recommendations in acute care: an observational study

Pressure ulcers are a common but preventable problem in hospitals. Implementation of best practice guideline recommendations can prevent ulcers from occurring. This 9-year cohort study reports prevalence data from point prevalence surveys during the observation period, and three practice metrics to assess implementation of best practice guideline recommendations: (i) nurse compliance with use of a validated pressure ulcer risk assessment and intervention checklist; (ii) accuracy of risk assessment scoring in usual-care nurses and experienced injury prevention nurses; and (iii) use of pressure ulcer prevention strategies. The prevalence of hospital-acquired pressure ulcers decreased following implementation of an evidence-based prevention programme from 12·6% (2 years preprogramme implementation) to 2·6% (6 years postprogramme implementation) (P < 0·001). Audits between 2003 and 2011 of 4368 patient medical records identified compliance with pressure ulcer prevention documentation according to best practice guidelines was high (>84%). A sample of 270 patients formed the sample for the study of risk assessment scoring accuracy and use of prevention strategies. It was found usual-care nurses under-estimated patients' risk of pressure ulcer development and under-utilised prevention strategies compared with experienced injury prevention nurses. Despite a significant reduction in prevalence of hospital-acquired pressure ulcers and high documentation compliance, use of prevention strategies could further be improved to achieve better patient outcomes. Barriers to the use of prevention strategies by nurses in the acute hospital setting require further examination. This study provides important insights into the knowledge translation of pressure ulcer prevention best practice guideline recommendations at The Northern Hospital.

Risk factors for pressure ulcer development in critically Ill patients: A conceptual model to guide research

This paper presents a proposed conceptual model to guide research on pressure ulcer risk in critically ill patients, who are at high risk for pressure ulcer development. However, no conceptual model exists that guides risk assessment in this population. Results from a review of prospective studies were evaluated for design quality and level of statistical reporting. Multivariate findings from studies having high or medium design quality by the National Institute of Health and Clinical Excellence standards were conceptually grouped. The conceptual groupings were integrated into Braden and Bergstrom's (Braden and Bergstrom [1987] Rehabilitation Nursing, 12, 8-12, 16) conceptual model, retaining their original constructs and augmenting their concept of intrinsic factors for tissue tolerance. The model could enhance consistency in research on pressure ulcer risk factors.

Different lying positions and their effects on tissue blood flow and skin temperature in older adult patients

To report a study to compare the effects of different lying positions on tissue blood flow and skin temperature in older adult patients. This article reports the evaluation of study design and procedures. To reduce risk of pressure ulcers, repositioning of immobile patients is a standard nursing practice; however, research into how different lying positions effect tissue microcirculation is limited. Descriptive comparative design. From March-October 2010, 20 inpatients, aged 65 years or older, were included in the study. Tissue blood flow and skin temperature were measured over bony prominences and in gluteus muscle in four supine and two lateral positions. The blood flow over the bony prominence areas was most influenced in the superficial skin and especially in the 30° lateral position, where the blood flow decreased significantly in comparison with the supine positions. There were significant individual differences in blood flow responses, but no common trend was identified among the patients considered at risk for pressure ulcer development. The study procedure worked well and was feasible to perform in an inpatient population. The lying positions seem to influence the tissue blood flow over the bony prominences in different ways in older adult inpatients, but further study is needed to confirm the results and to make recommendations to clinical practice. The study procedure worked well, although some minor adjustments with regard to heat accumulation will be made in future studies.

Evaluation of the risk for pressure ulcers in bedridden elderly at home

OBJECTIVE: To evaluate the risk for pressure ulcers in elderly in their homes, after a period of hospitalization. METHODS: A longitudinal prospective study conducted in the homes of 40 elderly identified with risk for pressure ulcer (PU) at hospital discharge, using the Braden Scale. The monitoring was conducted over four home visits, in the period between June and August of 2010, in Fortaleza (CE) and its metropolitan region. RESULTS: The majority of the elderly were female (65%) with a medical diagnosis of cerebral vascular accident (55%). In the first and second visits, 55% and 40% of the elderly, respectively, presented high risk for PU, and the incidence of PU was 22.5%. The association of the risk scores presented significant association in the first three visits. CONCLUSION: The risk for PU development was higher in the first two weeks, after hospital discharge, but diminished for the remainder of the visits.

Multi-stage versus single-stage inflation and deflation cycle for alternating low pressure air mattresses to prevent pressure ulcers in hospitalised patients: A randomised-controlled clinical trial

IntroductionThe duration and the amount of pressure and shear must be reduced in order to minimize the risk of pressure ulcer development. Alternating low pressure air mattresses with multi-stage inflation and deflation cycle of the air cells have been developed to relieve pressure by sequentially inflating and deflating the air cells. Evidence about the effectiveness of this type of mattress in clinical practice is lacking. AimThis study aimed to compare the effectiveness of an alternating low pressure air mattress that has a standard single-stage inflation and deflation cycle of the air cells with an alternating low pressure air mattress with multi-stage inflation and deflation cycle of the air cells. Methods and materialsA randomised controlled trial was performed in a convenience sample of 25 wards in five hospitals in Belgium. In total, 610 patients were included and randomly assigned to the experimental group (n=298) or the control group (n=312). In the experimental group, patients were allocated to an alternating low pressure air mattress with multi-stage inflation and deflation cycle of the air cells. In the control group, patients were allocated to an alternating low pressure air mattress with a standard single-stage inflation and deflation cycle of the air cells. The outcome was defined as cumulative pressure ulcer incidence (Grade II–IV). An intention-to-treat analysis was performed. ResultsThere was no significant difference in cumulative pressure ulcer incidence (Grade II–IV) between both groups (Exp.=5.7%, Contr.=5.8%, p=0.97). When patients developed a pressure ulcer, the median time was 5.0days in the experimental group (IQR=3.0–8.5) and 8.0days in the control group (IQR=3.0–8.5) (Mann–Whitney U-test=113, p=0.182). The probability to remain pressure ulcer free during the observation period in this trial did not differ significantly between the experimental group and the control group (log-rank χ2=0.013, df=1, p=0.911). ConclusionAn alternating low pressure air mattress with multi-stage inflation and deflation of the air cells does not result in a significantly lower pressure ulcer incidence compared to an alternating low pressure air mattress with a standard single-stage inflation and deflation cycle of the air cells. Both alternating mattress types are equally effective to prevent pressure ulcer development.

Relationship between Braden scale score and pressure ulcer development in patients admitted in trauma intensive care unit

The purpose of this study was to determine the relationship between the scores of Braden scale and pressure ulcer development among critically ill patients. All patients who admitted to intensive care unit (ICU) in 3 months (during July-October 2010) were surveyed with Braden scale. Patients who gained higher score of Braden scale were at lower risk for pressure ulcer development compared with the other patients. Braden scale is a useful tool for predicting pressure ulcer development in trauma ICU patients. Also, factors such as age and level of consciousness may influence pressure ulcer development.