Common Acute Immobility and Wound Management
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Pressure injuries place a heavy physical and mental strain on immobile patients, and they have increased the burden on patients and families to pay for medical care (Eriksson et al., 2022). Pressure injuries are a serious hazard to human health due to their high occurrence rate and serious sequelae. They are localized injuries to the skin and underneath soft tissue, frequently over a bony protrusion or associated with medical supplies.
Etiology and Risk Factors
Pressure (decubitus) ulcers are more common in elderly and bedridden people. Age over 65, limited mobility, exposure to skin irritants, poor wound healing capacity due to undernutrition, diabetes, inadequate organ perfusion because of peripheral artery disease, immobility, and venous insufficiency, for example, are all risk factors for pressure damage (Tran et al., 2019). Wounded pressure can also result from impaired sensibility.
Presentations
Those with muted awareness or feeling may not be aware of a wound’s pain or itching at any stage (Alam et al., 2021). Unusual changes in skin texture or color, swelling, and pus-like drainage are typical manifestations of wound pressure or pressure ulcer
s. Other signs include painful places and skin that feels different from other locations in terms of temperature.
Assessment, Diagnosis, and Differential Diagnosis
A common screening tool to identify patients at risk is the Braden scale. A pressure injury is diagnosed based on a clinical assessment. A pressure injury may usually be distinguished by its distinctive look and by the fact that it occurs over a bony protrusion (Tran et al., 2019). The most frequent place is the sacrum, followed by the heels. Stage 2 pressure ulcers, skin tears, incontinence-associated dermatitis, bruises, hemorrhages, venous edema, arterial insufficiency, necrotizing fasciitis, and terminal skin ulcers are among the differential diagnoses.
Evidence-based Therapy
Since its introduction more than 15 years ago, Negative Pressure Wound Treatment (NPWT) has been widely used for a variety of wound indications (Alam et al., 2021). In general, “NPWT” refers to a special and adaptable system that uses sub-atmospheric pressure to optimize wound healing by reducing inflammatory exudate and promoting granulation tissue.
References
Alam, W., Hasson, J., & Reed, M. (2021). Clinical approach to chronic wound management in older adults. Journal of the American Geriatrics Society, 69(8), 2327–2334. https://doi.org/10.1111/jgs.17177
Eriksson, E., Liu, P. Y., Schultz, G. S., Martins‐Green, M. M., Tanaka, R., Weir, D., Gould, L. J., Armstrong, D. G., Gibbons, G. W., Wolcott, R., Olutoye, O. O., Kirsner, R. S., & Gurtner, G. C. (2022). Chronic wounds: Treatment consensus. Wound Repair and Regeneration, 30(2). https://doi.org/10.1111/wrr.12994
Tran, H. A., Ly, K. L., Fox, K. E., Tran, P. A., & Nguyen, T.-H. (2019). Immobilization of Antimicrobial Silver and Antioxidant Flavonoid as a Coating for Wound Dressing Materials. International Journal of Nanomedicine, Volume 14, 9929–9939. https://doi.org/10.2147/ijn.s230214
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Important information on Writing a Discussion Question
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Participation –replies to your classmates or instructor
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