PRESSURE ULCERS

Prevention of pressure ulcer in nursing homes using pressure relieving cushions in chairs

Prevention of pressure ulcer in nursing homes using pressure relieving cushions in chairs

Introduction

Wheelchair users everywhere face many challenges in their life, mobility and access to name a few. Potentially the most devastating of them all is a pressure ulcer. Painful and debilitating, pressure ulcers are a major cause of discomfort to both the patient and their caregiver. They impose a heavy burden on the healthcare system and significantly lower the quality of life experienced by the individual. Treating pressure ulcers can cost anywhere from $15,000.00 to $60,000.00 and in most cases require a lengthy stay at the hospital? (Beitz, 2001) The individual, in cases of severe ulceration, may end up undergoing surgical interventions including debridement of the affected wound and bone removal. Ulceration due to pressure can occur in any individual who is restricted to a prolonged stay in a bed or a chair with no pressure relief.

Although a large number of factors in addition to pressure can increase the likelihood and severity of the ulceration, contact pressure stands out as one of the major influencing parameters. The problem is compounded in a wheelchair bound individual, since only a small area of the body has to support a large part of the body mass. Conceivably, a majority of people suffering from pressure ulcers are non-ambulant wheelchair bound. An estimated 30% of the paraplegic population and 50% of all quadraplegics will require hospitalization because of pressure related problems during their lifetime (Brem, 2004). The prevalence of pressure ulcers is even higher in a geriatric population. Most find the condition affecting them emotionally, mentally and socially. With the number of individuals using wheelchairs increasing every year, it has become imperative that an effective method of preventing pressure ulcers be found and experimentally ascertained to be effective. As can be inferred prevention is the best way of combating pressure ulceration, but lack of objective data on methods and their effectiveness make it quite difficult to distinguish between techniques. Pressure relief maneuvers, in most cases, are still performed by care takers of the individual by physically changing their position. Individuals who have the requisite upper body strength relieve pressure through a regime of exercises (Whittington, 2009).

Discussion

Pressure ulcers

A localized necrosis of skin tissue due to prolonged application of pressure or shear forces and/or friction is called a pressure ulcer. As a pressure ulcer develops, the necrosis deepens and penetrates to deeper tissues. More recently the theory of deep tissue injury (DTI) has been gaining wide spread acceptance. It is now believed that there exists another pathway to pressure ulcers and that is through damage to deep tissue near bony prominences due to pressure applied externally. In either of these cases, the situation is often complicated by concomitant conditions (sepsis, infection etc) which can be life-threatening. Pressure ulcers are a reality that many wheelchair users live with. It is estimated that nearly 30% of the paraplegic population and 50% of all quadraplegics will require ...