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Pressure ulcers study quantitative
A case study on pressure ulcer, prevention and management
Improving care with pressure ulcers
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Pressure ulcer is also known as bedsore. There is a skin lesion, which is caused by number of factors, that include friction and unrelieved pressure. Body that can be affected; bony or cartilaginous areas such as elbows, knees and ankles are commonly affected. The bedridden patient for extended period are more prone to get pressure ulcer. Bedsore is one of the most common complication in elderly group and due to increase in rapid population, there is high prevalence of pressure ulcer which can lead to most serious infection such as osteomyelitis and sepsis. Pressure ulcers (PU) are a common medical complication in the frail elderly [1]. These induce suffering and worsening in quality of life and prolong hospitalization [1]. Pressure ulcer are …show more content…
Pressure ulcers are common with the elderly bedbound patients in the community, nursing homes and hospitals [1]. The prevalence of PU in general hospitals heretofore was 4-30%, in long-term care facilities between 2.4%-23% and 4% in home care patients [1]. The older population is more susceptible to the development of skin wounds due to changes associated with the aging process that increase the fragility of the skin [2]. Among these changes one may cite the thinning of cell layers, decrease vascularization, cell proliferation, and delays in the healing process. Skin sensibility, pain response, barrier function, and inflammatory response are also reduced with aging, which makes skin more vulnerable to injury …show more content…
2) Swelling 3) Pus like draining. 4) Tender areas 5) An area of the skin that is cooler and warmer
What is the physiologic mechanism causing the wound to become red, hot, swollen, and painful?How is this different than the inflammatory response that might occur in an internal organ?
Risk assessment scales have been in situ for over 50 years within the adult sector. These scales consist of several categories, which are thought to be associated with the potential occurrence of a pressure ulcer. Factors such as mobility and incontinence etc. are considered. Each category of the assessment is added up to give a total. The score then suggests whether a patient is at low, medium or high risk of developing a pressure ulcer. Higher-risk patients are therefore more susceptible to develop pressure ulcers and interventions are implemented such as, Air mattresses or nutritional support which is hoped to reduce the occurrence of pressure
...may have the same symptoms. The symptoms are red bumps that may bleed if the sores are picked over.
...ssure ulcers can be preventable if there is a systemic and multi-professional approach to their prevention and continuing assessment of skin integrity. Mary was determined and worked well with the physiotherapist; she was up and on her feet within a week of returning. Staff had to prompt her to move around the ward, which at times was hard for her due to her anxiety. Mary was deemed high risk for falls, so was put on a prevention of falls chart in conjunction with the pressure area chart and repositioning chart.
In addition to its traditional clinical manifestations, GAS can also cause serious invasive disease such as necrotizing fasciitis, colloquially known as the flesh-eating disease. First broadly reported during the Civil War, when it was known as gangrene, necrotizing fasciitis occurs when an individual’s subcutaneous fat and superficial fascia become rapidly necrotic. Though incidence data is limited, one study estimated that, worldwide, there are approximately 660,000 cases of invasive GAS disease per year, with 97% of those cases occurring in low-income populations (4). Many microorganisms other than GAS have been linked with necrotizing fasciitis, including Staphyloccocus aureus, Escherichica coli, and Klebsiella pneumoniae, and the disease is often caused by a polymicrobial infection. However, the most well known causative agent in necrotizing fasciitis cases is usually Group A streptococci (6). Although risk factors for necrotizing fasciitis include diabetes, old age, and immunosuppression, nearly half of all infections occur i...
Sayar S.,Turgut, S., Dogan, H., Ekici, A., Yurtsever, S., Dermirkan, F., Doruk, N., Tsdelen, B. (2009) Incidence of pressure ulcers in intensive care unit patients at risk according to the Waterlow scale and factors influencing the development of pressure ulcers. Journal of Clinical Nursing 18, 765-774.
These specific sacral ulcers limits the patient to perform many activities of daily living (ADL). Patients who are elderly in an acute hospitalization or have a different impairment are at risk to suffer from ulcers (Kirman, C. et al. 2014). Also, these ulcers can happen from laying down in a constant position. According to Hartmann, a pressure sore is one of the most severe complications
Cellulitis is an acute spreading bacterial infection of the connective tissue, dermis and subcutaneous layers of the skin (ProQuest 07/2012 pg.5). Characterized by redness, swelling, warmth, tight/shiny skin and pain. It is sometimes accompanied by fever, swollen lymph nodes, chills and fatigue. Cellulitis first appears on pink-to-red minimally inflamed skin. The area of infection rapidly becomes deeper red and increases in size as the infection spreads. Occasionally, red streaks may radiate outward from cellulitis. Blisters or pus filled bumps may also be present (skinsight 12/2012 pg.5). The main culprit is the bacteria Streptococcus and Staphylococcus which can enter through a break in the skin.
Thomas, D. R. (2001). Issues and dilemmas in the prevention and treatment of pressure ulcers: A
Sepsis is defined as a systemic inflammatory response caused by an infective process such as viral, bacterial or fungal (Holling, 2011). Assessment on a patient and starting treatment for sepsis is based on identifying several factors including the infective source, antibiotic administration and fluid replacement (Bailey, 2013). Because time is critical any delay in identifying patients with sepsis will have a negatively affect the patients’ outcome. Many studies have concluded every hour in delay of treatment mortality is increased by 7% (Bailey, 2013). Within this assignment I will briefly discuss the previous practice and the recent practice including the study based on sepsis. I will show what enabled practice to change and I will use the two comparisons of current practice and best practice.
The normal wound healing process mainly consists of four main stages being haemostasis, inflammation, proliferation or new tissue formation, and tissue remodeling or resolution. For a wound to heal well the above mentioned stages should occur in a sequential and orderly manner. Disturbances, abnormalities and delays in any of the above stages may lead to impaired healing or even chronic wounds. In adults, this process of normal healing takes place in the following steps (1)rapid haemostasis (2)appropriate inflammation (3)mesenchymal cell differentiation, proliferation, and migration to the wound site (4)suitable angiogenesis (5)prompt re-epithelialization and (6) proper synthesis, cross-linking, and alignment of collagen to provide strength to the healing tissue.
The symptoms of psoriasis differ from type to type, although inflamed, scaly lesions are present in all five types. The most common form of the disease, plaque psoriasis, is identified by small bumps that begin to grow and become scaly. These lesions flake easily, but removing these patches can cause the tender skin below to bleed. In the Guttate type, small, individual, red drops form. This type does not have as much scaling as plaque psoriasis. The drops usually clear up on their own, but may also reappear as a different form of psoriasis, usually plaque. Inverse psoriasis usually occurs in places where the skin folds, such as the genitals, breasts, armpits or the backs of knees. This type will appear red, yet it will be smooth and dry. Also, no scaling will occur. Pustular psoriasis is a type that's significantly more rare. It is also more painful. In this type, blisters filled with non-infectious pus appear within a few hours and then dry up and peel within another two days. Severe medical risks exist for those who have this particular form of psoriasis, due to its side effects; exhaustion, anemia, weight loss, fever, chills, rapid pulse rate, severe itching and muscle weakness. Even less common than pustular psoriasis is erythrodermic psoriasis. This type is...
Sepsis is a “cunning, insidious and non-specific illness” (Raynor, 2012) but progression can be rapturous with a sudden catastrophic circulatory collapse and mortality up to 50%. (Angus et al., 2001) Over five million cases arise per year of maternal sepsis, resulting in an estimated 62,000 maternal deaths globally (WHO, 2008) During the 18th and 19th century, puerperal sepsis resulted in 50% of maternal deaths over Europe (Loudon, 2000). The World Health Organisation (WHO) defined puerperal sepsis as ‘infection of the genital tract occurring at any time between the rupture of membranes or labour, and the 42nd day postpartum, of which two or more of the following are present: pelvic pain, fever 38.5C or more, abnormal vaginal discharge, abnormal smell of discharge, and delay in the rate of reduction of size of uterus (less than 2 cm a day during the first 8 days)’ (WHO, 1992).
When a wound is determined as non-healable, as described by Sibbald et al (1), it should not be treated with a moist treatment and should be kept dry in order to reduce the risk of infection that would compromise the limb. It is also important to consider the patient 's preferences and try to control his pain, his discomfort in activities of daily living and the odour that their wound may produce. In this case, special attention must be given to infection prevention and control. Some charcoal dressing would be interesting in the care of our non-healable wounds at St. Mary 's Hospital.
“Peptic ulcers are open sores that develop in the lining of the stomach, esophagus, and small intestine as a result of an imbalance of hydrochloric acid and pepsin. These acidic digestive juices are secreted by the cells of the stomach. Named for where they are found, “peptic ulcers are a very common and often reoccurring health problem, and it is estimated that more than 20 million Americans will experience a peptic ulcer in their lifetime” (Cleveland).