Rethinking treatment for pressure ulcers
Wound Care According to research conducted by the University of Leeds 7% of patients in hospital has a pressure ulcer and new methods need to be developed to prevent the problem growing.
It's estimated that just under half a million people in the UK will develop at least one pressure ulcer in any given year, according to the NHS. The wounds vary in size and severity from a patch of discoloured skin to an open wound that exposes the bone and muscle. The most severe cases can leave the patient open to life-threatening infections such as blood poisoning.
The global number of people dying every year as a result of pressure ulcers has increased from 32,100 in 1990 to 42,600 in 2010 according to research published in the Lancet. “This increase is due to the ageing population,” explains Professor Lisette Schoonhoven, Professor of Nursing within the Faculty of Health Sciences, University of Southampton and president of the European Pressure Ulcer Advisory Panel. “However, pressure ulcers aren’t exclusively a disease of the elderly. They can affect anyone of any age.”
Why do they form?
Pressure ulcers are caused when pressure or shearing is applied to the same area of skin for a period of time and disrupts the blood supply. As a result, the skin and muscle begins to break down and an ulcer is formed.
“Ulcers can form in neonates who require masks to promote breathing or in other patients who need medical devises that put pressure on the skin,” continues Schoonhoven. “Patients who are on the operating table for a long period of time are also at greater risk as are those with spinal injury and those who have been given spinal blocks and are unable to feel pain and move when pressure becomes uncomfortable.”
Most of us are constantly making small movements that encourage blood flow around the body. However, when there is no movement, an ulcer can form in as little as two to four hours, depending on the condition of a person and the number of other factors.
“To prevent ulcers we simply need to get patients to off load pressure, which all sounds very easy,” explains Schoonhoven. “But ulcers are a multifaceted condition affected by the issues such as the condition of a person’s skin and their nutrition.” In response, Schoonhoven believes there needs to be a more unified approach to treating patients that involves a wider variety of professionals and extends beyond a hospital setting. Technology could play an important role as sensors are used more widely to alert over-stretched nurses when patients need to change their position.
Early intervention is also key and research is being carried out to help predict which patients are at greater risk of developing pressure ulcers. A number of investigations are underway to measure biomarkers and sub-epidermal moisture levels to give an early indicator of tissue damage. However, it’s vital that education of both healthcare professionals and the public continues to go hand in hand with any medical research, so we don’t get complacent about the condition that can affect anyone of any age.