الفهرس | Only 14 pages are availabe for public view |
Abstract It is concluded that the pressure ulcer is an area of localized damage to the skin and under lying tissue. Pressure ulcers are a serious medical problem that can affect a patient in any health care setting. Pressure ulcers typically occur among patients who can’t move or have lost sensation and result from prolonged periods of immobility Pressure ulcers constitute an important cause of morbidity particularly amongst frail elderly and physically disabled patients. The presence of pressure ulcers often makes the patient’s medical care more complicated and reduces the patient’s quality of life. Pressure ulcers are caused by sustained mechanical loading; without a mechanical loading no pressure ulcer will develop. External loading of the tissues leads to a no uniform internal stress and strain state. This internal mechanical state depends on the magnitude of the applied loading, type of external loading (pressure, shear, friction), and the mechanical and geometrical properties of the tissues. In addition, the time of exposure to mechanical loading also plays an important role in the development of tissue damage. On the other hand, the ability of the tissue to withstand mechanical loading determines whether a certain loading will lead to the development of an ulcer or not. Both the mechanical loading and patient susceptibility are influenced by intrinsic and extrinsic factors. Intrinsic factors are related to the individual, e.g. with age, mobility, weight, posture, incontinence and nutritional state. Extrinsic factors are related to the environment, e.g. with nursing, the contact surface, nutrition, and the temperature and humidity of the environment. In clinical practice, these risk factors are used in risk assessment scales to identify patients at risk of developing pressure ulcers. Pressure ulcers are common in older populations. whereas it takes only hours for an ulcer to develop, complete healing can take months. Preventive measures are available and begin with risk assessment in every individual. Good nursing care plays a central role in the care of elderly patients with pressure ulcers. However, optimum ulcer management frequently requires a multidisciplinary approach. Pressure ulcers can be prevented by using standardized protocols that guide nursing practice. Through early detection of pressure ulcers, relief of pressure, skin care, control of spasms, and release of contractures. appropriate support surface selection and a deliberate strategy of prevention based on risk potential, patient outcomes can be improved while costs are reduced. Education is the essential element of an effective pressure ulcer prevention and treatment program. Today, more than ever, the nurse is in an excellent position to educate other health care providers, allied health care workers, patients and their families about the risks associated with pressure ulcers. Treatment options need to be based on scientific research, regular risk assessment, and clinical judgment. |