Management of pressure ulcers in obese patients in Intensive Care Unit
Mai AbdEl Salam Taha Ibrahim Ashoush;
Abstract
Obesity is defined as BMI between 30 and 39.9 kg/m2 and extreme or severe obesity, defined as a BMI >40kg/m2. It involves interplay between genetic, behavioral, hormonal, invironmental factors and developmental factors. Obese patient may have longer ICU and hospital long stay, duration of mechanical ventilation and increased mortality.
Obesity is a complex disorder involving an excessive amount of body fat and may have adverse effect on health. It increases risk of diseases and health problems,such as heart diseases, type 2 diabetes,high blood pressure, osteoarthritis and bed sores.
Obesity may be risk factor for pressure ulcer development due to immobility,sensory perception loss and insufficient circulation. It also increases the risk for infection, tissue injury and impaired skin integrity.It restrict activity, body movement and optimal blood flow.
Pressure ulcers (PrUs), also known as a pressure sores, decubitus ulcers and bed sores, are localized injuries of the skin or underlying tissue that most often occur over bony prominences and which can be caused by any combination of pressure, shear forces or friction. They are a significant problem in critically ill patients, the elderly and in persons with spinal cord injury. Other factors developing pressure ulcer such as malnutrition, incontinence, hypoalbuminemia, stroke, hypertension, poor wound healing, inadequate nursing care and chronic illness.
Immobility is a significant PrU risk factor. This is logical: people who are unable to reposition themselves are more likely to be exposed to prolonged external mechanical forces. The risk is especially high for patients subjected to prolonged mechanical ventilation or the use of sedatives, and this is because these patients are likely to experience a lowered level of consciousness and decreased sensation.
The development of hospital acquired pressure ulcers is a great concern in health care today.A medical device related pressure ulcer (MDRPU) is defined as a localized injury to the skin or underlying tissue resulting from sustained pressure caused by a medical device, such as a brace, splint,cast,respiratory mask or tubing tracheostomy tube, collar or strap,feeding tube or negative pressure wound therapy device.
Preventive measures involve reducing or eliminating factors contributing to development of pressure ulcer including time and amount of pressure,friction and shear forces,malnutrition and fecal incontinence.These measures mostly include teaching nursing staff how to identify risk factors and how to stage pressure ulcer. Pressure redistribution is the most important factor in preventing pressure ulcers and nutrition support.
Obesity is a complex disorder involving an excessive amount of body fat and may have adverse effect on health. It increases risk of diseases and health problems,such as heart diseases, type 2 diabetes,high blood pressure, osteoarthritis and bed sores.
Obesity may be risk factor for pressure ulcer development due to immobility,sensory perception loss and insufficient circulation. It also increases the risk for infection, tissue injury and impaired skin integrity.It restrict activity, body movement and optimal blood flow.
Pressure ulcers (PrUs), also known as a pressure sores, decubitus ulcers and bed sores, are localized injuries of the skin or underlying tissue that most often occur over bony prominences and which can be caused by any combination of pressure, shear forces or friction. They are a significant problem in critically ill patients, the elderly and in persons with spinal cord injury. Other factors developing pressure ulcer such as malnutrition, incontinence, hypoalbuminemia, stroke, hypertension, poor wound healing, inadequate nursing care and chronic illness.
Immobility is a significant PrU risk factor. This is logical: people who are unable to reposition themselves are more likely to be exposed to prolonged external mechanical forces. The risk is especially high for patients subjected to prolonged mechanical ventilation or the use of sedatives, and this is because these patients are likely to experience a lowered level of consciousness and decreased sensation.
The development of hospital acquired pressure ulcers is a great concern in health care today.A medical device related pressure ulcer (MDRPU) is defined as a localized injury to the skin or underlying tissue resulting from sustained pressure caused by a medical device, such as a brace, splint,cast,respiratory mask or tubing tracheostomy tube, collar or strap,feeding tube or negative pressure wound therapy device.
Preventive measures involve reducing or eliminating factors contributing to development of pressure ulcer including time and amount of pressure,friction and shear forces,malnutrition and fecal incontinence.These measures mostly include teaching nursing staff how to identify risk factors and how to stage pressure ulcer. Pressure redistribution is the most important factor in preventing pressure ulcers and nutrition support.
Other data
| Title | Management of pressure ulcers in obese patients in Intensive Care Unit | Other Titles | علاج قرح الفراش لمرضي السمنة في وحدة الرعاية المركزة | Authors | Mai AbdEl Salam Taha Ibrahim Ashoush | Issue Date | 2017 |
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