Pressure ulcers

ABSTRACT

Bedside information on the need for repositioning the patient at 2-h intervals to avoid the appearance of pressure ulcers can reduce hospitalization time, risk of skin lesions, and maintenance costs.

Keywords:
Information; Time of hospitalization; Ulcer; Skin; Plastic Surgery

RESUMO

As informações no leito, sobre a necessidade de manobras do paciente, em intervalos de 2h, para evitar o aparecimento de lesões por pressão podem reduzir o tempo de permanência, diminuir o risco de lesões de pele e os custos de manutenção do paciente.

Descritores:
Informação; Tempo de internação; Úlcera; Pele; Cirurgia plástica

The mentoring group III represented by Dr. Bismarck Ascar Sauaia and the 2nd year medical students of the Integrating Axis III-Ana Rita da Silva Nunes, Brenno Raniere da Silva Araújo, Bruno Lobão Fernandes, Carolina Ramos Oliveira, Eliara Laísa Cirino de Oliveira Lima, Ester Godinho Sousa, João Gabriel Queiroz Samineses, Leonardo Domingues Gomes, Luiza Oliveira Silva, Matheus Bidney Bayma Paiva, and Thiago Dutra Mendonça- of the Faculty of Medicine, Federal University of Maranhão in collaboration with Dr. Rayssa Yasmin Pereira Sauaia, MD - Plastic Surgeon at HU-UFMA and President Dutra, São Luis, MA. After a technical visit, we, hereby, wish to share information with the members and readers of the Journal of the Brazilian Society of Plastic Surgery as a new perspective with regard to the prophylaxis of pressure ulcers after reading numerous articles from publications in the RBCP and a technical visit to the HU-UFMA through a modular presentation of the integrating axis of Medicine III.

PRESSURE ULCERS

Pressure ulcers (PU), skin lesions, or soft tissue lesions, are associated with friction, shearing, and continuous pressure experienced in protuberances and develop in individuals who have been hospitalized for a long time; PU usually arise from other pathologies and often requiring surgical intervention¹,².

Other predisposing factors for PU include a lack of skilled labor, insufficient number of professionals, lack of awareness of prevention, and scarcity of material resources and operationalization of the risk clinic³.

Although surgical approaches are used for wounds in the advanced stages, PU and the changes in the skin have been a major concern for health service providers impacting patients and families with prolonged hospitalizations, thus, presenting other risks⁴,⁵.

It is the responsibility of health professionals to identify, plan, and implement preventive measures through an assessment of risk factors that may contribute to the development of PU in hospitalized patients⁶.

Patient evaluation measures, management of nutritional status, including hydration, daily inspection and assessment of the skin, care with exposure to moisture, and redistribution of pressure are the prophylactic measures for reducing the incidence of PU⁷.

The installation of a focal image showing the time interval and need for patient repositioning, thus, indicating the risk of PU, at the bedside of the patient is also an important educational and prophylactic measure for PU⁸,⁹.

PU represent a serious public health problem associated with the time of hospitalization and patient evolution, and provision of accurate information can lead to more efficient prevention of PU, subsequently, leading to a reduction in costs for the patient.

• Institution: Hospital Universitário Presidente Dutra da Universidade Federal do Maranhão, MA, Brazil.
• COLLABORATIONS
  BAS Writing - Review & Editing RYPS Supervision ARSN Writing - Review & Editing BRSA Writing - Review & Editing BLF Writing - Review & Editing CRO Writing - Review & Editing ELCOL Writing - Review & Editing EGS Writing - Review & Editing
  

  BAS	Writing - Review & Editing
  RYPS	Supervision
  ARSN	Writing - Review & Editing
  BRSA	Writing - Review & Editing
  BLF	Writing - Review & Editing
  CRO	Writing - Review & Editing
  ELCOL	Writing - Review & Editing
  EGS	Writing - Review & Editing

REFERÊNCIAS

• ¹
  Blanes L, Duarte IS, Calil JA, Ferreira LM. Avaliação clínica e epidemiológica das úlceras por pressão em pacientes internados no hospital São Paulo. Rev Assoc Med Bras. 2004;50(2):182-7.
• ²
  Figueiras RG. Tratamento cirúrgico de úlceras por pressão: experiência de dois anos. Rev Bras Cir Plást. 2011;26(3):418-27.
• ³
  Rolim JA, Vasconcelos JMB, Caliri MHL, Santos IBC. Prevenção e tratamento de úlceras por pressão no cotidiano de enfermeiros intensivistas. Rev Rene. 2013;14(1):148-57.
• ⁴
  Batista KT, Pereira ICC, Romano ACL. Tratamento Cirúrgico de úlcera por pressão na unidade de pediatria de hospital de reabilitação. Rev Bras Cir Plást. 2017;32(4):570-78.
• ⁵
  Arruda FCF. Opções de retalho da região glútea no tratamento da úlcera de pressão nas regiões isquiática e sacral. Rev Bras Cir Plást. 2013;28(3):476-82.
• ⁶
  Araújo TM, Araújo MFM, Caetano JÁ. Comparison of risk assessment scales for pressure ulcers in critically ill patients. Acta Paul Enferm. 2011;24(5):695-700.
• ⁷
  Borghardt AT, Prado TN, Bicudo SDS, Castro DS, Brinquente MEO. Úlcera por pressão em pacientes críticos: incidência e fatores associados. Rev Bras Enferm. 2016;69(3):460-7.
• ⁸
  Ministério da Saúde (BR). Anexo 2: Protocolo para prevenção de úlcera por pressão. Brasília (DF): ANVISA, FIOCRUZ; 2013; [acesso em 2019 set 10]. Disponível em: http://www.hospital-santalucinda.com.br/downloads/prot_prevencao_ulcera_por_pressao.pdf
  » http://www.hospital-santalucinda.com.br/downloads/prot_prevencao_ulcera_por_pressao.pdf
• ⁹
  Ministério da Saúde (BR). Gabinete do Ministro. Portaria n. 529, de 1 de abril de 2013. Institui o Programa Nacional de Segurança do Paciente (PNSP). Brasília (DF): Ministério da Saúde; 2013; [acesso em 2019 set 10]. Disponível em: http://bvsms.saude.gov.br/bvs/saudelegis/gm/2013/prt0529_01_04_2013.html
  » http://bvsms.saude.gov.br/bvs/saudelegis/gm/2013/prt0529_01_04_2013.html

Publication Dates

• Publication in this collection
  01 May 2023
• Date of issue
  Oct-Dec 2019

History

• Received
  02 Oct 2019
• Accepted
  21 Oct 2019