Pressure ulcers in trauma patients with suspected spine injury: a prospective cohort study with emphasis on device‐related pressure ulcers

Of all patients in a hospital environment, trauma patients may be particularly at risk for developing (device‐related) pressure ulcers (PUs), because of their traumatic injuries, immobility, and exposure to immobilizing and medical devices. Studies on device‐related PUs are scarce. With this study, the incidence and characteristics of PUs and the proportion of PUs that are related to devices in adult trauma patients with suspected spinal injury were described. From January–December 2013, 254 trauma patients were visited every 2 days for skin assessment. The overall incidence of PUs was 28·3% (n = 72/254 patients). The incidence of device‐related PUs was 20·1% (n = 51), and 13% (n = 33) developed solely device‐related PUs. We observed 145 PUs in total of which 60·7% were related to devices (88/145). Device‐related PUs were detected 16 different locations on the front and back of the body. These results show that the incidence of PUs and the proportion of device‐related PUs is very high in trauma patients.

[1]  M. Poeze,et al.  Effects of unconsciousness during spinal immobilization on tissue-interface pressures: A randomized controlled trial comparing a standard rigid spineboard with a newly developed soft-layered long spineboard. , 2014, Injury.

[2]  M. Schuurmans,et al.  Pressure ulcers from spinal immobilization in trauma patients: A systematic review , 2014, The journal of trauma and acute care surgery.

[3]  E. Cole,et al.  Nursing challenges with a severely injured patient in critical care. , 2013, Nursing in critical care.

[4]  C. W. J. Oomens,et al.  A numerical study to analyse the risk for pressure ulcer development on a spine board. , 2013, Clinical biomechanics.

[5]  Jane Nixon,et al.  Patient risk factors for pressure ulcer development: systematic review. , 2013, International journal of nursing studies.

[6]  Julie Apold,et al.  Preventing Device-Related Pressure Ulcers: Using Data to Guide Statewide Change , 2012, Journal of nursing care quality.

[7]  Zena Moore,et al.  A randomised controlled clinical trial of repositioning, using the 30° tilt, for the prevention of pressure ulcers. , 2011, Journal of clinical nursing.

[8]  D. Lamping,et al.  Development of a conceptual framework of health-related quality of life in pressure ulcers: a patient-focused approach. , 2010, International journal of nursing studies.

[9]  Joyce M Black,et al.  Medical device related pressure ulcers in hospitalized patients , 2010, International wound journal.

[10]  Jane Nixon,et al.  Impact of Pressure Ulcers on Quality of Life in Older Patients: A Systematic Review , 2009, Journal of the American Geriatrics Society.

[11]  J. Powers,et al.  The Incidence of Skin Breakdown Associated With Use of Cervical Collars , 2006, Journal of trauma nursing : the official journal of the Society of Trauma Nurses.

[12]  D. De Bacquer,et al.  The reliability of two observation methods of nonblanchable erythema, Grade 1 pressure ulcer. , 2006, Applied nursing research : ANR.

[13]  L. Leenen,et al.  Is there a Reason for Spine Board Immobilization in the Emergency Department for Patients with a Potential Spinal Injury? , 2005, European Journal of Trauma.

[14]  M. Elia,et al.  Malnutrition in hospital outpatients and inpatients: prevalence, concurrent validity and ease of use of the ‘malnutrition universal screening tool’ (‘MUST’) for adults† , 2004, British Journal of Nutrition.

[15]  N. Bergstrom,et al.  Predicting pressure ulcer risk: a multisite study of the predictive validity of the Braden Scale. , 1998, Nursing research.

[16]  K. Baldwin,et al.  Pressure ulcer risk following critical traumatic injury. , 1998, Advances in wound care : the journal for prevention and healing.

[17]  W. Haddon,et al.  The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. , 1974, The Journal of trauma.

[18]  Tom Defloor,et al.  Effectiveness of turning with unequal time intervals on the incidence of pressure ulcer lesions. , 2007, Journal of advanced nursing.

[19]  R. Halfens,et al.  Rapportage resultaten Landelijke Prevalentiemeting Zorgproblemen , 2007 .

[20]  Dirk De Bacquer,et al.  The effect of various combinations of turning and pressure reducing devices on the incidence of pressure ulcers. , 2005, International journal of nursing studies.

[21]  E. Molano Alvarez,et al.  [Pressure sores secondary to immobilization with cervical collar: a complication of acute cervical injury]. , 2004, Enfermeria intensiva.

[22]  Ad Hoc Subcommittee on Outcomes.  Practice management guidelines for emergency department thoracotomy. Working Group, Ad Hoc Subcommittee on Outcomes, American College of Surgeons-Committee on Trauma. , 2001, Journal of the American College of Surgeons.

[23]  T. Fitzpatrick.  The validity and practicality of sun-reactive skin types I through VI. , 1988, Archives of dermatology.