Plastic Surgery Essentials for Students-Chapter 14: Pressure Injuries

Chapter 14: Pressure Injuries

Pdf Summary

The chapter on pressure injuries, authored by Lee Squieteri, MD, and Jeffrey Kozlow, MD, addresses the updated terminology and comprehensive approach to managing pressure injuries, previously known as pressure ulcers or bed sores. The term "pressure injury" is now favored as these injuries can occur due to sustained pressure in various positions and situations besides lying down, such as sitting or after surgical procedures involving casting or splinting.<br /><br />Pressure injuries are categorized into different stages, from Stage I, presenting as non-blanchable erythema, to Stage IV, involving extensive tissue loss exposing deeper structures like muscle or bone. Other categories include unstageable injuries, masked by slough or eschar, and deep tissue injuries characterized by persistent discoloration.<br /><br />These injuries can have significant financial implications, costing the healthcare system billions annually. The affected body areas most frequently include the ischium, sacrum, trochanter, and heel. Factors contributing to pressure injuries are divided into extrinsic elements like pressure and shear, and intrinsic ones such as mobility issues, cognitive deficits, and chronic illness.<br /><br />Prevention is emphasized as the most effective approach, entailing activities like keeping the skin clean, using pressure-relieving devices, and optimizing nutrition. Non-surgical treatments involve managing localized infections, while surgical interventions are considered for patients with reversible conditions, focusing on debridement, reducing bony prominence, and wound closure using durable tissue flaps.<br /><br />Ultimately, overcoming high recurrence rates involves factors like patient motivation and modification of lifestyle or activity. The Braden scale is a tool used to assess risk levels in patients, guiding preventive and management strategies for pressure injuries.

Keywords

pressure injuries

Lee Squieteri

Jeffrey Kozlow

stages

prevention

Braden scale

surgical interventions

healthcare costs

risk factors

patient motivation