Úlceras por presión en pacientes hospitalizados
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Feb 5, 2015
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Resumo
Las úlceras por presión (UPP) son lesiones de origen isquémico, localizadas en la piel y los tejidos subyacentes, con pérdida cutánea por la presión prolongada o fricción entre dos planos duros. Se estima que casi 60.000 pacientes de los hospitales en Estados Unidos mueren cada año por complicaciones debido a las UPP adquiridas intrahospitalariamente y el costo estimado del tratamiento está alrededor de los 11.000 millones de dólares por año. Estas lesiones cutáneas son un problema grave y frecuente en personas de edad avanzada; representan una de las principales complicaciones del síndrome de inmovilidad; están asociadas con mayor tiempo de estancia hospitalaria, sepsis y una mayor tasa de mortalidad, por lo que su prevención y manejo adecuado, en el ámbito hospitalario, constituyen un indicador de calidad asistencial.
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References
1. Institute for Clinical Systems Improvement (ICSI). Pressure ulcer prevention and treatment protocol. 3rd ed.; 2012.
2. European Pressure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel. Prevention and treatment of pressure ulcers: quick reference guide. Washington DC: National Pressure Ulcer Advisory Panel; 2014.
3. Thomas DR. Prevention and treatment of pressure ulcers. J Am Med Dir Assoc. 2006;7:46-59.
4. Arango Salazar C, Fernández Duque O, Torres Moreno B. Síndromes geriátricos: úlceras por presión. En: Tratado de geriatría para residentes. Madrid: Sociedad Española de Geriatría y Gerontología; 2006. p. 217-26.
5. Garcia AD, Thomas DR. Assessment and management of chronic pressure ulcers in the elderly. Med Clin N Am. 2006;(90):925-44.
6. Markova A, Mostow EN. US skin disease assessment ulcer and wound. Care Dermatol Clin. 2012;(30):107-11.
7. White-Chu EF, Flock P, Struck B, Aronson L. Pressure ulcers in long-term care. Clin Geriatr Med. 2011;(27):241-58.
8. Shahin ES, Dassen T, Halfens RJ. Pressure ulcer prevalence and incidence in intensive care patients: a literature review. Nurs Crit Care. 2008 Mar-Apr;13(2):71-9.
9. Hartoch RS, McManus JG, Knapp S, Buettner MF. Emergency management of chronic wounds. Emerg Med Clin N Am. 2007;25(1):203-21.
10. Sibbald RG, Krasner DL, Woo KY. Pressure ulcer staging revisited: superficial skin changes & deep pressure ulcer framework©. Adv Skin Wound Care. 2011;24:571.
11. Australian Wound Management Association. Pan Pacific clinical practice guideline for the prevention and management of pressure injury. Cambridge Media Osborne Park, WA; 2012.
12. Victorian Quality Council. VQC Statewide PUPPS Report––2003: Pressure ulcer point prevalence survey [internet]. Department of Human Services; 2004. Disponible en: http://www.health.vic.gov.au/qualitycouncil.
13. Villalba LI, Bilevich E. Consenso sobre la cicatrización de heridas. Buenos Aires: Sociedad Argentina de Dermatología; 2008.
14. Siebers MJ. Pressure ulcers. En: Duthie: practice of geriatrics. 4th ed. Philadelphia: Elsevier; 2007. p. 245-53.
15. Thomas DR. Does pressure cause pressure ulcers?: An inquiry into the etiology of pressure ulcers. J Am Med Dir Assoc. 2010;11(6):397-405.
16. Singer AJ, Clark RAF. Cutaneous wound healing. N Engl J Med. 1999;341:738-46.
17. Suárez Amor O, Pereiro Ferreirós MM. Protocolo diagnóstico de las úlceras cutáneas y lesiones por decúbito. Medicine. 2006;9(48):3165-7.
18. Feinsod FM, Levenson SA. The importance of differentiating pressure sores from other skin ulcers. Nursing Home Med. 1997;5:216-9.
19. Lyder CH, Ayello EA. Pressure ulcers: a patient safety issue. En: Patient safety and quality: an evidence-based handbook for nurses [internet]. Vol. 1. Rockville: Agency for Healthcare Research and Quality; 2008. Disponible en: http://archive.ahrq.gov/professionals/cliniciansproviders/resources/nursing/resources/nurseshdbk/index.html
20. Wounds International. Pressure ulcer prevention: pressure, shear, friction and microclimate in context. A consensus document. London: Wounds International; 2010.
21. Gorecki C, Brown JM, Nelson EA, et al. Impact of pressure ulcers on quality of life in older patients: a systematic review. J Am Geriatr Soc. 2009;57:1175.
22. National Pressure Ulcer Advisory Panel. Support surface, standards initiative: Terms and definitions related to support, surfaces. NPUAP; 2007.
23. Bluestein D. Pressure ulcers: prevention, evaluation, and management. Norfolk, Virginia: American Academy of Family Physicians; 2008.
24. Thomas DR. Clinical management of pressure ulcers. Clin Geriatr Med. 2013;29:397-413.
25. Grey JE, Harding KG, Enoch S. Pressure ulcers. BMJ. 2006;332:472.
26. Yarkony GM, Kirk PM, Carlson C, et al. Classification of pressure ulcers. Arch Dermatol. 1990;126:1218.
27. Clark AM. Management of chronic wounds. En: The Osler medical handbook. 2nd ed. Philadelphia: Saunders; 2006. p. 282-291.
28. Brown SJ. The Braden Scale: A review of the research evidence. Orthop Nurs. 2004;23(1):30-8.
29. Moore Z, Cowman S. Risk assessment tools for the prevention of pressure ulcers. Cochrane Database of Systematic Reviews. 2008 Jul 16;(3):CD006471.
30. Thomas DR. Diseases of the skin: pressure ulcers. En: Bope & Kellerman. Conn’s: current therapy. Philadelphia: Saunders; 2013.
31. Velasco M. Aspectos diagnósticos y terapéuticos de las úlceras de las piernas. Actas Dermosifiliogr. 2011;102(10):780-90.
32. McInnes E, Jammali-Blasi A, Bell-Syer SEM, Dumville JC, Cullum N. Support surfaces for pressure ulcer prevention. Cochrane Database of Systematic Reviews. 2011, Apr 13;(4):CD00173.
33. Ho CH, Bogie K. The prevention and treatment of pressure ulcers. Phys Med Rehabil Clin N Am. 2007;18(2):235-53.
34. Millán Bustamante B, Hernández Cristóbal J, Vaduva RC. Prevención y tratamiento de las úlceras por presión: protocolos de práctica asistencial. Medicine. 2011;10(77):5259-63.
35. Sebern MD. Pressure ulcer management in home health care: efficacy and cost effectiveness of moisture vapor permeable dressing. Arch Phys Med Rehabil. 1986;67:726.
36. Schultz GS, Sibbald RG, Falanga V, et al. Wound bed preparation: a systematic approach to wound management. Wound Repair Regen. 2003 Mar;11 Suppl 1:S1-28.
37. CADIME. Tratamiento local de las úlceras de presión. Bol Ter Andal. 2000;(16):5.
38. Reddy M, Gill SS, Kalkar SR, et al. Treatment of pressure ulcers: a systematic review. JAMA. 2008;300:2647.
39. Stotts NA, Horng-Shiuann W. Hospital recovery is facilitated by prevention of pressure ulcers in older adults. Crit Care Nurs Clin N Am. 2007;19:269-75.
40. Panel for the Prediction and Prevention of Pressure Ulcers in Adults. Pressure ulcers in adults, prediction and prevention. Rockville (MD): Agency for Health Care Policy and Research, Public Health Service; 1992.
41. Levine SM, Sinno S, Levine JP, Saadeh PB. Current thoughts for the prevention and treatment of pressure ulcers: using the evidence to determine fact or fiction. Ann Surg. 2013;257:603.
42. Vermeulen H, van Hattem JM, Storm-Versloot MN, et al. Topical silver for treating infected wounds. Cochrane Database Syst Rev. 2007;44(5):531-3.
43. Staas WE Jr, Cioschi HM. Pressure sores, a multifaceted approach to prevention and treatment. West J Med. 1991;154:539-44.
44. Lykke Sørensen J, Jørgensen B, Gottrup F. Surgical treatment of pressure ulcers. Am J Surg. 2004;188 (Suppl):42S-51S.
45. Sarabia Lavín R, Rojo Santos E. Manejo de las lesiones por presión: best practice. Enferm Clin. 2010;20(2):136-8.
46. O’Meara S, Al-Kurdi D, Ovington L. Antibiotics and antiseptics for venous leg ulcers. Cochrane Database Syst Rev. 2010 Jan 20;(1):CD003557.
47. Breslow RA, Hallfrisch J, Guy DG, et al. The importance of dietary protein in healing pressure ulcers. J Am Geriatr Soc. 1993;41:357-62.
48. Thomas DR. Improving the outcome of pressure ulcers with nutritional intervention: a review of the evidence. Nutrition. 2001;17:121-5.
49. Smith ME, Totten A, Hickam DH, et al. Pressure ulcer treatment strategies: a systematic comparative effectiveness review. Ann Intern Med. 2013;159:39.
50. Dryburgh N, Smith F, Donaldson J, Mitchell M. Debridement for surgical wounds. Cochrane Database Syst Rev. 2008 Jul 16;(3):CD006214.
2. European Pressure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel. Prevention and treatment of pressure ulcers: quick reference guide. Washington DC: National Pressure Ulcer Advisory Panel; 2014.
3. Thomas DR. Prevention and treatment of pressure ulcers. J Am Med Dir Assoc. 2006;7:46-59.
4. Arango Salazar C, Fernández Duque O, Torres Moreno B. Síndromes geriátricos: úlceras por presión. En: Tratado de geriatría para residentes. Madrid: Sociedad Española de Geriatría y Gerontología; 2006. p. 217-26.
5. Garcia AD, Thomas DR. Assessment and management of chronic pressure ulcers in the elderly. Med Clin N Am. 2006;(90):925-44.
6. Markova A, Mostow EN. US skin disease assessment ulcer and wound. Care Dermatol Clin. 2012;(30):107-11.
7. White-Chu EF, Flock P, Struck B, Aronson L. Pressure ulcers in long-term care. Clin Geriatr Med. 2011;(27):241-58.
8. Shahin ES, Dassen T, Halfens RJ. Pressure ulcer prevalence and incidence in intensive care patients: a literature review. Nurs Crit Care. 2008 Mar-Apr;13(2):71-9.
9. Hartoch RS, McManus JG, Knapp S, Buettner MF. Emergency management of chronic wounds. Emerg Med Clin N Am. 2007;25(1):203-21.
10. Sibbald RG, Krasner DL, Woo KY. Pressure ulcer staging revisited: superficial skin changes & deep pressure ulcer framework©. Adv Skin Wound Care. 2011;24:571.
11. Australian Wound Management Association. Pan Pacific clinical practice guideline for the prevention and management of pressure injury. Cambridge Media Osborne Park, WA; 2012.
12. Victorian Quality Council. VQC Statewide PUPPS Report––2003: Pressure ulcer point prevalence survey [internet]. Department of Human Services; 2004. Disponible en: http://www.health.vic.gov.au/qualitycouncil.
13. Villalba LI, Bilevich E. Consenso sobre la cicatrización de heridas. Buenos Aires: Sociedad Argentina de Dermatología; 2008.
14. Siebers MJ. Pressure ulcers. En: Duthie: practice of geriatrics. 4th ed. Philadelphia: Elsevier; 2007. p. 245-53.
15. Thomas DR. Does pressure cause pressure ulcers?: An inquiry into the etiology of pressure ulcers. J Am Med Dir Assoc. 2010;11(6):397-405.
16. Singer AJ, Clark RAF. Cutaneous wound healing. N Engl J Med. 1999;341:738-46.
17. Suárez Amor O, Pereiro Ferreirós MM. Protocolo diagnóstico de las úlceras cutáneas y lesiones por decúbito. Medicine. 2006;9(48):3165-7.
18. Feinsod FM, Levenson SA. The importance of differentiating pressure sores from other skin ulcers. Nursing Home Med. 1997;5:216-9.
19. Lyder CH, Ayello EA. Pressure ulcers: a patient safety issue. En: Patient safety and quality: an evidence-based handbook for nurses [internet]. Vol. 1. Rockville: Agency for Healthcare Research and Quality; 2008. Disponible en: http://archive.ahrq.gov/professionals/cliniciansproviders/resources/nursing/resources/nurseshdbk/index.html
20. Wounds International. Pressure ulcer prevention: pressure, shear, friction and microclimate in context. A consensus document. London: Wounds International; 2010.
21. Gorecki C, Brown JM, Nelson EA, et al. Impact of pressure ulcers on quality of life in older patients: a systematic review. J Am Geriatr Soc. 2009;57:1175.
22. National Pressure Ulcer Advisory Panel. Support surface, standards initiative: Terms and definitions related to support, surfaces. NPUAP; 2007.
23. Bluestein D. Pressure ulcers: prevention, evaluation, and management. Norfolk, Virginia: American Academy of Family Physicians; 2008.
24. Thomas DR. Clinical management of pressure ulcers. Clin Geriatr Med. 2013;29:397-413.
25. Grey JE, Harding KG, Enoch S. Pressure ulcers. BMJ. 2006;332:472.
26. Yarkony GM, Kirk PM, Carlson C, et al. Classification of pressure ulcers. Arch Dermatol. 1990;126:1218.
27. Clark AM. Management of chronic wounds. En: The Osler medical handbook. 2nd ed. Philadelphia: Saunders; 2006. p. 282-291.
28. Brown SJ. The Braden Scale: A review of the research evidence. Orthop Nurs. 2004;23(1):30-8.
29. Moore Z, Cowman S. Risk assessment tools for the prevention of pressure ulcers. Cochrane Database of Systematic Reviews. 2008 Jul 16;(3):CD006471.
30. Thomas DR. Diseases of the skin: pressure ulcers. En: Bope & Kellerman. Conn’s: current therapy. Philadelphia: Saunders; 2013.
31. Velasco M. Aspectos diagnósticos y terapéuticos de las úlceras de las piernas. Actas Dermosifiliogr. 2011;102(10):780-90.
32. McInnes E, Jammali-Blasi A, Bell-Syer SEM, Dumville JC, Cullum N. Support surfaces for pressure ulcer prevention. Cochrane Database of Systematic Reviews. 2011, Apr 13;(4):CD00173.
33. Ho CH, Bogie K. The prevention and treatment of pressure ulcers. Phys Med Rehabil Clin N Am. 2007;18(2):235-53.
34. Millán Bustamante B, Hernández Cristóbal J, Vaduva RC. Prevención y tratamiento de las úlceras por presión: protocolos de práctica asistencial. Medicine. 2011;10(77):5259-63.
35. Sebern MD. Pressure ulcer management in home health care: efficacy and cost effectiveness of moisture vapor permeable dressing. Arch Phys Med Rehabil. 1986;67:726.
36. Schultz GS, Sibbald RG, Falanga V, et al. Wound bed preparation: a systematic approach to wound management. Wound Repair Regen. 2003 Mar;11 Suppl 1:S1-28.
37. CADIME. Tratamiento local de las úlceras de presión. Bol Ter Andal. 2000;(16):5.
38. Reddy M, Gill SS, Kalkar SR, et al. Treatment of pressure ulcers: a systematic review. JAMA. 2008;300:2647.
39. Stotts NA, Horng-Shiuann W. Hospital recovery is facilitated by prevention of pressure ulcers in older adults. Crit Care Nurs Clin N Am. 2007;19:269-75.
40. Panel for the Prediction and Prevention of Pressure Ulcers in Adults. Pressure ulcers in adults, prediction and prevention. Rockville (MD): Agency for Health Care Policy and Research, Public Health Service; 1992.
41. Levine SM, Sinno S, Levine JP, Saadeh PB. Current thoughts for the prevention and treatment of pressure ulcers: using the evidence to determine fact or fiction. Ann Surg. 2013;257:603.
42. Vermeulen H, van Hattem JM, Storm-Versloot MN, et al. Topical silver for treating infected wounds. Cochrane Database Syst Rev. 2007;44(5):531-3.
43. Staas WE Jr, Cioschi HM. Pressure sores, a multifaceted approach to prevention and treatment. West J Med. 1991;154:539-44.
44. Lykke Sørensen J, Jørgensen B, Gottrup F. Surgical treatment of pressure ulcers. Am J Surg. 2004;188 (Suppl):42S-51S.
45. Sarabia Lavín R, Rojo Santos E. Manejo de las lesiones por presión: best practice. Enferm Clin. 2010;20(2):136-8.
46. O’Meara S, Al-Kurdi D, Ovington L. Antibiotics and antiseptics for venous leg ulcers. Cochrane Database Syst Rev. 2010 Jan 20;(1):CD003557.
47. Breslow RA, Hallfrisch J, Guy DG, et al. The importance of dietary protein in healing pressure ulcers. J Am Geriatr Soc. 1993;41:357-62.
48. Thomas DR. Improving the outcome of pressure ulcers with nutritional intervention: a review of the evidence. Nutrition. 2001;17:121-5.
49. Smith ME, Totten A, Hickam DH, et al. Pressure ulcer treatment strategies: a systematic comparative effectiveness review. Ann Intern Med. 2013;159:39.
50. Dryburgh N, Smith F, Donaldson J, Mitchell M. Debridement for surgical wounds. Cochrane Database Syst Rev. 2008 Jul 16;(3):CD006214.
Como Citar
Hoyos Porto, S., García Arias, R. L., Chavarro-Carvajal, D. A., & Alberto Heredia, R. (2015). Úlceras por presión en pacientes hospitalizados. Universitas Medica, 56(3), 341–355. https://doi.org/10.11144/Javeriana.umed56-3.upph
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