Article

Repositioning patients regularly to prevent pressure ulcers and reduce interface
pressures is the standard of care, yet prior work has found that standard
repositioning does not relieve all areas of at-risk tissue in nondisabled
subjects. To determine whether this holds true for high-risk patients, we
assessed the effectiveness of routine repositioning in relieving at-risk tissue
of the perisacral area using interface pressure mapping. Bedridden patients at
risk for pressure ulcer formation (n = 23, Braden score <18) had their perisacral
skin-bed interface pressures recorded every 30 s while they received routine
repositioning care for 4-6 h. All participants had specific skin areas (206 +/-
182 cm(2)) that exceeded elevated pressure thresholds for >95% of the observation
period. Thirteen participants were observed in three distinct positions (supine,
turned left, turned right), and all had specific skin areas (166 +/- 184 cm(2))
that exceeded pressure thresholds for >95% of the observation period. At-risk
patients have skin areas that are likely always at risk throughout their hospital
stay despite repositioning. Healthcare providers are unaware of the actual
tissue-relieving effectiveness (or lack thereof) of their repositioning
interventions, which may partially explain why pressure ulcer mitigation
strategies are not always successful. Relieving at-risk tissue is a necessary
part of pressure ulcer prevention, but the repositioning practice itself needs
improvement.

Langue : ANGLAIS