Document Detail

Skin alterations of intact skin and risk factors associated with pressure ulcer development in surgical patients: a cohort study.
MedLine Citation:
PMID:  16631178     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The pathology literature suggests three types of pressure ulcer with six possible mechanisms leading to tissue breakdown. A limitation of current evidence is the difficulty in replicating the clinical situation and in determining the point at which a tissue assault becomes irreversible and results in tissue breakdown. In particular clinical observations of alteration in darkly pigmented skin, blanching erythema, non-blanching erythema and non-blanching erythema with other skin changes including induration, oedema, pain, warmth or discolouration have not been assessed in relation to subsequent skin/tissue loss and their pathophysiological and aetiological importance is not fully understood. OBJECTIVES: To assess the validity of clinical signs of erythema as predictors of pressure ulcer development and identify variables which independently are predictive of Grade 2 pressure ulcer development. DESIGN: Prospective cohort study. PARTICIPANTS: 109 general, vascular and orthopaedic hospital patients, aged over 55 years with an expected length of stay of 5 days were recruited. Of these 97 were pressure ulcer free at baseline and/or had complete follow-up including 59 women and 38 men with a median age of 75 years (range 55-95). SETTING: Single centre large acute UK NHS hospital. METHODS: To identify clinical signs of erythema predictive of skin loss, the odds of pressure ulcer development were examined using logistic regression. To identify variables independently predictive of Grade 2 pressure ulcer development logistic regression modeling was undertaken. RESULTS: There was significantly increased odds of pressure ulcer development associated with non-blanching erythema (7.98, p=0.002) and non-blanching erythema with other skin changes (9.17, p=0.035). Logistic regression modeling identified non-blanching erythema, pre-operative albumin, weight loss, and intra-operative minimum diastolic blood pressure, as independent predictors of Grade > or =2 pressure ulcer development. CONCLUSIONS: Non-blanching erythema with or without other skin changes is distinct from normal skin/blanching erythema and is associated with subsequent pressure ulcer development.
Jane Nixon; Gillian Cranny; Senga Bond
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Validation Studies     Date:  2006-04-24
Journal Detail:
Title:  International journal of nursing studies     Volume:  44     ISSN:  0020-7489     ISO Abbreviation:  Int J Nurs Stud     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-06-15     Completed Date:  2007-08-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0400675     Medline TA:  Int J Nurs Stud     Country:  England    
Other Details:
Languages:  eng     Pagination:  655-63     Citation Subset:  IM; N    
Clinical Trials Research Unit, University of Leeds, 17 Springfield Mount, Leeds LS2 9NG, UK.
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MeSH Terms
England / epidemiology
Erythema / complications*,  diagnosis,  physiopathology
Factor Analysis, Statistical
Hospitals, University
Logistic Models
Middle Aged
Mobility Limitation
Multivariate Analysis
Nursing Assessment / methods*,  standards
Nursing Evaluation Research
Nutritional Status
Odds Ratio
Postoperative Complications / epidemiology,  etiology*
Predictive Value of Tests
Pressure Ulcer / epidemiology,  etiology*
Prospective Studies
Risk Assessment / methods*,  standards
Risk Factors
Severity of Illness Index

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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