Monitorization of pressure ulcers in a critical care Unit
Esperón Güimil J.A., Angueira Castelo C., Escudero Quiñones A.I., Ocampo Piñeiro A., Pérez Jiménez J.M., Poceiro Salgado S.M., Vilas Pastoriza Mª.D.

SUMMARY

   Introduction: Pressure ulcers (PU) are an indicator of poor assistance quality. Patients in units of intensive care present a considerable number of risk factors of suffering UPP, in fact, these units are among with a higher of incidence of Pus.

   Objectives: To determine the prevalence of PUs and the type of patient who develops PUs.

   Material and methods: Prospective study of prevalence. Dependent variables: no. of PUs (no. of PUs, excluding iatrogenic ones); no. of IPUs (no. of iatrogenic PU) and no. of TPUs (no. of PUs + no. of IPUs). Independent variables: sex, age, diagnostic, risk Nova 4, stadiums, Index of severity, localizations, dates of registration of the UPP, preventive measures. Analysis: statistical package G-Stat 2.0. Descriptive: mean and standard desviation; relative and absolute frequencies. Inferential: T-Student, ANOVA, linear regression model. Statistical significance: p< 0,05; IC 95%.

   Results: PUs prevalenc: 12,7%; IPUs prevalence: 6,8%. 142 PUs registered, 45 of them of iatrogenic origin. More frequent localizations: sacrum and heels and nose, lips, ears for the iatrogenic ones. Causal factors of IPU: 49% were caused by endotraqueal tube and fixation system; 42% by nasogastric tube. The highest number of lesions was registered in surgical patients. Average patient: male, 63 years old, surgical diagnosis, high risk of suffering PU. A statistically significant association could only be established between the no. of PUs and the use of special surfaces for the handling of the pressure (S.D.: -0,553; 95% CI: -1,089, -0,017), p= 0, 04.

   Discussion: An important factor in the appearance of the PUs appears to be iatrogenic causes. To classify patients according to their risk of suffering PUs, it is critical to carry out a continuous assessment. The use of special surfaces for the handling of the pressure has a positive influence in the mean number of PUs patients present.

KEY WORDS

   Pressure ulcer, intensive care, critical care, incidence, prevalence, epidemiology.

Vol. 18 nº3-2007