PRESSURE ULCERS IN THE ELDERLY

Pressure ulcers are areas of damaged skin caused by staying in one position for too long time. Commonly form where bones are closer to the skin, shuch as the ankles, heels and hips.

They are more frequent as age advances, by increased fragility and immobility in older people. Given their frequency of apperance in the geriatric and prognostic significance in this age group, has come regarded as a geriatric syndrome.

It is considered that 95% of pressure ulcers are preventable, using simple techniques such as postural changes and the exquisite care of skin and general condition of the patient. Once appeared ulcer healing can be long and cause significant morbidity, and major expense of health resources.

The most common site of pressure ulcers are the sacrum and the buttocks, heels, elbows, shoulder blades, shoulders and occipital.

They are classified into four grade levels, grade four is the most serius, because it destroys all the tissue to the bone.

As the lesion depth increases, increases healing time.

RISK FACTORS

The main cause of the occurrence of pressure ulcers is the same pressure to cause the closure of capillaries, reducing the supply of oxygen to tissues. However, there are a number of situations or risk factors that increase the likelihood of developing ulcers favorable situation.

The factors that contribute to the production of pressure ulcers can be grouped in this groups:

Pathophysiological

- Skin lesions

- Disorder in the transport of oxygen

- Nutritional deficiencies (default or excess)

- Immune disorders

- Altered state of consciousness

- Motor impairments

- Sensory impairments

Derivatives of treatment:

- Immobility imposed

- Treatments or immunosuppressive drugs

- Sedatives

- Drilling and vascular pathways

Situation:

- Immobility

- By rubbing effect of both clothing and other objects

Derivatives of the environment:

- Lack of health education for caregivers of dependents, infrequent changes of position, wet diaper too long, etc..

- Mattresses and seat cushions are too hard or too soft, easy to crush and become hard.

- Praxis poor by health teams.

All patients who are considered at risk of developing pressure ulcers should have a written care plan personalized prevention and a holistic approach that values ​​both the skin and the nutrition and hydration of the patient.

Regarding the treatment of ulcerative lesion, it must be individualized according to the degree of depth of exudate, presence or absence of infection and location.

CONCLUSION:Approximately up to 95% of pressure ulcers are preventable, so the need for prevention is a top priority, rather than focusing only on the treatment of established ulcers.

BIBLIOGRAPHY:

Baranoski S. Pressure ulcers: A renewerd awareness. 2006; 36(8):36-42

Zamora Sánchez Juan José. Conocimiento y uso de las directrices de prevención y tratamiento de las úlceras por presión en un hospital de agudos. Gerokomos [revista en Internet]. 2006 Jun[citado 2012 Mayo 23]; 17(2): 51-61. Disponible en: 
http://scielo.iscii.es/scielo.php?script=sci_arttext&pid=S1134-928X2006000200006&Ing=es.