title: Management and treatment of decubital ulcers of an elderly population in the assisted sanitary residence of Futura-Viagrande (Catania, Sicily, Italy).
abstract: Decubital lesions indicate the gravity of the pathologies of the elderly patients, representing a serious cause of disability and of mortality. The present study was aimed at evaluating the decubital lesions during 1 year of treatment in an assisted sanitary residence (abbreviated as RSA from the Italian name), through observations of the assistential and therapeutical outcomes, aimed at improving the quality of life of the recovered elderly patients. We had 131 patients involved from a total of 308 recovered patients in the RSA. Their mean age was 83.4+/-1.3 years (74 women and 57 men). All cases were treated, considering the actual clinical stages, according to the advanced protocols on the basis of the guidelines of the National Pressure Ulcer Advisory Panel (NPUAP). All patients were evaluated by using the Braden-scale at the start and after 30 days for having a risk for the development of decubital ulcers and also for monitoring the modifications during the therapy, while the improvements were evaluated only clinically, establishing the reduction of the stage of the lesions. A precise analysis of the data revealed a higher prevalence of decubital lesions at the entrance to the RSA, particularly the advanced Grades III and IV (84 patients, 27% of all recovered subjects), compared to those with lower gravity Grades I and II (47 cases, 15% of all recovered subjects). Complete healing was observed only in a few cases (18.0%), mainly in the lower grades. Applying the therapeutic methods and protocols of NPUAP, most of the ulcers displayed an improving tendency. We had only a few mortal cases due to the ulcers (3 deaths of 131 patients), nevertheless, numerous death cases for other causes occurred among the patients, having advanced grades of ulcers (12%). Our data confirm the statement that the decubital ulcers represent the marker of severity of the polypathological state of the fragile elderly patients.
authors.affiliation: Dipartimento Scienze della Senescenza, Urologiche e Neurourologiche Scuola di Specializzazione in Geriatria, Universita di Catania, Via Messina 829, I-95126 Catania, Italy. ninosantangelo@virgilio.it
authors.forename: Antonino
authors.initials: A
authors.lastname: Santangelo
authors.forename: Manuela
authors.initials: M
authors.lastname: Testaì
authors.forename: Mosè Cirino
authors.initials: MC
authors.lastname: Ossino
authors.forename: Patrizia
authors.initials: P
authors.lastname: Barbagallo
authors.forename: Cristiano
authors.initials: C
authors.lastname: Crisafulli
authors.forename: Giuliana
authors.initials: G
authors.lastname: Muscarà
authors.forename: Marcello
authors.initials: M
authors.lastname: Tomarchio
authors.forename: Domenico
authors.initials: D
authors.lastname: Maugeri
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D003668:Pressure Ulcer / Q000453:epidemiology* / Q000401:mortality; D015995:Prevalence; D012307:Risk Factors; D012802:Sicily / Q000453:epidemiology