Prevention and treatment of pressure ulcers in the surgical intensive care unit.
OBJECTIVE
To review recent work on pressure ulcer prevention and treatment in the intensive care unit within the context of previous work.


RESULTS
Although pressure ulcerations are an age-old and relatively common problem, their pathophysiology, risk factors for their development, and treatment options lack complete understanding. Most of the available literature is based on noncritical care patient clinical experience in noncritical care journals. Previous estimates of pressure ulcer underestimate the problem in high-acuity intensive care units. Available risk factors in previously validated tools may not be accurate in the intensive care unit patient population. However, the current literature provides an initial footing for intensivists to improve their pressure ulcer prevention and treatment methods that will become increasingly important for clinical certification as well as research.


CONCLUSIONS
Preventing and treating pressure ulcers will continue to be a troublesome problem for intensivists. Accurate assessments and comparisons remain problematic across a heterogeneous intensive care unit population. Risk stratification schema need tailoring to the problems of intensive care unit patients. Treatment modalities may not prevent all pressure ulcer development or extension. Available data support dedicated training of nurses and physicians to maximize local intensive care unit resources to minimize the impact of pressure ulceration.
Kirby
John P
JP
Washington University, St. Louis, Barnes-Jewish Hospital, St Louis, Missouri 63110, USA. kirbyj@wudosis.wustl.edu
Gunter
Oliver L
OL
D003422:Critical Care; D006801:Humans; D007362:Intensive Care Units; D003668:Pressure Ulcer / Q000517:prevention & control* / Q000628:therapy*