Cervical collar-related pressure ulcers in trauma patients in intensive care unit.
BACKGROUND
The application of a cervical collar (C-collar) in trauma patients can be life-saving. Previous studies, however, describe development of pressure ulcers related to C-collars.


OBJECTIVE
To retrospectively compare collar-related pressure ulcers (CRPUs) occurring in trauma patients admitted to the intensive care unit wearing a C-collar before and after implementation of preventive interventions and to identify risk factors for CRPU development.


METHODS
Retrospective chart review of 88 trauma patients admitted to the intensive care unit before (2006) and after (2008) implementation of preventive interventions; early C-collar removal (<24 hours) and an occipital foam ring. Data were collected in the first 14 days of admission on pressure ulcer incidence, risk factors, and preventive interventions.


RESULTS
The incidence of CRPUs was 1.1%. Although risk factors were present in the sample, it was impossible to identify significant risk factors for CRPU development and explore the effect of preventive interventions.


CONCLUSIONS
The incidence of CRPUs in this study was low. CRPUs, however, should never be accepted as an inevitable complication of cervical immobilization. To identify trauma patients at risk and to apply effective preventive interventions for CRPU development, further research is needed.
University Medical Center, Utrecht, the Netherlands (Ms Ham); Nursing Science, Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands (Dr Schoonhoven); Elmhurst Hospital Center, Elmhurst, New York (Ms Galer); and Department of Graduate Studies, Lienhard School of Nursing, Pace University, New York (Prof Shortridge-Baggett).
H W Wietske
HW
Ham
L Lisette
LL
Schoonhoven
A Anju
AA
Galer
L Lillie M
LL
Shortridge-Baggett
D000293:Adolescent; D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000293:injuries; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007103:Immobilization / Q000295:instrumentation*; D015994:Incidence; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D009519:New York City; D009989:Orthotic Devices / Q000009:adverse effects*; D003668:Pressure Ulcer / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment; D013124:Spinal Injuries / Q000175:diagnosis / Q000628:therapy*; D014193:Trauma Centers; D014947:Wounds and Injuries / Q000451:nursing; D055815:Young Adult