Controversies in the prevention and treatment of pressure sores

Author : Marcus E.L,

Source : Clinical Geriatrics, vol.5, No. 10, pp. 39-45

Date : 01/09/1997

Authors: Marcus, E.L., Clarfield, A.M. Abstract Pressure ulcelrs occur commonly in the frail elderly. The prevalence of these sores in hospitalized patients range from 3 to 11%. Seventeen to 35% of patients admitted to a nursing home have pressure ulcers, and most of those patients are transferred from acute care hospitals. The prevalence rate among nursing home residents range from 7 to 23%. Over the past few years, two clinical practice guidelines, one regarding prediction and prevention and the other relating to therapy of pressure ulcers have been published by the Agency for Health Care Policy and Research (AHCPR) in the United States. These guidelines were developed by a multidisciplinary panel of experts that critically reviewed the relevant litterature and offered recommendations accordingly. The panel assigned each recommendation a rating of A,B or C to indicate the strength of the supporting evidence. The ratings were based on the following criteria: A. Results of two more randomized controlled clinical trials in humans provide support; B. Results of two or more controlled clinical trials in an animal model provide indirect support; and C. One or more of the following: results of one controlled trial; results of at least two case series/descriptive studies on pressure ulcers in humans; or expret opinion. Because many reviews on pressure sores in the elderly have already been published, this article focuses on several controversial issues that have been raised in the last few years.