Not just "bed sores": Researchers expose risk of pressure ulcers

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Not just "bed sores": Researchers expose risk of pressure ulcers

Hospital patients undergoing surgery for more than three hours face a clear risk of developing potentially fatal pressure ulcers, warn leading medical experts who said this is a major "underreported problem."

Each year more than 1.5 million hospitalized patients develop pressure ulcers (also known as bed sores), resulting in 60,000 deaths at an estimated annual cost approaching $10 billion to the nation's health care system.

Although pressure ulcers are a problem commonly linked to nursing homes, they pose a serious risk to an otherwise healthy patient undergoing a conventional surgical procedure, according to the studies presented at the First Annual Symposium on Operating Room-Acquired Pressure Ulcers.

Research findings presented during the symposium indicated that up to one fourth of all pressure ulcers in hospitalized patients begin in the operating room.

Moreover, about one in 12 individuals undergoing surgeries lasting more than three hours will develop pressure ulcers within four days of their operation. Coronary artery bypass patients and patients with vascular disease and poor circulation are especially at risk since their surgeries may take up to five hours to perform.

"The lesion may not be apparent immediately following surgery, yet the patient has suffered irreversible tissue damage while in the operating room," said Sharon Aronovitch, Ph.D., R.N., C.E.T.N., a consultant for education at Regents College, New York. "Because pressure ulcers may not develop into serious sores until days after surgery, the connection back to the operating room is difficult to establish. As a result, the occurrence of OR-acquired pressure ulcers is often underreported."

Surgical patients are subject to prolonged immobility, which results in unrelieved pressure and impaired blood flow to the skin. Because of anesthesia, they are unable to perceive discomfort or reposition themselves. The unrelieved pressure, particularly at bony prominences, can disrupt blood flow and cause irreversible soft-tissue damage.

"Most people are not aware of the severity of OR-acquired pressure ulcers and the great need for preventative measures," said James Ramsay, M.D., director of critical care service and associate professor of anesthesiology in the cardiothoracic division, Emory University Hospital in Atlanta. "These ulcers are not simple bruises. Patients suffer severe physical pain and, for those afflicted with a high degree of tissue damage, these wounds can potentially lead to fatal infections."

SOURCE: "Researchers Expose Hidden Risk of Pressure Ulcers in the Operating Room," Media Advisory, Versaggi Biocommunications, March 11, 1998.

The Chiropractic Journal.

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