Intervenções aplicadas às lesões por pressão em pacientes hospitalizados: uma revisão Integrativa/ Interventions applied to pressure injuries in hospitalized patients: an integrative review
DOI:
https://doi.org/10.34119/bjhrv5n2-297Keywords:
adulto hospitalizado, úlcera de pressão, posicionamento funcional, posicionamento do paciente.Abstract
INTRODUÇÃO: As lesões por pressão (LPP) caracterizam-se pela lesão da pele e tecidos moles, resultante de pressão constante ou prolongada à pele. As LPP são um problema importante de saúde pública que afetam negativamente o orçamento e a qualidade de vida, impactando na morbidade e mortalidade de pacientes internados em hospitais. OBJETIVO: levantar e sintetizar estratégias de prevenção de LPP que vêm sendo trazidas pela literatura. METODOLOGIA: revisão integrativa da literatura realizada nas bases de dados PubMed, Scientific Electronic Library Online e Literatura Latino-Americana e do Caribe em Ciências da Saúde e Scopus por meio da estratégia PICOS com estudos publicados entre 2011 a 2021. RESULTADOS: As intervenções para o combate às LPP no paciente internado em hospitais e em unidade de terapia intensiva são diversas e variam desde o uso de colchões pneumáticos, curativos especializados e mudança de decúbito e podem ter vários aspectos que contribuem ou não à profilaxia de possíveis injúrias à pele. CONCLUSÃO: Existem várias estratégias no combate a LPP, incluindo uso de colchões, curativo, pomadas, mudança de decúbito e medidas educativas que se mostram efetivas na prevenção de LPP e que incluem a participação da equipe multiprofissional.
References
Zaidi SRH, Sharma S. Decubitus Ulcer. 2021 Aug 11. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 31971747. Avaiable: https://www.ncbi.nlm.nih.gov/books/NBK553107/
Edsberg LE, Black JM, Goldberg M, McNichol L, Moore L, Sieggreen M. Revised National Pressure Ulcer Advisory Panel Pressure Injury Staging System: Revised Pressure Injury Staging System. J Wound Ostomy Continence Nurs. 2016 Nov/Dec;43(6):585-597. doi: 10.1097/WON.0000000000000281. PMID: 27749790; PMCID: PMC5098472.
DicionárioMerriam-Webster. http://www.merriam-webster.com/dictionary/ulcer. Acessado em 21 de dezembro de 2021.
Bezerra SMG, Luz MHBA, Andrade EMLR, Araújo TME de, Teles JBM, Caliri MHL. Artigo Original 4 - Prevalência, Fatores Associados e Classificação de Úlcera por Pressão em Pacientes com Imobilidade Prolongada Assistidos na Estratégia Saúde da Família.
Bansal C, Scott R, Stewart D, Cockerell CJ. Decubitus ulcers: a review of the literature. Int J Dermatol. 2005 Oct;44(10):805-10.
Dittmer DK, Teasell R. Complications of immobilization and bed rest. Part 1: Musculoskeletal and cardiovascular complications. Can Fam Physician. 1993 Jun;39:1428-32, 1435-7. PMID: 8324411; PMCID: PMC2379624.
Labeau SO, Afonso E, Benbenishty J, Blackwood B, Boulanger C, Brett SJ, Calvino-Gunther S, Chaboyer W, Coyer F, Deschepper M, François G, Honore PM, Jankovic R, Khanna AK, Llaurado-Serra M, Lin F, Rose L, Rubulotta F, Saager L, Williams G, Blot SI; DecubICUs Study Team; European Society of Intensive Care Medicine (ESICM) Trials Group Collaborators. Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study. Intensive Care Med.
Feb;47(2):160-169. doi: 10.1007/s00134-020-06234-9. Epub 2020 Oct 9. Erratum in: Intensive Care Med. 2021 Apr;47(4):503-520. PMID: 33034686; PMCID: PMC7880913.
Lima Serrano M, González Méndez MI, Carrasco Cebollero FM, Lima Rodríguez JS. Risk factors for pressure ulcer development in Intensive Care Units: A systematic review. Med Intensiva. 2017 Aug-Sep;41(6):339-346. English, Spanish. doi: 10.1016/j.medin.2016.09.003. Epub 2016 Oct 22. PMID: 27780589.
Manzano F, Navarro MJ, Roldán D, Moral MA, Leyva I, Guerrero C, et al. Pressure ulcer incidence and risk factors in ventilated intensive care patients. J Crit Care. 2010;25:469---76
Kathirvel S, Kaur S, Dhillon MS, Singh A. Impact of structured educational interventions on the prevention of pressure ulcers in immobile orthopedic patients in India: A pragmatic randomized controlled trial. J Family Med Prim Care. 2021 Mar;10(3):1267-1274. doi: 10.4103/jfmpc.jfmpc_1436_20. Epub 2021 Apr 8. PMID: 34041164; PMCID: PMC8140256.
Oe M, Sasaki S, Shimura T, Takaki Y, Sanada H. Effects of Multilayer Silicone Foam Dressings for the Prevention of Pressure Ulcers in High-Risk Patients: A Randomized Clinical Trial. Adv Wound Care (New Rochelle). 2020 Dec;9(12):649-656. doi: 10.1089/wound.2019.1002. Epub 2020 Feb 4. PMID: 33124968; PMCID: PMC7698645.
Jiang Q, Liu Y, Yu H, Song S, Li G, Liu H, Zhou Y, Zhu Y, Jia J, Huang Y, Wang J. A Multicenter, Comparative Study of Two Pressure-Redistribution Mattresses with Repositioning Intervals for Critical Care Patients. Adv Skin Wound Care. 2020 Mar;33(3):1-9. doi: 10.1097/01.ASW.0000653160.13611.5d. PMID: 32058444.
da Silva Augusto F, Blanes L, Ping PZX, Saito CMM, Masako Ferreira L. Hydrocellular Foam Versus Hydrocolloid Plate in the Prevention of Pressure Injuries. Wounds. 2019 Aug;31(8):193-199. Epub 2019 May 31. PMID: 31184996.14
Nixon J, Brown S, Smith IL, McGinnis E, Vargas-Palacios A, Nelson EA, Brown J, Coleman S, Collier H, Fernandez C, Gilberts R, Henderson V, McCabe C, Muir D, Rutherford C, Stubbs N, Thorpe B, Wallner K, Walker K, Wilson L, Hulme C. Comparing alternating pressure mattresses and high-specification foam mattresses to prevent pressure ulcers in high-risk patients: the PRESSURE 2 RCT. Health Technol Assess. 2019 Sep;23(52):1-176. doi: 10.3310/hta23520. PMID: 31559948; PMCID: PMC6790649.
Hekmatpou D, Mehrabi F, Rahzani K, Aminiyan A. The effect of Aloe Vera gel on prevention of pressure ulcers in patients hospitalized in the orthopedic wards: a randomized triple-blind clinical trial. BMC Complement Altern Med. 2018 Sep 29;18(1):264. doi: 10.1186/s12906-018-2326-2. PMID: 30268162; PMCID: PMC6162886.
Forni C, D'Alessandro F, Gallerani P, et al. Effectiveness of using a new polyurethane foam multi-layer dressing in the sacral area to prevent the onset of pressure ulcer in the elderly with hip fractures: A pragmatic randomised controlled trial. Int Wound J. 2018;15(3):383-390. doi:10.1111/iwj.12875
Jafary M, Adibi H, Shayanfard K, Zohdi M, Godarzi Z, Yaseri M, Najafpour Z. Pressure Ulcer Rate in Multidisciplinary Hospital Units After Multifactorial Intervention: A Stepped-Wedge, Cluster Randomized Controlled Trial. J Patient Saf. 2018 Sep;14(3):e61-e66. doi: 10.1097/PTS.0000000000000518. PMID: 29985886.
Araya Farías I, Febré N. Impacto de un programa de gestión de riesgo en la tasa de úlceras por presión [Impact of interventions in the pressure ulcer rate]. Rev Calid Asist. 2017 Nov-Dec;32(6):322-327. Spanish. doi: 10.1016/j.cali.2017.10.003. Epub 2017 Nov 24. PMID: 29174626.
Park KH, Park J. The Efficacy of a Viscoelastic Foam Overlay on Prevention of Pressure Injury in Acutely Ill Patients: A Prospective Randomized Controlled Trial. J Wound Ostomy Continence Nurs. 2017 Sep/Oct;44(5):440-444. doi: 10.1097/WON.0000000000000359. PMID: 28877109.
Whitty JA, McInnes E, Bucknall T, Webster J, Gillespie BM, Banks M, Thalib L, Wallis M, Cumsille J, Roberts S, Chaboyer W. The cost-effectiveness of a patient centred pressure ulcer prevention care bundle: Findings from the INTACT cluster randomised trial. Int J Nurs Stud. 2017 Oct;75:35-42. doi: 10.1016/j.ijnurstu.2017.06.014. Epub 2017 Jun 27. PMID: 28711725.
Gunningberg L, Sedin IM, Andersson S, Pingel R. Pressure mapping to prevent pressure ulcers in a hospital setting: A pragmatic randomised controlled trial. Int J Nurs Stud. 2017 Jul;72:53-59. doi: 10.1016/j.ijnurstu.2017.04.007. Epub 2017 Apr 21. PMID: 28460263.
Kim RS, Mullins K. Preventing Facial Pressure Ulcers in Acute Respiratory Distress Syndrome (ARDS). J Wound Ostomy Continence Nurs. 2016 Jul-Aug;43(4):427-9. doi: 10.1097/WON.0000000000000247. PMID: 27391293.
Powers J. Two Methods for Turning and Positioning and the Effect on Pressure Ulcer Development: A Comparison Cohort Study. J Wound Ostomy Continence Nurs. 2016 Jan-Feb;43(1):46-50. doi: 10.1097/WON.0000000000000198. PMID: 26727682.
Ozyurek P, Yavuz M. Prevention of pressure ulcers in the intensive care unit: a randomized trial of 2 viscoelastic foam support surfaces. Clin Nurse Spec. 2015 Jul-Aug;29(4):210-7. doi: 10.1097/NUR.0000000000000136. PMID: 26053604.
Santamaria N, Gerdtz M, Sage S, McCann J, Freeman A, Vassiliou T, De Vincentis S, Ng AW, Manias E, Liu W, Knott J. A randomised controlled trial of the effectiveness of soft silicone multi-layered foam dressings in the prevention of sacral and heel pressure ulcers in trauma and critically ill patients: the border trial. Int Wound J. 2015 Jun;12(3):302-8. doi: 10.1111/iwj.12101. Epub 2013 May 27. PMID: 23711244; PMCID: PMC7950350.
COSTA, Ana Carolina Oliveira et al . Úlcera por presión: incidencia y factores demográficos, clínicos y nutricionales asociados en pacientes de una unidad de cuidados intensivos. Nutr. Hosp., Madrid , v. 32, n. 5, p. 2242-2252, nov. 2015 .
Manzano F, Colmenero M, Pérez-Pérez AM, Roldán D, Jiménez-Quintana Mdel M, Mañas MR, Sánchez-Moya MA, Guerrero C, Moral-Marfil MÁ, Sánchez-Cantalejo E, Fernández-Mondéjar E. Comparison of two repositioning schedules for the prevention of pressure ulcers in patients on mechanical ventilation with alternating pressure air mattresses. Intensive Care Med. 2014 Nov;40(11):1679-87. doi: 10.1007/s00134-014-3424-3. Epub 2014 Sep 5. PMID: 25189288.
Hartigan I, Murphy S, Hickey M. Older adults' knowledge of pressure ulcer prevention: a prospective quasi-experimental study. Int J Older People Nurs. 2012 Sep;7(3):208-18. doi: 10.1111/j.1748-3743.2011.00274.x. Epub 2011 Apr 19. PMID: 21631885.
Fernandes NCS, Torres GV, Vieira D. Fatores de risco e condições predisponentes para úlcera de pressão em pacientes de terapia intensiva. Rev Eletr Enf 2008, 10(3): 733-46.
