Characteristics of Recurrent Pressure Ulcers in Veterans With Spinal Cord Injury
Characteristics of Recurrent Pressure Ulcers in Veterans With Spinal Cord Injury
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DOI：
10.1080/10790268.2009.11760750
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发表时间：
2009-02-01
影响因子：
1.7
通讯作者：
Burns, Stephen P.
中科院分区：
文献类型：
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作者：
Bates-Jensen, Barbara M.;Guihan, Marylou;Burns, Stephen P.
背景/目的：探讨退伍军人脊髓损伤（SCI）复发性压疮（PrUs）的特点。设计：描述性队列研究。环境和参与者：来自退伍军人事务部6个脊髓损伤中心的24名脊髓损伤退伍军人。方法：对24例退伍军人9个月内29例复发性pru进行前瞻性研究。另外还分析了15名接受住院治疗的退伍军人的回顾性医疗记录数据。结果：参与者为男性，50%为非西班牙裔白人，截瘫（63%），完全性脊髓损伤（83%），平均年龄56岁，脊髓损伤后平均时间21年。大多数PrUs复发（63%,n = 15例）在与最近溃疡相同的位置和坐骨结节（63%）。平均复发时间为16.6周。pru为III期（28%,n = 8）或IV期（45%,n = 13），伴有破坏（48%）、坏死脱落（50%）和少量渗出。三分之一（n = 9）大于16厘米(2)。平均Bates-Jensen伤口评估工具评分为33.63。住院医疗记录数据（n = 15）显示，73%的患者使用抗生素治疗感染（53%,n = 8），骨髓炎（47%,n = 7）和/或蜂窝组织炎（13%,n = 2）。67%的人接受整形手术咨询，73%的人选择手术（1人没有咨询）。计划重新定位的记录占21%。结论：pru大多严重，位于同一解剖部位，并在4个月内复发，提示复发的溃疡更可能是初始pru愈合不完全。这个脊髓损伤退伍军人的样本提供了复发性PrU特征的早期数据。
Background/Objective: To describe characteristics of recurrent pressure ulcers (PrUs) in veterans with spinal cord injury (SCI).Design: Descriptive, cohort study.Settings and Participants: Twenty-four veterans with SCI from 6 SCI centers in the Department of Veterans Affairs.Methods: Data from a prospective study evaluating PrUs were analyzed for 24 veterans with 29 recurrent PrUs during 9 months. Additional retrospective medical record data were analyzed for 15 veterans who received inpatient treatment.Results: Participants were male, 50% non-Hispanic white, with paraplegia (63%), complete SCI (83%), a mean age of 56 years, and mean time since SCI of 21 years. Most PrUs recurred (63%, n = 15 patients) in the same location as the most recent ulcer and at the ischial tuberosities (63%). Mean time to recurrence was 16.6 weeks. PrUs were stage III (28%, n = 8) or IV (45%, n = 13) with undermining (48%), necrotic slough (50%), and minimal exudate. One third were (n = 9) larger than 16 cm(2). Mean Bates-Jensen Wound Assessment Tool Score was 33.63. Inpatient medical record data (n = 15) showed 73% with documentation indicating infection treated with antibiotics (53%, n = 8 patients), osteomyelitis (47%, n = 7), and/or cellulitis (13%, n = 2) noted. Plastic surgery consultation was obtained for 67% with surgery as an option for 73% (1 without consultation). Scheduled repositioning was documented for 21%.Conclusions: Most PrUs were severe, located at the same anatomic site, and recurred within 4 months, suggesting that the recurrent ulcers were more likely incomplete healing of the initial PrUs. This sample of veterans with SCI provides early data on recurrent PrU characteristics.