The incidence of pressure ulcers after the implementation of a prevention protocol

Even in the present, pressure ulcers still represent a severe health problem, particularly in Intensive Care Units (ICU). This study assesses the implementation of a protocol to prevent pressure ulcers in ICU inpatients. This prospective, descriptive and exploratory study verifies the incidence of pressure ulcers following the implementation of a prevention protocol. Data were collected from April 17th to July 15th 2009. The incidence observed in this study (23.1%) was below that reported in a similar study developed in the same institution (41.02%) before the implementation of the protocols to assess risk and prevent pressure ulcers. The prevention protocols are essential tools that have an impact on controlling the incidence of pressure ulcers, when used consistently.

Assessment of functional capacity of the elderly associated with the risk for pressure ulcer

OBJECTIVE: To characterize the elderly with physical limitations; to assess functional capacity as it relates to physical mobility, cognitive status and level of functional independence in activities of daily living, and to relate functional capacity to the risk for pressure ulcers. METHODS: A quantitative cross-sectional approach, conducted in households in the city of João Pessoa (PB) with seniors who presented physical limitation. Fifty-one elderly were investigated in a two-stage cluster sampling design. RESULTS: There was evidence of impairments in functional capacity of the elderly aged 80 years or more, with more severe physical limitations, cognitive impairment and a higher level of dependency for activities. Significant differences were observed between the level of functional independence in performing activities of daily living and the risk of pressure ulcers. CONCLUSION: This study allowed for the identification of the elderly in functional decline and at risk for developing pressure ulcers, supporting the implementation of preventive actions at the household level.

In Vitro Analysis of Bacterial Morphology by Atomic Force Microscopy of Low Level Laser Therapy 660, 830 and 904 nm

Objective: The objective of this study was to analyze the bacterial morphology by atomic force microscopy (AFM) after the application of low-level laser therapy (LLLT) in in vitro culture of Staphylococcus aureus ATCC 29213. Background data: Infections caused by S. aureus are among the highest occurring in hospitals and can often colonize pressure ulcers. LLLT is among the methods used to accelerate the healing of ulcers. However, there is no consensus on its effect on bacteria. Materials and methods: After being cultivated and seeded, the cultures were irradiated using wavelengths of 660, 830, and 904 nm at fluences of 0, 1, 2, 3, 4, 5, and 16 J/cm(2). Viable cells of S. aureus strain were counted after 24 h incubation. To analyze the occurrence of morphological changes, the topographical measurement of bacterial cells was analyzed using the AFM. Results: The overall assessment revealed that the laser irradiation reduced the S. aureus growth using 830 and 904 nm wavelengths; the latter with the greatest inhibition of the colony-forming units (CFU/mL) (331.1 +/- 38.19 and 137.38 +/- 21.72). Specifically with 660 nm, the statistical difference occurred only at a fluence of 3 J/cm(2). Topographical analysis showed small changes in morphological conformity of the samples tested. Conclusions: LLLT reduced the growth of S. aureus with 830 and 904 nm wavelengths, particularly with 904 nm at a fluence of 3 J/cm(2), where the greatest topographical changes of the cell structure occurred.

Ocorrência de úlcera por pressão em pacientes submetidos a cirurgias eletivas

OBJETIVO: Identificar a ocorrência de úlcera por pressão em pacientes submetidos a cirurgias eletivas de porte II, III e IV. MÉTODOS: Estudo de abordagem quantitativa, com delineamento de pesquisa não experimental, tipo descritivo e prospectivo. A amostra foi composta por 148 pacientes adultos, de ambos os gêneros, submetidos à cirurgia eletiva, conforme os critérios de seleção determinados previamente. RESULTADOS: Da amostra avaliada, 108 pacientes receberam alta hospitalar, três faleceram e 37 desenvolveram úlceras por pressão. Esses pacientes apresentaram 44 lesões, sendo a maioria diagnosticada de estágio II (56,8%), seguida por lesões de estágio I (40,9%) e estágio III (2,3%). As áreas corporais mais acometidas foram a região sacro/glútea (68,2%), calcâneos (18,1%), região dorsal (9%) e o pavilhão auricular (4,6%). CONCLUSÃO: A ocorrência de úlcera por pressão foi de 25% indicando a necessidade de implementação de intervenções efetivas para a prevenção desse evento adverso no perioperatório.