Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-28T09:44:13.487Z Has data issue: false hasContentIssue false

Infected Pressure Ulcers in the Long-Term–Care Facility

Published online by Cambridge University Press:  02 January 2015

Philip W. Smith*
Affiliation:
Departments of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska
Joyce M. Black
Affiliation:
Departments of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska The College of Nursing, University of Nebraska Medical Center, Omaha, Nebraska
Steven B. Black
Affiliation:
Nebraska Health System, Omaha, Nebraska
*
Department of Internal Medicine, University of Nebraska Medical Center, 985400 Nebraska Medical Center, Omaha, NE 68198-5400

Abstract

Pressure ulcers occur with some frequency in the elderly, debilitated population in long-term–care facilities. Pressure ulcers cause morbidity and mortality and, by virtue of breaking the integumentary barrier, predispose to skin and soft-tissue infections. The latter often are deep and require lengthy medical and surgical therapy. Prevention depends on avoidance of pressure, as well as providing adequate nutrition and meticulous skin care.

Type
Topics in Long-Term Care
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Bergstrom, N, Allman, RM, Carlson, CE, Eaglstein, W, Franz, RA, Garber, SL, et al. Pressure ulcers in adults: prediction and prevention. Quick Reference Guide for Clinicians. Washington, DC: US Dept of Health & Human Services, Public Health Service; 1992.Google Scholar
2. Young, L. Pressure ulcer prevalence and associated patient characteristics in one long-term care facility. Decubitus 1989;2:5254.Google Scholar
3. Brandeis, GH, Morris, JN, Nash, DJ, Lipsitz, LA. The epidemiology and natural history of pressure ulcers in elderly nursing home residents. JAMA 1990;264:29052909.Google Scholar
4. Langemo, DK, Olson, B, Hunter, S, Hanson, D, Burd, C, Cathcart-Silverberg, T. Incidence of pressure sores in acute care, rehabilitation, extended care, home health and hospice in one locale. Decubitus 1991;2:4244.Google Scholar
5. Smith, DM. Pressure ulcers in the nursing home. Ann Intern Med 1995;123:433442.Google Scholar
6. Brandeis, GH, Berlowitz, DR, Hossain, M, Morris, JN. Pressure ulcers: the minimum data set and the resident assessment protocol. Advances in Wound Care 1995;8:1825.Google Scholar
7. Brandeis, GH, Ooi, WL, Hossain, M, Morris, JN, Lipsitz, LA. A longitudinal study of risk factors associated with the formation of pressure ulcers in nursing homes. J Am Geriatr Soc 1994;42:388393.Google Scholar
8. Allman, RM, Damiano, AM, Strauss, MJ. Pressure ulcer status and post-discharge health care resource utilization among older adults with activity limitations. Advances in Wound Care 1996;9:3844.Google Scholar
9. Brandeis, GH, Morris, JN, Lipsitz, LA, Nash, DJ. Correlates of pressure sores in the nursing home. Decubitus 1989;2:60.Google Scholar
10. Garibaldi, RA, Brodine, S, Matsumiya, S. Infections among patients in nursing homes—policies, prevalence and problems. N Engl J Med 1981;305:731735.Google Scholar
11. Seda, R, Serventi, I, Lorenz, P. Nosocomial infections among patients in a long-term care facility: spectrum, prevalence and risk factors. Am J Infect Control 1985;13:5762.Google Scholar
12. Scheckler, WE, Peterson, PJ. Infections and infection control among residents of eight rural Wisconsin nursing homes. Arch Intern Med 1986;146:19811984.CrossRefGoogle ScholarPubMed
13. Smith, PW. Approach to nursing home patients with skin and soft tissue infections. In: Duma, RJ, ed. Recognition and Management of Nursing Home Infections. Bethesda, MD: National Foundation for Infectious Diseases; 1992.Google Scholar
14. Miller, H, Delozier, J. Cost implications of the pressure ulcer treatment guideline. Washington, DC: Center for Health Policy Studies; 1994.Google Scholar
15. Alman, RM. Pressure ulcers among the elderly. N Engl J Med 1989;320:850853.Google Scholar
16. Black, JM, Black, SB. Pressure ulcers. In: Smith, PW, ed. Infection Control in Long Term Care Facilities. 2nd ed. Albany, NY: Delmar Publishers; 1994.Google Scholar
17. Spector, WD. Correlates of pressure ulcers in nursing homes: evidence from the National Medical Expenditure Survey. J Invest Dermatol 1994;102:42s45s.Google Scholar
18. Sugarman, B, Hawes, S, Musher, DM, Klima, M, Young, EJ, Pircher, F. Osteomyelitis beneath pressure sores. Arch Intern Med 1983;143:683688.Google Scholar
19. Galpin, JE, Chow, AW, Bayer, AS, Guze, LB. Sepsis associated with decubitus ulcers. Am J Med 1976;61:346350.Google Scholar
20. Bryan, CS, Dew, CE, Reynolds, KL. Bacteremia associated with decubitus ulcers. Arch Intern Med 1983;143:20932095.Google Scholar
21. Ruler, JB, Cooney, TG. The pressure sore: pathophysiology and principles of management Ann Intern Med 1981;94:661666.Google Scholar
22. Chow, AW, Burdg, DR. Pressure sores. In: Gleckman, RA Gantz, NM, eds. Infections in the Elderly. Boston, MA Little Brown & Co; 1993.Google Scholar
23. McGeer, A Campbell, B, Emori, T, Hierholzer, WJ, Jackson, MM, Nicolle, LE, et al. Definitions of infection for surveillance in long-term care facilities. Am J Infect Control 1991;19:17.Google Scholar
24. Abbasi, AA, Rudman, D. Under-nutrition in the nursing home: prevalence, consequences, causes and prevention. NutrRev 1994;52:113122.Google Scholar
25. Davies, AD, Snaith, PA. Mealtime problems in a continuing care hospital for the elderly. Age Ageing 1980;9:100105.Google Scholar
26. Breslow, RA Hallfrisch, J, Goldberg, AP Malnutrition in tube fed nursing home patients with pressure sores. J Parenteral and Enteral Nutrition 1991;15:663668.Google Scholar
27. Breslow, PA, Hallfrisch, J, Guy, DG, Crawley, B, Goldberg, AP. The importance of dietary protein in healing pressure ulcers. J Am Geriatr Soc 1993;41:357362.Google Scholar
28. Allman, RM, Walker, JM, Hart, MK Laprade, CA Noel, LP, Smith, CR. Air-fluidized beds or conventional therapy for pressure sores. Ann Intern Med 1987;107:641648.CrossRefGoogle ScholarPubMed
29. Ferrell, BA Osterweil, D, Christenson, P. A randomized trial of low-air-loss beds for the treatment of pressure ulcers. JAMA 1993;269:494497.Google Scholar
30. Bennett, RG, Bellantoni, MF, Ouslander, JG. Air-fluidized bed treatment of nursing home patients with pressure sores. J Am Geriatr Soc 1989;37:235242.CrossRefGoogle ScholarPubMed
31. Xakellis, GC, Chrischffles, EA. Hydrocolloid versus saline gauze dressings in treating pressure ulcers: a cost effectiveness analysis. Arch Phys MedRehabil 1992;73:463469.Google Scholar
32. Johnson, AR, White, AC, McAnalley, B. Comparison of common topical agents for wound treatment: cytotoxicity for human fibroblasts in culture. Wounds—A Compendium of Clinical Research and Practice 1989;1:186192.Google Scholar
33. Alvarez, OH, Mertz, PM, Eaglstein, WH. The effect of occulsive dressings on collagen synthesis and epifhelialization in superficial wounds. J Surg Res 1983;149:110.Google Scholar
34. Hornmark, AM, Fall, PA Under, L, Bergstrand, B, Ehrenbo, M, Madsen, SM, et al. Care of pressure ulcers: a controlled study of the use of hydro-colloid dressing compared with wet saline gauze compresses. Acta Derm Venereol Suppl (Stockh) 1989;149:110.Google Scholar
35. Fneill, KM, Conflitti, C, Kedas, A Bums, JF. Pressure sore response to a new hydrocolloid dressing. Wounds—A Compendium of Clinical Research and Practice 1989;1:173185.Google Scholar