Bell Mary Ann
VA Texas Valley Coastal Bend Health Care System, Harlingen, Texas, USA.
Ostomy Wound Manage. 2010 Dec;56(12):36-9.
Medical devices often are overlooked as a potential cause of pressure ulcers. Indwelling urinary catheters have been described as a cause of urethral erosion. In men, the resultant partial-thickness or full-thickness wound can involve a small area of the glans penis or cleave the glans or penile shaft, requiring reconstructive surgery or urinary diversion. During a 3-month period, four elderly men, all residing in one unit of a long-term care facility, were referred to the wound specialist for erosive urethral injuries. All were observed to have a history of improper securement of a rigid style silicone catheter. As part of creating a latex-free environment, the facility had recently replaced the (softer) latex-containing catheters with new silicone catheters. In addition to providing meticulous catheter care and comfort measures for the patients, all securement procedures were reviewed and different silicone catheters were evaluated for their potential to cause pressure ulcers. This case series highlights the importance of careful evaluation of catheter materials and securement devices before selecting them for widespread patient use and emphasizes the need for research focused on catheter composition and pressure injury risk.
医疗设备常被忽视是导致压疮的一个潜在原因。留置导尿管被认为是尿道糜烂的一个病因。在男性中，由此导致的部分厚度或全层伤口可能累及阴茎头的一小片区域，或使阴茎头或阴茎干裂开，需要进行重建手术或尿流改道。在3个月的时间里，有4名老年男性，均居住在一家长期护理机构的一个单元中，因尿道糜烂性损伤被转诊至伤口专科医生处。据观察，他们都有使用刚性硅胶导尿管固定不当的病史。作为创建无乳胶环境的一部分，该机构最近用新的硅胶导尿管取代了（较软的）含乳胶导尿管。除了为患者提供细致的导管护理和舒适措施外，还对所有固定程序进行了审查，并评估了不同硅胶导尿管导致压疮的可能性。这个病例系列突出了在为广泛的患者使用而选择导管材料和固定装置之前进行仔细评估的重要性，并强调了开展针对导管成分和压力损伤风险研究的必要性。
