Division of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA.
Advanced Wound Care Center, Stanford University Medical Center, Redwood City, CA.
Ann Surg. 2020 Apr;271(4):671-679. doi: 10.1097/SLA.0000000000003567.
Pressure injury is seen across all healthcare settings and affects people of any age and health condition. It imposes a significant burden, with annual costs of up to $17.8 billion in the United States alone. Despite considerable resources it exhausts, the disease remains very prevalent, and the incidence is on the rise. This is in part due to aging population, growing number of nursing home residents, poorly understood biology, and dismal track record of clinical research in this field.
In our Review Article, we discuss the disease pathophysiology, clinical manifestation, evidence based recommendations for risk assessment, prevention and timely management, existing challenges, and directions to improve research on the field. This article encompasses dedicated sections on the full spectrum of the pressure related pathologies including "conventional pressure ulcers", "medical device related pressure injuries", "pressure injuries in mucosal membranes", "pressure injuries in pediatric population", "pressure injury at end of life", and the "role of pressure in pathogenesis of diabetic foot ulcers".
压力性损伤可见于所有医疗保健环境中,影响任何年龄和健康状况的人群。它造成了巨大的负担,仅在美国,每年的成本就高达 178 亿美元。尽管投入了大量资源,但该疾病仍然非常普遍,发病率呈上升趋势。部分原因是人口老龄化、养老院居民人数增加、对其生物学机制了解不足,以及该领域临床研究的记录不佳。
在我们的综述文章中,我们讨论了疾病的病理生理学、临床表现、基于证据的风险评估、预防和及时管理建议,以及现有的挑战和改善该领域研究的方向。本文涵盖了与压力相关病理的各个方面,包括“传统压力性溃疡”、“医疗器械相关压力性损伤”、“黏膜压力性损伤”、“儿科人群压力性损伤”、“生命终末期压力性损伤”以及“压力在糖尿病足溃疡发病机制中的作用”。