Nurse, PhD. Associate researcher, Department of Research and Nursing. Fundación Cardioinfantil, Instituto de Cardiología, Bogotá, Colombia.
Nurse, Master's. Associate professor, Nursing Program, Universidad Autónoma de Bucaramanga, Floridablanca, Colombia.
Invest Educ Enferm. 2024 Mar;42(1). doi: 10.17533/udea.iee.v42n1e07.
This article presents a literature review to explore and analyze the current situation of pressure ulcers or lesions or decubitus ulcers, pathophysiological, epidemiological aspects, and risk factors. The progress in evidence of the effectiveness of preventive repositioning in the appearance of these lesions in vulnerable hospitalized patients is also evaluated.
Databases were reviewed in non-systematic manner, including the Cochrane Wounds Specialized Register; Medline, Scopus, PubMed, the Cochrane Central Register of Controlled Trials; MEDLINE (Ovid); EMBASE (Ovid), Web of Science, SciELO, and Lilacs. The general search terms included [pressure ulcers or pressure lesions or decubitus ulcers] and [prevention or preventive] and [repositioning or positioning or position changes or postural change] and [patient at risk or vulnerable] and [hospitalized or ICU or intensive care]. Systematic literature reviews, randomized clinical trials, observational studies, cost-effectiveness and qualitative studies in English or Spanish were included.
Although globally, the incidence, prevalence, and years of disability associated to these lesions has diminished between 1990 and 2019, the high impact on health persists. Evidence found on the effectiveness of repositioning in preventing pressure ulcers and health associated costs has been evaluated with certainty between low and very low, as a result of conducting research with serious methodological limitations that report results with high inaccuracy.
The findings reported present that these lesions persist at hospital level and continue being a global social and health problem with high impact on health budgets. Likewise, there is a need to develop greater quality research on prevention strategies, such as repositioning, which validate their effectiveness, and justify their use.
本文通过文献回顾，探讨和分析压疮或病变或褥疮的现状、病理生理、流行病学方面以及风险因素。还评估了在易患住院患者中预防重新定位对这些病变出现的有效性的证据进展。
以非系统性方式审查了数据库，包括 Cochrane 伤口专业登记册；Medline、Scopus、PubMed、Cochrane 对照试验中心注册处；MEDLINE（Ovid）；EMBASE（Ovid）、Web of Science、SciELO 和 Lilacs。一般搜索词包括[压疮或压力性损伤或褥疮]和[预防或预防性]和[重新定位或定位或位置变化或姿势变化]和[有风险或易患的患者]和[住院或 ICU 或重症监护]。纳入了英语或西班牙语的系统文献综述、随机临床试验、观察性研究、成本效益和定性研究。
尽管全球范围内，这些病变的发病率、患病率和残疾年限在 1990 年至 2019 年间有所下降，但它们对健康的影响仍然很大。对重新定位预防压疮和与健康相关的成本的有效性的证据已经在低到非常低的确定性范围内进行了评估，这是由于进行了具有严重方法学限制的研究，这些研究报告的结果准确性很高。
报告的研究结果表明，这些病变在医院层面仍然存在，并且仍然是一个具有全球影响的社会和健康问题，对健康预算有很大的影响。同样，需要对预防策略（如重新定位）进行更多高质量的研究，以验证其有效性并证明其使用的合理性。
