JOMPAC

Journal of Medicine and Palliative Care (JOMPAC) is an open access scientific journal with independent, unbiased, and double-blind review under international guidelines. The purpose of JOMPAC is to contribute to the literature by publishing articles on health sciences and medicine.

EndNote Style
Index
Original Article
Evaluation of risk factors contributing to device-related pressure ulcer development in critically ill patients
Aims: Device-related pressure ulcers are one of the most common complications observed in patients treated in intensive care units (ICUs). These ulcers negatively impact patient comfort and significantly increase treatment costs. To prevent and manage pressure ulcers caused by medical devices, it is essential to thoroughly understand the associated risk factors. This study aims to determine the prevalence of device-related pressure ulcers in critically ill patients and evaluate the risk factors contributing to their development.
Methods: The study included 91 patients who were monitored with non-invasive mechanical ventilation (NIMV) in the pulmonary intensive care unit between January 1, 2021, and December 31, 2021. The patients’ demographic characteristics, nutritional status, body-mass index (BMI), biochemical parameters, and Braden pressure ulcer risk assessment scale scores of the patients were retrospectively analyzed.
Results: The findings revealed no direct relationship between the duration of medical device use and the development of pressure ulcers. However, an increase in the number of days masks were used was significantly associated with the progression of pressure ulcer stages, particularly from early to advanced stages. The study also found that the Braden scoring system was insufficient in predicting pressure ulcers caused by oronasal masks, while patients with higher blood urea nitrogen (BUN) levels tended to have ulcers that remained at early stages without progression. No significant association was found between pressure ulcer development and nutritional status, albumin levels, BMI, or corticosteroid use. However, prolonged ICU stays were associated with the progression of pressure ulcers to more advanced stages.
Conclusion: These results emphasize the importance of optimizing the duration of device usage and selecting appropriate devices to prevent device-related pressure ulcers.


1. Salcido R, Hart D, Smith AM. The prevention and management of pressure ulcers. In: Braddom RL, ed. Physical Medicine & Rehabilitation. Philadelphia: WB Saunders Company; 1996.
2. Yarkony GM, Kirk PM, Carlson C, et al. Classification of pressure ulcers. Arch Dermatol. 1990;126(9):1218-1225. doi:10.1001/archderm.1990. 01670330098016
3. Sivrioğlu K, Özcan O. Basınç yaraları. In: Oğuz H, Dursun E, Dursun N, eds. Tıbbi Rehabilitasyon. Ankara: Nobel Tıp Kitabevleri; 2004.
4. Doley J. Nutrition management of pressure ulcers. Nutr Clin Pract. 2010; 25(1):50-60. doi:10.1177/0884533609359294
5. Nola GT, Vistnes LM. Differential response of skin and muscle in the experimental production of pressure sores. Plast Reconstr Surg. 1980; 66(5):728-733. doi:10.1097/00006534-198011000-00008
6. Magnan MA, Maklebust J. Braden Scale risk assessments and pressure ulcer prevention planning: what's the connection?.J Wound Ostomy Continence Nurs. 2009;36(6):622-634. doi:10.1097/WON. 0b013e3181bd812c
7. Black JM, Kalowes P. Medical device-related pressure ulcers. Chronic Wound Care Management Res. 2016;3:91-99.
8. Coyer FM, Stotts NA, Blackman VS. A prospective window into medical device-related pressure ulcers in intensive care. Int Wound J. 2014;11(6): 656-664. doi:10.1111/iwj.12026
9. Bergstrom N, Braden BJ, Laguzza A, et al. The Braden scale for predicting pressure sore risk. Nurs Res. 1987;36(4):205-210.
10. Pınar R, Oğuz S. Norton ve Braden bası yarası değerlendirme ölçeklerinin yatağa bağımlı aynı hasta grubunda güvenirlik ve geçerliğinin sınanması. In: Uluslararası Katılımlı VI. Ulusal Hemşirelik Kongresi Kongre Kitabı. Ankara; 1998.
11. Stoelting J, McKenna L, Taggart E, et al. Prevention of nosocomial pressure ulcers: a process improvement project. J Wound Ostomy Continence Nurs. 2007;34(4):382-388. doi:10.1097/01.WON.0000281654.40578.88
12. Miller N, Frankenfield D, Lehman E, et al. Predicting pressure ulcer development in clinical practice: evaluation of Braden scale scores and nutrition parameters. J Wound Ostomy Continence Nurs. 2016;43(2):133-139. doi:10.1097/WON.0000000000000184
13. Rashvand F, Shamekhi L, Rafiei H, Nosrataghaei M. Incidence and risk factors for medical device-related pressure ulcers: the first report in this regard in Iran. Int Wound J. 2020;17(2):436-442. doi:10.1111/iwj.13290
14. Ferrari G, Gallo V, Panero F, Elia F, Aprà F. Late-breaking abstract: noninvasive positive airway pressure ventilation and risk of pressure ulcers in patients with acute respiratory failure. Eur Respir J. 2014; 44(Suppl 58):2081.
15. Visscher M, White C, Jones J, et al. Face masks for noninvasive ventilation: fit, excess skin hydration, and pressure ulcers. Respir Care. 2015;60:1536-1547. doi:10.4187/respcare.04036
16. Shahin E, Meijers J, Schols J, et al. The relationship between malnutrition parameters and pressure ulcers in hospitals and nursing homes. Nutrition. 2010;26(9):886-889. doi:10.1016/j.nut.2010.01.016
17. Drake D, Swanson M, Baker G, et al. The association of BMI and Braden total score on the occurrence of pressure ulcers. J Wound Ostomy Continence Nurs. 2010;37:367-371. doi:10.1097/WON.0b013e3181e45774
18. Chen F, Wang X, Pan Y, Ni B, Wu J. The paradox of obesity in pressure ulcers of critically ill patients. Int Wound J. 2023;20:2753-2763. doi:10. 1111/iwj.14152
19. Graves N, Birrell F, Whitby M. Effect of pressure ulcers on length of hospital stay. Infect Control Hosp Epidemiol. 2005;26:293-297. doi:10. 1086/502542
20. Theisen S, Drabik A, Stock S. Pressure ulcers in older hospitalised patients and its impact on length of stay: a retrospective observational study. J Clin Nurs. 2012;21(3-4):380-387. doi:10.1111/j.1365-2702.2011.03915.x
21. Frankel H, Sperry J, Kaplan L. Risk factors for pressure ulcer development in a best practice surgical intensive care unit. Am Surg. 2007;73:1215-1217. doi:10.1177/000313480707301203
22. Marum R, Meijer J, Ooms M, et al. Relationship between internal risk factors for development of decubitus ulcers and the blood flow response following pressure load. Angiology. 2001;52:409-416. doi:10.1177/ 000331970105200606
Volume 6, Issue 2, 2025
Page : 151-158
_Footer