QUAL O CURATIVO PERFEITO PARA TRATAR LESÃO POR PRESSÃO I AULA COMPLETA

Summary

In this video, Professor Ivo Sales provides an in-depth guide on pressure ulcers, including stages, prevention, and treatment. He explains what pressure ulcers are, their causes, and risk factors such as age, immobility, and medical conditions. The video breaks down the six stages of pressure ulcers, from intact skin with redness (Stage 1) to deep tissue injury (Stage 4), and offers practical advice on selecting the appropriate dressings for each stage. Additionally, viewers are offered a free course on wound healing techniques, aimed at helping healthcare professionals enhance their skills and deliver better patient care.

Takeaways

• 😀 Pressure injuries are common in healthcare settings, particularly in intensive care units, with a prevalence of 22% to 90% among patients.
• 😀 Pressure injuries occur due to prolonged pressure on bony prominences or medical devices, leading to ischemia and tissue damage.
• 😀 The correct term is 'pressure injury,' not 'pressure ulcer,' reflecting a broader understanding of the condition.
• 😀 The main risk factor for pressure injuries is immobility, but factors such as age, malnutrition, dehydration, and certain comorbidities also increase risk.
• 😀 The skin is composed of three layers: epidermis, dermis, and hypodermis, with deeper layers exposed in more severe stages of pressure injuries.
• 😀 There are six stages of pressure injuries: Stage 1 (intact skin with redness), Stage 2 (damage to the dermis), Stage 3 (damage to the hypodermis), and Stage 4 (damage to deeper tissues such as muscle, tendon, or bone).
• 😀 Stage 1 pressure injuries show erythema (redness) that doesn’t blanch with pressure, while Stage 2 involves a blister or wound that exposes the dermis.
• 😀 Stage 3 injuries expose the hypodermis (fat), while Stage 4 injuries can involve muscle, tendon, or bone, often with necrosis or slough.
• 😀 Non-classifiable or indeterminate pressure injuries occur when necrosis or slough covers the wound bed, preventing accurate staging until debridement is performed.
• 😀 For early-stage pressure injuries (Stage 1 and 2), treatments include moisturizing the skin, repositioning the patient, and using foam dressings to relieve pressure.
• 😀 For advanced stages (Stage 3 and 4), hydrofibers or alginate dressings are preferred for wound absorption, while silver-impregnated dressings help treat infections.
• 😀 For those in the healthcare field, ongoing education and training in wound care are essential to stay current with effective treatments and practices.

Q & A

What is a pressure injury, and how is it defined by the NPUAP?

A pressure injury, according to the NPUAP (National Pressure Ulcer Advisory Panel), is a localized damage to the skin or underlying soft tissues, usually over a bony prominence, or related to the use of medical devices. It can appear as intact skin or an open ulcer and may be painful.

What are the main causes of pressure injuries?

The main cause of pressure injuries is prolonged pressure on the skin, particularly over bony prominences. This pressure can lead to ischemia (lack of blood flow), causing skin damage. Factors like immobility, aging, poor nutrition, dehydration, and certain medical conditions can increase the risk.

Why is it important to change a patient's position frequently to prevent pressure injuries?

Frequent repositioning helps relieve pressure on bony prominences, improving blood circulation and oxygen flow to the affected areas. This prevents ischemia, which is the primary cause of tissue damage leading to pressure injuries.

What are the key risk factors for developing a pressure injury?

Risk factors include advanced age, poor nutrition, dehydration, immobility (due to conditions like stroke, fractures, or dementia), comorbidities (like diabetes, hypertension, heart failure, or kidney failure), and inadequate skin hydration.

How many stages are there in the classification of pressure injuries, and what are they?

There are six stages of pressure injury classification: Stage 1 (intact skin with redness that doesn't blanch), Stage 2 (partial-thickness skin loss with exposed dermis), Stage 3 (full-thickness skin loss involving subcutaneous tissue), Stage 4 (full-thickness tissue loss with exposure of muscle, tendon, or bone), Unstageable (necrotic tissue obscuring the wound), and Deep Tissue Pressure Injury (purple or maroon localized area of skin damage).

What are the key features of a Stage 1 pressure injury?

Stage 1 pressure injury presents as intact skin with erythema (redness) that does not blanch when pressed. It may also involve changes in skin texture, temperature, or consistency, especially in patients with darker skin tones, making it harder to assess visually.

How is a Stage 2 pressure injury different from Stage 1?

In Stage 2, there is partial-thickness loss of the skin, exposing the dermis. The wound appears as a shallow ulcer with a red-pink wound bed or may present as a blister with serous fluid. Stage 1, on the other hand, has no skin loss, only redness.

What treatments are recommended for Stage 3 and Stage 4 pressure injuries?

For Stage 3 and Stage 4 pressure injuries, which are deeper and involve more tissue damage, hydrocolloid dressings, hydrofiber, or alginate dressings are recommended. These dressings help absorb exudate and maintain a moist wound environment, promoting healing.

Why is it important to use a dressing with hydrocolloids or hydrogels for Stage 2 pressure injuries?

Hydrocolloids and hydrogels are effective for Stage 2 pressure injuries because they help maintain a moist wound environment, promote granulation tissue formation, and reduce pain. They also help to prevent maceration and protect the wound from infection.

What should be done when a pressure injury is classified as unstageable or indeterminate?

For unstageable or indeterminate pressure injuries, the necrotic tissue covering the wound must be debrided (removed) to allow proper staging. Once the necrosis is removed, the wound can be classified as Stage 3 or Stage 4 depending on the level of tissue damage.