Preventionp of Pressure Sores: Monitoring Mobility and Assessment of Clinical Condition

Summary

The fundamental cause of tissue damage leading to pressure sores is sustained pressure over localised areas of the body. Bodily movements, which determine the duration of pressure, are related to the general condition of the patient. Studies of mobility and the assessment of clinical condition by a scoring system, show that approximately 20 per cent of patients admitted to a geriatric department are at risk of developing pressure sores. Seventy per cent of sores develop within the first two weeks of hospital stay; the incidence of these sores is related to the initial assessment score. Patients whose condition is fluctuating require monitoring by frequent assessment of their scores in order that prophylactic measures can be adopted at a time when they will be most effective.

At the beginning of this century the patients who were most prone to develop pressure sores were young people suffering from certain wasting diseases, such as tuberculosis, osteomyelitis, typhoid fever and renal disease. Today, by far the largest susceptible group consists of the elderly, who in increasing numbers suffer from long-term debilitating illnesses. The incidence of pressure sores rises steadily with age (Norton et al. 1962). Indeed, so great is the likelihood of elderly patients developing pressure sores that the problems of their prophylaxis have a most pertinent connection with the practice of geriatric medicine. It is safe to say that if we are to attempt to treat diseases in old age, we must devote considerable attention to the potential damaging effects of sustained pressure on the tissues.