ABSTRACT
El presente artículo hace un repaso histórico por los marcos conceptuales sobre las lesiones por presión y otros tipos de heridas crónicas. En esta revisión se presentan 4 de los modelos más influyentes y representativos de las últimas décadas: a) el modelo conceptual de Braden-Bergstrom, que se desarrolló en 1987 como base teórica para el desarrollo de la escala de Braden y que identifica los factores etiológicos definidos, el aumento de la presión y la disminución de la tolerancia de los tejidos; b) el modelo teórico de las lesiones cutáneas relacionadas con la dependencia, que analiza el principal marco teórico de estas lesiones crónicas, desde su origen en 2011, su difusión en 2014 y las últimas modificaciones realizadas en 2021, en las que ya se incluyen hasta 10 tipos de lesiones distintas; c) el modelo conceptual de la dermatitis asociada a la incontinencia, este modelo hace referencia a la más frecuente de todas las lesiones cutáneas asociadas a la humedad, la dermatitis asociada a la incontinencia, de la que se analizan sus dos grandes factores etiológicos, la sobrehidratación y el aumento del pH, y d) el modelo conceptual de las lesiones por compromiso vital grave, finalmente se analiza el último y más reciente de los modelos, el de las lesiones inevitables y que se dan en las personas cuya situación vital es extremadamente grave, e incluso son el anuncio de una muerte inminente, distinguiendo entre las lesiones por fracaso multiorgánico y las lesiones por vasoconstricción extrema (AU)
This article takes a historical review through the theoretical frameworks of pressure injuries and other chronic wounds. In this review, 4 of the most influential and representative models of the last decades are presented: a) the Braden-Bergstrom conceptual framework, developed in 1987 is presented as the theoretical basis for the development of the Braden scale and the defined etiological factors are identified: increased pressure and decreased tissue tolerance; b) the theoretical model of dependence-related skin lesions, the main theoretical model of these chronic lesions is also analyzed, from its origin in 2011, its dissemination in 2014 and the latest modifications made in 2021 in which up to ten different types of lesions are already included; c) the conceptual model of incontinence-associated dermatitis, this model analyzed refers to the most important of all moisture-associated skin lesions: incontinence-associated dermatitis, analyzing the two major etiological factors: overhydration and increased pH; and d) the conceptual model of severe life-threatening injuries, finally, the last and most recent model is analyzed, that of unavoidable injuries that occurin people whose life situation is extremely serious, and even heralds imminent death, distinguishing between multiorgan dysfunction syndrome skin injuries and skin injuries by extreme vasoconstriction (AU)
Subject(s)
Humans , Models, Theoretical , Pressure Ulcer/history , Pressure Ulcer/etiology , Wounds and Injuries/history , Wounds and Injuries/etiology , Chronic DiseaseSubject(s)
Pressure Ulcer/history , History, 21st Century , Humans , Risk Factors , Terminology as TopicSubject(s)
Pressure Ulcer/history , World War II , Wound Healing , Adult , History, 20th Century , Humans , Male , Pressure Ulcer/therapySubject(s)
Anniversaries and Special Events , Diabetes Mellitus/drug therapy , Diabetic Foot/therapy , Pressure Ulcer/therapy , Seasons , Animals , Diabetes Mellitus/diagnosis , Diabetic Foot/history , Diabetic Foot/physiopathology , Disease Models, Animal , Dogs , History, 20th Century , Humans , Insulin/therapeutic use , Pressure Ulcer/diagnosis , Pressure Ulcer/historyABSTRACT
Las úlceras por presión están catalogadas como un evento adverso grave. Pese a poder evitarse en el 95% de los casos, mantienen altas tasas de prevalencia. Las personas que las padecen ven mermada su calidad de vida afectándose la salud física, psíquica y social. Este Relato Biográfico tiene como objetivo comprender la experiencia que supone haber desarrollado una úlcera por presión en el entorno hospitalario. El informante es Juan, que, como consecuencia de su estancia en UCI durante un mes, desarrolla una úlcera por presión de grandes dimensiones en el sacro, de categoría IV. Se recogen los datos mediante una entrevista semiestructurada. Del análisis cualitativo emergen varias categorías temáticas con un hilo conductor muy claro: el sufrimiento, para terminar con una llamada a la profesionalidad e humanidad que evite que se repitan situaciones como la suya. Con sus propias palabras, cuenta su estancia en UCI, el gran impacto emocional que supuso descubrir la lesión, las repercusiones físicas y anímicas, la frustración al haberse podido prevenir y exige unos cuidados empáticos, seguros y de calidad
Pressure ulcers are classified as a serious adverse event. In spite of being able to be avoided in 95% of the cases, they keep high prevalence rates. People who suffer from them have their quality of life reduced, affecting their physical, mental and social health. The aim of this Biographical Report is to understand the experience of having developed a pressure ulcer at the hospital environment. The informant is Juan who, as a consequence of his stay in ICU for a month, develops a large dimensions stage IV pressure ulcer in the sacrum. The data are collected through a semi-structured interview. Several thematic categories emerge from qualitative analysis, with a very clear unifying thread: suffering, to end up with a call to professionalism and humanity in order to avoid situations like his being repeated. In his own words, he relates his stay in the ICU, the great emotional impact of discovering the injury, the physical and emotional repercussions, the frustration of having been able to prevent it and he also demands empathic, safe and quality care
Subject(s)
Humans , Pressure Ulcer/history , Quality of Life , Primary Health Care , Narration , Stress, Psychological , Patient Safety , Health SystemsABSTRACT
Just over 100 years ago, an article was published describing a plan to treat decubitus ulcers that can shed light upon medical progress and current practices. Key prevention and treatment elements included a dedicated ward, staff continuity, frequent position changes and special surfaces, cleanliness, disinfectants, and dressing changes. The necessity of resource allocation and interdisciplinary collaboration was acknowledged. This article sheds light on not only how much we have learned, but also how far we have to go.
Subject(s)
Pressure Ulcer/history , Publications/history , History, 19th Century , Humans , New York CityABSTRACT
A través de una revisión narrativa, los autores revisan elementos clave relacionados con la historia de las úlceras por presión y su contexto, desde la Edad Antigua, el Renacimiento, el siglo xix hasta la edad moderna
Through a narrative review, the authors review key facts related with the history of pressure ulcers and their framework, from ancient age, Renaissance, xix's century up to the modern age
Subject(s)
Humans , History, Ancient , History, 16th Century , History, 19th Century , History, 20th Century , Pressure Ulcer/epidemiology , Pressure Ulcer/history , Wounds and Injuries/epidemiology , Wounds and Injuries/history , Frail Elderly/statistics & numerical dataABSTRACT
Doreen Norton was a delightful, widely respected nurse who devoted her life to improving the care of elderly people. She researched the neglected problem of pressure sores, revolutionised their nursing care, and thus achieved international fame. Her Pressure Sore Scale was established as a management tool and is still used today. She was a key member of the design team that produced the 'King's Fund Bed', researched equipment required on geriatric wards, assessed all geriatric long stay units in Scotland and established research as a valuable nursing tool within her profession and health authorities. She lectured extensively and her publications attracted worldwide acclamation. After her retirement, she was subsequently appointed to the world's first Chair of Gerontological Nursing in Cleveland, Ohio.
Subject(s)
Geriatric Nursing/history , Pressure Ulcer/history , History, 20th Century , History, 21st Century , Pressure Ulcer/prevention & control , United KingdomABSTRACT
A lo largo de la historia de la humanidad muchas personas se han visto afectadas por la presencia de heridas crónicas. Millones de personas anónimas han padecido úlceras por presión, venosas, arteriales o neuropáticas. Pero también han existido personajes famosos que, de vez en cuando, sacan estas lesiones de su invisibilidad. En nuestros días, cada vez que alguna persona famosa las padece, vemos cómo los medios de comunicación se hacen eco del problema. Pero, en el pasado, también personajes ilustres las sufrieron. En el presente artículo histórico efectuaremos un repaso a personajes históricos que también han muerto por las temidas «llagas». Así, reyes o santos, se han visto afectados por este problema. Concretamente nos centraremos en seis personajes históricos: tres reyes, un compositor y dos santos y analizaremos la influencia de las heridas crónicas en la causa de su muerte. Artículo expuesto en el VII Simposio Nacional de Úlceras por Presión y Heridas Crónicas y I Congreso Latinoamericano sobre Úlceras y Heridas(AU)
Throughout the course of human history, many people have been affected by the presence of chronic wounds. Millions of anonymous people have suffered bed sores, varicose ulcers, arterial ulcers or neuropathic ulcers. But there have been some famous people who, from time to time, remove these lesions from their cloak of invisibility. In our day and age, every time a famous person suffers from these wounds, we observe how the means of communication publicize this health problem. However, famous people also suffered from these wounds in the past. In this article, the authors will review historical figures who died due to these feared sores. Kings or saints have been affected by this problem. Specifically, the authors will focus on six historical figures: three kings, one composer and two saints; the authors shall analyze the influence of chronic wounds as a cause of their deaths. This article was submitted at the VII National Symposium on Bed Sores and Chronic Wounds and at the First Latin American Congress on Ulcers and Wounds(AU)
Subject(s)
History, Medieval , History, 15th Century , History, 16th Century , Skin Ulcer/history , Ulcer/history , Pressure Ulcer/history , History of Medicine , Wound Infection/history , Wounds and Injuries/history , Wounds, Penetrating/historyABSTRACT
En pacientes con úlceras masivas o confluentes en la región glútea, puede ser necesaria la amputación dela extremidad inferior y la reconstrucción mediante colgajos totales de muslo para la cobertura del defecto. Esta técnica es muy agresiva y además de las evidentes secuelas físicas que crea puede generar importantes trastornos psíquicos para el paciente. Presentamos el caso de una paciente con una granúlcera por decúbito en la región isquio-trocantéreosacra en la que se empleó el colgajo Adductor como alternativa a la amputación de la extremidad inferior (AU)
Amputation of the lower extremity and total thigh flaps may be necessary for coverage in patients with massive multiple or confluent sores in the buttock region. This is an aggressive technique with important physical and psychological consequences for the patient. The Adductor flap was used as an alternative of the amputation in a patient with a big ischial-trocanteric sacral pressure sore (AU)
