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Pressure ulcers in maturing skin - A clinical perspective
1Department of Nursing Development and Science, Children's University Hospital Zurich, Switzerland; Children's Research Center, Children's University Hospital Zurich, Switzerland.
Insights
Pediatric pressure ulcers (PUs) require more research as improved survival rates present new care challenges. Early skin assessment and proper device management are key for preventing PUs in neonates and children.
Area of Science:
- Pediatric Nursing
- Dermatology
- Neonatal Care
Background:
- Pressure Ulcers (PUs) are well-studied in adults, but less is known about their occurrence in neonates and children.
- Improved survival rates in critically and chronically ill pediatric populations introduce new healthcare challenges, including PU development.
- Children's skin physiology changes significantly during the first 18 years, impacting its protective functions.
Purpose of the Study:
- To highlight the knowledge gap in pediatric pressure ulcer research.
- To underscore the unique challenges in preventing PUs in neonates and children.
- To emphasize the importance of skin integrity in pediatric populations.
Main Methods:
- Literature review focusing on pediatric pressure ulceration.
- Analysis of risk factors specific to neonates and children.
- Discussion of current prevention strategies.
Main Results:
- Pediatric pressure ulceration is under-researched compared to adult populations.
- Specific pediatric conditions (e.g., prematurity, congenital abnormalities, low immunity) increase PU risk.
- Effective prevention involves device-related padding, careful positioning, and regular skin assessments.
Conclusions:
- Further research is crucial to understand and manage pressure ulcers in pediatric patients.
- Proactive prevention strategies, including vigilant skin assessment and appropriate device management, are essential for neonates and children at risk.
- Addressing pediatric pressure ulcers is vital for improving overall patient outcomes and quality of care.
Abstract:
While the problem of Pressure Ulcers (PU) in adults has received a great deal of attention, far less is known about PUs in neonates and children. The overall health status of children is generally better and multi-morbidity is limited to a small percentage of patients, like very low term neonates (born before 32 weeks of gestation age), newborns with congenital abnormalities, genetic disorders, perinatal distress syndrome or children with a limited immunity. Survival rates of both critically and chronically ill neonates, infants and children have improved dramatically in recent years, introducing new challenges for medical and nursing care. Children's skin undergoes several changes throughout the first 18 years of life. The most important function of the skin is to protect against water loss, absorptions of noxious substances, intrusions of microorganisms and physical trauma. Effective PU prevention includes device related under-padding and careful positioning and fixation of such devices. At least regular head-to-toe-skin assessment of neonates and infants at risk of PUs should be performed.
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