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Decubitus ulcers in neurosurgery


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Decubitus ulcers in neurosurgery

  1. 1. Decubitus Ulcers in Neurosurgery Ward Implications of Adult Diapers Presented by:- Anu Susan Mathew Sister Grade II JPNATC,AIIMS Guided by :- Dr.Deepak Agrawal Consultant of Neurosurgery JPNATC,AIIMS
  3. 3. <ul><li>FACTORS AFFECTING DECUBITUS </li></ul><ul><li>ULCER DEVELOPMENT </li></ul><ul><li>Pressure </li></ul><ul><li>Friction and shearing </li></ul><ul><li>Nutrition and hydration </li></ul><ul><li>Skin moisture </li></ul><ul><li>Mental status and age </li></ul>
  4. 4. <ul><li>Main Focus </li></ul><ul><ul><ul><li>Skin moisture </li></ul></ul></ul><ul><ul><ul><li>Due to diapers </li></ul></ul></ul>
  5. 5. Diapers <ul><li>Advantages </li></ul><ul><ul><ul><ul><li>Easy </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Comfortable </li></ul></ul></ul></ul>
  6. 6. Disadvantages <ul><li>Made of Plastic </li></ul><ul><ul><ul><li>Allergy </li></ul></ul></ul><ul><ul><ul><li>Loss of aeration </li></ul></ul></ul><ul><li>Cause perspiration </li></ul><ul><ul><ul><li>Medium for bacterial growth </li></ul></ul></ul>Ignore to change
  8. 8. AIMS AND OBJECTIVES <ul><li>Assess the incidence of decubitus ulcers </li></ul><ul><li>in Neurosurgery ward </li></ul><ul><li>Attempt to find the causative factors </li></ul>
  9. 9. MATERIALS AND METHODS <ul><li>Retrospective, cross sectional study </li></ul><ul><li>Clients admitted in Neurosurgery ward, </li></ul><ul><li>JPN Apex Trauma Center </li></ul><ul><li>At a given point of time(23 Sep 2009) </li></ul><ul><li>Total no. of patients evaluated : 28 </li></ul>
  10. 10. <ul><li>All clients were having ripple beds </li></ul><ul><li>and DVT prophylaxis pumps </li></ul>
  11. 11. RESULTS
  12. 13. <ul><li>No. of clients had preexisting decubitus </li></ul><ul><li>ulcers from ICU: 2(33.33%) </li></ul>
  13. 15. MOST COMMON SITES <ul><li>Sacral : 6(100%) </li></ul><ul><li>Occipital : 3(50%) </li></ul><ul><li>Due to hard collar : 2(66.67%) </li></ul><ul><li>Bilateral ankles : 2(33.33%) </li></ul><ul><li>Due to skin traction: 2(100%) </li></ul>
  14. 16. COMMON SITES Sacral Bilateral ankles Occipital Common
  15. 19. <ul><li>The major cause of development </li></ul><ul><li>of SACRAL decubitus ulcers was the </li></ul><ul><li>indiscriminate use of adult diapers </li></ul><ul><li>in the majority of the patients </li></ul><ul><li>(66.67%) </li></ul>
  17. 21. <ul><li>Require </li></ul><ul><ul><ul><li>Sensitization of staff </li></ul></ul></ul><ul><ul><ul><li>More aggressive management </li></ul></ul></ul>
  18. 22. FOLLOW UP <ul><li>Following this study we have stopped using adult diapers routinely in the neurosurgery ward & ICU </li></ul><ul><li>Use of adult diapers is strictly monitered. </li></ul>
  19. 23. Thank You