EWMA 2013 - Ep531 - Treatment of pressure ulcer in childhood

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Judit Vasas1, Angéla Meszes MD1, Gyula Tálosi MD2, Katalin Rácz MD2, Lajos KeményMD1, Zsanett Csoma MD1 1Department of Dermatology and Allergology, University of Szeged, Hungary 2Department of Paediatrics, University of Szeged, Hungary

Health & Medicine Business

 high prevalence of pressure ulcers (PUs):
27 % in paediatric intensive care units (PICUs)
23 % in neonatal intensive care units (NICUs)
 acutely ill, sedated, paralysed or immobilized neonates
and children are at risk
 occipital region, ear, nose or knees
medical devices and equipment can also cause PUs at
any sites
 Braden Q Scale for risk of PUs in paediatric population
 hydrogels, hydrocolloids, foam and film dressings are
advised

 to review pressure ulcers
 between January 2012 and January 2013
 tertiary NICU and PICU
 Patients were studied for:
age
sex
area of involvement
stages of decubitus (NUPAP)
treatment

Patients
Gender
(M/F)
Gestational
age (week)
Birth weigth
(g)
Lesion Localisation Treatment
1. F 39 3980 erythema (St. I.)
occipital
region
herb
containing
gel
2 M 40 3440
erythema (St. I).
occipital
region
herb
containing
gel
3. M 37 3500
haemorrhagious
erosion with crust
(St. II.)
occipital
region
hydrogels,
epithelizing
ointment
4. F 38 2480
haemorrhagious
ulcers with crust
(St. II.)
occipital
region
hydrogels,
epithelizing
ointment
5. F 26 700
superficial ulcers
with crusts (St. II)
left nasal
orifice
boracic acid
containing
ointment
211 neonates in NICU
5 neonates with pressure ulcers - prevalence of 2,36%
4/5 in the occipital region
1/5 in the left nasal orifice due to nasal CPAP cannule

Patients
in PICU
Gender
M/F
Age Lesion Localisation Treatment
1. M 3 year superficial ulcers with crusts (St. II) occipital region hydrogels, hydrocolloids
2. M 2 years two necrotic ulcers (St. III.) occipital region
hydroactive wound dressings
hydrogels, alginates, hydrocolloids,
silicon and foam dressings
3 M 1 year
two necrotic ulcers with crusts (St. II-
III.)
occipital region
hydrogels, alginates, foam
dressings, hydrocolloids
4. M 20 months 4 rounded necrotoic ulcers (St. II, III.) occipital region hydrogels hydrocolloids
5. F 10 years
superficial ulcer (St. II.), ulcer with
crusts (ST. III.)
sacrum, occipital
region
hydrogels, foam dressings
6. M 7 years
deep, necrotic ulcer, bone at the
bottom (St. IV.)
sacrum alginate
7. F 14 years bulla 3 cm in diameter (St. II.) right heel hydrogels, foam dressing
8 M 11 months superficial ulcer with crust (St. II.) occipital region hydrogels, foam dressings
9. M 4 months haemorrhage, erythema (St.I.) occipital region herb containing gel
10. F 18 months superficial ulcer with crust (St. II.) occipital region hydrogels, epithelizing ointment
11 M 15 years
deep, necrotic ulcer with bone at the
wound base (St, IV.)
sacrum alginate dressings
12. F 4 months superficial ulcers with crusts (St. II.) occipital region hydrogels, epithelizing ointment
13 M 10 years eryhema (St. I.)
both lateral
malleus
herb containing gel
14 F 11 years
haemorrhagious, necrotic based
ulcers (St. III.)
occipital region,
trunk, sacrum
hydrogels, hydrocolloids, silver
alginate,
15 M 12 years
haemorrhage, bulla, superficial ulcer
(St. II.)
left heel hydrogels, povidone iodine cream

 385 neonates in PICU
 15 children with
pressure ulcers
 prevalence 3,89%

 Prevention is inevitable
reposition of patients
check and reposition of medical equipments
weight-relieving gel pillows and foam
mattresses
 Minimizing risk with nutritional considerations
 Paucity of evidence-based local therapy
 Futher researches are needed with dressings

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