Prevención de las úlceras por presión.

Abstract

Introduction: The pressure ulcer is an ischemic lesion of the skin caused as a result of compression of the skin between two hard planes that will reduce the flow of blood and lymph. The extrinsic factors that contribute to the appearance of the injury are pressure, friction and shear, while the risk factors that promote its development are humidity, the nutritional status of the patient, cognitive impairment, sensory alterations, immunological alterations, diseases that cause tissue oxygenation disorders, immunosuppressant treatments, advanced age, race and immobility, as the main risk factor. The most widely used tool for the assessment of PUs is the Norton scale. Objective: The goal is to know the latest scientific evidence about pressure ulcer prevention. Methodology: A narrative review of the latest scientific evidence from journals indexed in the Cochrane Library, Pubmed, Cuiden and Medline databases has been carried out. Results: About 95% of pressure ulcers are preventable. Risk assessment is a key aspect in prevention. Skin care includes daily inspection of the skin, taking extreme precautions in areas exposed to moisture, not massaging bony prominences or reddened areas, avoiding float-shaped cushions and buns to relieve pressure, maintaining good hygiene with neutral PH soap, dry carefully without friction, use oil or hyperoxygenated fatty acids, as long as the skin is intact. Products with alcohol are contraindicated. For pressure management, make postural changes and mobilization every 2-3 hours in bedridden patients, using a rotation scheme. Avoid dragging in mobilizations. Use local protection in areas with special risk to develop UPP and / or special surfaces for pressure management (SEMP). Adequate dietary intake must be ensured to prevent malnutrition. The loss of fat and muscle tissue decreases the protection on the bone surfaces. Conclusion: The role of nursing in the prevention of these injuries is essential, carrying out individualized care and recurrent evaluations. Skin care, pressure management and nutritional status are essential aspects to take into account to reduce risk.