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CG29 Pressure ulcer management: NICE. 2005;

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Pressure ulcers

Device-related atypical pressure ulcer after cardiac surgery

02 May 2019
Case Report
02 May 2019
Volume 3 · Issue 2

Abstract

Medical devices must be closely monitored to prevent harm to patients. Pressure ulcers secondary to medical devices present a significant health burden in terms of length of stay in hospital and cost. Intensivists, anaesthetists and other professionals involved in managing critically ill patients following cardiac surgery need to be aware that pressure ulcers (PU) may develop in atypical sites and present at a later stage of the hospital stay. This case report highlights the important issue of device-related PUs in the cardiac surgical intensive care setting, particularly when the clinical status of the patient may preclude routine assessment and prophylaxis. An algorithm for preventing such PUs is suggested.

A pressure ulcer is a localised injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear.1 The European Pressure Ulcer Advisory Panel (EPUAP) has classified pressure ulcers (PU) as I–IV depending on their severity (Table 1).1,2 The resource and financial costs of PUs are significant. A Dutch research team observed that in a cohort of cardiothoracic patients the length of stay in the intensive care unit was significantly longer for patients who developed a PU.3 In addition, it is estimated that the financial burden of PUs in the UK is between £1.4–2.1 billion.4

Table 1.

EPUAP Classification of Pressure Ulcer Grading1,2

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pressure ulceration
medical devices
cardiac surgery
critical care