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      Pressure Injuries in Medically Complex Children: A Review

      review-article
      Author(s):
      Editor(s):
      Publication date (Electronic):
      Journal: Children
      Publisher: MDPI
      Keywords: children with medical complexity, pressure injury, pressure ulcer

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          Abstract

          Pressure injuries are a challenging problem in the care of medically complex children. Available evidence is limited, and there are theoretical reasons to use caution before extrapolating adult data, including key differences in body composition, common locations of pressure injury, and association with medical devices. The focus of this article will be to review the definition of a pressure injury and what is known about pathophysiology, prevention, recognition, staging, and treatment of pressure injuries in children with medical complexity.

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          Children with medical complexity: an emerging population for clinical and research initiatives.

          Eyal Cohen, Dennis Kuo, Rishi Agrawal … (2011)
          Children with medical complexity (CMC) have medical fragility and intensive care needs that are not easily met by existing health care models. CMC may have a congenital or acquired multisystem disease, a severe neurologic condition with marked functional impairment, and/or technology dependence for activities of daily living. Although these children are at risk of poor health and family outcomes, there are few well-characterized clinical initiatives and research efforts devoted to improving their care. In this article, we present a definitional framework of CMC that consists of substantial family-identified service needs, characteristic chronic and severe conditions, functional limitations, and high health care use. We explore the diversity of existing care models and apply the principles of the chronic care model to address the clinical needs of CMC. Finally, we suggest a research agenda that uses a uniform definition to accurately describe the population and to evaluate outcomes from the perspectives of the child, the family, and the broader health care system.
          Article 0 comments Cited 246 times – based on 0 reviews     Review now
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            Wound healing and treating wounds: Chronic wound care and management.

            Catherine Higham, Jennifer G Powers, Karen C Broussard … (2016)
            In the United States, chronic ulcers--including decubitus, vascular, inflammatory, and rheumatologic subtypes--affect >6 million people, with increasing numbers anticipated in our growing elderly and diabetic populations. These wounds cause significant morbidity and mortality and lead to significant medical costs. Preventative and treatment measures include disease-specific approaches and the use of moisture retentive dressings and adjunctive topical therapies to promote healing. In this article, we discuss recent advances in wound care technology and current management guidelines for the treatment of wounds and ulcers.
            Article 0 comments Cited 164 times – based on 0 reviews     Review now
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              Pressure ulcers in neonates and children: an NPUAP white paper.

              Catherine R. Ratliff, Mona Mylene Baharestani (2007)
              Acutely ill and immobilized neonates and children are at risk for pressure ulcers, but a paucity of evidence-based research exists on which to base guidelines for clinical practice. Most prevention and treatment protocols for pressure ulcers in the pediatric population are extrapolated from adult practice. Clinical practice guidelines for prevention and treatment of pressure ulcers that specifically address the needs of the pediatric population are needed. The purpose of this article is to highlight the research that is currently available and to identify gaps that need to be addressed so that science-based, age-appropriate prevention and treatment pressure ulcer guidelines can be developed.
              Article 0 comments Cited 32 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Paul Nathan: Role: Academic Editor
                Journal
                Journal ID (nlm-ta): Children (Basel)
                Journal ID (iso-abbrev): Children (Basel)
                Journal ID (publisher-id): children
                Title: Children
                Publisher: MDPI
                ISSN (Electronic): 2227-9067
                Publication date (Electronic): 07 April 2017
                Publication date Collection: April 2017
                Volume: 4
                Issue: 4
                Electronic Location Identifier: 25
                Affiliations
                Department of Pediatrics, Division of Hospital Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA; katie.freundlich@ 123456vanderbilt.edu
                Article
                Publisher ID: children-04-00025
                DOI: 10.3390/children4040025
                PMC ID: 5406684
                PubMed ID: 28387749
                SO-VID: a3d18b52-58b2-4f21-96c1-8f0be6d66c26
                Copyright © © 2017 by the author.
                License:

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                Date received : 27 February 2017
                Date accepted : 03 April 2017
                Categories
                Subject: Review

                Keywords: children with medical complexity,pressure injury,pressure ulcer
                Data availability:
                Keywords: children with medical complexity, pressure injury, pressure ulcer

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