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Preventing pressure sores

BMJ 2000; 320 doi: https://doi.org/10.1136/bmj.320.7237.801 (Published 18 March 2000) Cite this as: BMJ 2000;320:801

Good nursing care should prevent pressure sores

  1. Amanda Hahn (chtgas@chtgas.force9.co.uk), consultant anaesthetist.,
  2. Fran Hall, clinical nurse specialist.
  1. Acute Pain Service, Dudley Road, Birmingham B18 7QH
  2. Queen's Hospital, Burton on Trent, Staffordshire DE13 0RB
  3. Wound Healing Research Unit, University of Wales College of Medicine, Cardiff CF4 4UJ
  4. Homerton Hospital, London E9 6SR
  5. Anaesthesia, Intensive Care, and Pain Management Unit, Ospedale, 55100 Lucca, Italy

    EDITOR—Bliss and Simini state that “postoperative epidural analgesia … has been associated with the development of severe sacral sores in elderly patients.”1

    Pressure sores may develop as a result of decreased sensation and mobility, but awareness of this possibility and good nursing care should prevent this complication.

    Conversely, because epidurals can provide excellent analgesia, patients will require no systemic sedative analgesia, which is also identified in the editorial as a cause of immobility. Patients who have good analgesia are easier to nurse and faster to mobilise, especially in the high risk group.2

    In this present climate of evidence based medicine we are surprised that an editorial in the BMJ is making such a sweeping statement based only on a personal communication.

    References

    1. 1.↵
      1. Bliss M,
      2. Simini B
      . When are the seeds of postoperative pressure sores sown? BMJ 1999; 319: 863–864. (2 October.)
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    2. 2.↵
      1. Buggy DJ,
      2. Smith G
      . Epidural anaesthesia and analgesia: better outcome after major surgery? BMJ 1999; 319: 530–531.
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    More research is needed into the origins of pressure sores

    1. Linda Russell, tissue viability nurse,
    2. Tim Reynolds, professor of chemical pathology,
    3. Michael Clark, senior research fellow
    1. Acute Pain Service, Dudley Road, Birmingham B18 7QH
    2. Queen's Hospital, Burton on Trent, Staffordshire DE13 0RB
    3. Wound Healing Research Unit, University of Wales College of Medicine, Cardiff CF4 4UJ
    4. Homerton Hospital, London E9 6SR
    5. Anaesthesia, Intensive Care, and Pain Management Unit, Ospedale, 55100 Lucca, Italy

      EDITOR—The origin of postoperative pressure ulcers troubles many clinicians.1 It is traditional to quote Versluysen to support the assertion that pressure sores develop during surgery.2 She showed that 66 of 100 elderly patients with hip fractures developed some stage of pressure sore during their …

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