The most important factor in the development of the UP is the pressure maintained. She can be associated frictional forces parallel and / or tangential, as well as a number of risk factors mainly depend on the patient's condition.
The UP require the existence of microcirculatory disorders in support areas of the body located on a hard surface. For this reason bony areas are the most frequent occurrence of UP. The pressure exerted on skin and soft tissue produces a interstitial pressure increased with obstruction of blood vessels (formation of microthrombi) and nodes, leading to autolysis and accumulation of toxic and metabolic waste. Prolonged local ischemia leads to necrosis and subsequent ulceration of tissues, both skin and deeper layers.
The hydrostatic pressure in skin capillaries between 16 and 32 mmHg. All these figures exceed pressure decreases blood flow and ischemic damage may occur even in less than two hours.
friction forces (frictional forces parallel to the epidermal surface) and shear (tangential forces increase friction in the areas of pressure when the head of the bed rises above 30 °), decrease the pressure required to cause tissue damage.
have described a series of risk factors in the onset of the UP dependent on the patient's condition. Of these immobility is the most important.
are factors that contribute to the production of ulcers and can be grouped into five major groups: 1
.- pathophysiological :
As a result of different health problems.
- Skin lesions: edema, dry skin, lack of elasticity. - Impaired Transportation Oxygen: peripheral vascular disorders, venous stasis, cardiopulmonary disorders ... - Nutritional Deficiencies (default or by excess): Thinness, malnutrition, Odessa, hypoproteinemia, dehydration .... - Immune disorders, cancer, infection ....... - Altered State of Consciousness: Stupor, confusion, coma ...... - Motor Impairments: paresis, paralysis ....... - Sensory Impairments: Loss of pain sensation .... - Altered Elimination (urine / bowel): urinary and bowel incontinence.
2 .- Derived Treatment :
As a result of certain therapies or diagnostic procedures.
- immobility Imposed as a result of certain alternative therapies, devices / equipment such as casts, traction, respirators .......... - Treatments or drugs that have action inmunopresora: Radiotherapy, corticosteroids, cytostatics ...... - Drilling for diagnostic and therapeutic: IUC, NG ...... 3 .-
Situation:
result of changes in personal, environmental, habits, etc.
- immobility, related to pain, fatigue, stress ..... - Wrinkle in linens, nightgown, pajamas, rubbing objects, etc. .. 4 .-
Developmental : Related
maturation.
- infants, the diaper rash ... - Elderly: Loss of skin elasticity, dry skin, restricted mobility ..... 5 .-
Environment:
- Deterioration of the individual's own image in the disease. - The lack of health education to patients. - The lack of uniform criteria in the planning of the priests by the medical team. - The lack or misuse of the material to prevent both the basic and the complementary. - The motivation for the lack of professional training and / or specific information. - Overwork professional.
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