PRESSURE ULCERS IN PEDIATRIC PATIENTS: CAUSAL FACTORS AND THERAPEUTIC MANAGEMENT

Ramos, Gabriely Westphal; Monteiro, Daiane da Rosa; Rodrigues, Pâmela de Oliveira; Wegner, Wiliam; Breigeiron, Márcia Koja

doi:10.1590/ce.v28i0.90401

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Sumário

ORIGINAL ARTICLE • Cogitare Enferm. 28 • 2023 • https://doi.org/10.1590/ce.v28i0.90401 copy

PRESSURE ULCERS IN PEDIATRIC PATIENTS: CAUSAL FACTORS AND THERAPEUTIC MANAGEMENT

Authorship SCIMAGO INSTITUTIONS RANKINGS

HIGHLIGHTS

Children in intensive care have a higher risk of developing PU.
Limited mobility and medical devices favor the onset of PU.
Nursing consultation has a resolutive role in PU.
Safety strategies to avoidable incidents should be a practice.

ABSTRACT

Objective:

to trace the sociodemographic and clinical profile, causal factors, and therapeutic management provided to children with pressure ulcers during hospitalization.

Method:

cross-sectional study; retrospective. Sample of 64 medical records of children with PU, admitted to a hospital in southern Brazil, from January/2016 to July/2021. Data analyzed by descriptive and inferential statistics.

Results:

Profile of children in intensive care (62.5%); stage 1 pressure ulcers (35.9%); and use of simple cover (37.5%). Of the total cases, 25% by medical device use. Consultations were related to stage 3 injury (p=0.027). Nursing diagnosis risk of pressure ulcer was identified in 48.4% of cases, while the Braden/Braden Q scale was identified in 78.1%. Patients classified as high risk (46%) had limited mobility (p=0.000).

Conclusions:

Pressure ulcers in children in intensive care with limited mobility require everything from simple intervention to consulting according to the classification of the injury.

DESCRIPTORS:
Pressure Ulcer; Child; Hospitalization; Nursing Diagnosis; Patient Safety.

Variables		n	%	p
Age Group				0.003^* * Pearson’s Chi-square test - in bold p<0.05.
	< 1 year old	17	26.6
	1 to 4 years old	26	40.6
	5 to 9 years old	16	25
	10 to 12 years old	5	7.8
Gender				0.000^* * Pearson’s Chi-square test - in bold p<0.05.
	Male	46	71.9
	Female	18	28.1
Race/color				0.000^ Fisher’s Exact test - in bold p<0.05.
	White	58	90.6
	Brown	3	4.7
	Indigenous	3	4.7
Pediatric admission unit				0.000^ Fisher’s Exact test - in bold p<0.05.
	Intensive Care Unit	40	62.5
	Clinical/surgical admission	23	35.9
	Oncology	1	1.6
Reason for hospitalization				0.036^ Fisher’s Exact test - in bold p<0.05.
	Congenital malformation	16	25
	Genetic syndrome	16	25
	Infectious disorder	13	20.3
	Nervous system disorder	8	12.5
	Neoplasia	7	10.9
	Autoimmune disorder	4	6.3
Level of consciousness				0.001^* * Pearson’s Chi-square test - in bold p<0.05.
	Conscience Preserved	35	54.7
	Unawareness	18	28.1
	Alternates awareness/unawareness	11	17.2
Mobility				0.000^* * Pearson’s Chi-square test - in bold p<0.05.
	Limited	33	51.6
	Slightly limited	17	26.6
	Slightly limited	9	14.1
	No limitations	5	7.8
Nutritional status				0.045^* * Pearson’s Chi-square test - in bold p<0.05.
	Thinness	29	45.3
	Eutrophic	17	26.6
	Overweight/obesity	10	15.6
	No record	8	12.5

Variables		n	%	p ^* * Pearson’s Chi-square test - in bold p<0.05.
Staging of the lesion				0.000
	Stage 1	23	35.9
	Stage 2	21	32.8
	Stage 3	7	10.9
	Not classifiable	6	9.4
	Unregistered	7	10.9
Consulting Request				0.617
	No	34	53.1
	Yes	30	46.9
Lesion resolution at hospital discharge
	Yes	30	46.9	0.720
	No	29	45.3
	No record	5	7.8

	Risk Classification
Mobility	Risk Classification
	Low	Moderate	High	Very high	n (%)	p^* * Fisher’s Exact Test - in bold p<0.05.
Limited	1	5	20	1	27 (54)	0.000
Moderately limited	0	4	2	0	6 (12)	>0.05
Slightly limited	2	11	1	0	14 (28)	>0.05
No limitations	2	1	0	0	3 (6)	>0.05

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[1] Role of Authors:

Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work - Ramos GW, Monteiro D da R, Rodrigues P de O, Wegner W, Breigeiron MK; Drafting the work or revising it critically for important intellectual content - Ramos GW, Monteiro D da R, Rodrigues P de O, Wegner W, Breigeiron MK; Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved - Ramos GW, Monteiro D da R, Rodrigues P de O, Wegner W, Breigeiron MK. All authors approved the final version of the text.