FOURTEENTH ANNUAL EUROPEAN PRESSURE ULCER ...
FOURTEENTH ANNUAL EUROPEAN PRESSURE ULCER ...
FOURTEENTH ANNUAL EUROPEAN PRESSURE ULCER ...
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Thursday September 1st<br />
Proceedings of the 14th Annual European Pressure Ulcer Meeting<br />
Oporto, Portugal<br />
Care of Pressure Ulcers in Palliative Care Individuals<br />
Diane Langemo, PhD, RN, FAAN 1* , Joyce Black, PhD, RN, CPSN, CWCN, FAAN 2<br />
1* University of North Dakota College of Nursing, Grand Forks, ND, USA, dianelangemo@aol.com<br />
2 University of Nebraska Medical Center, Omaha, Nebraska, USA<br />
Introduction<br />
Pressure ulcers occur all too frequently throughout the<br />
world, as do fungating wounds, particularly among<br />
palliative care individuals, and are painful, expensive<br />
to treat, and diminish quality of life. Individuals in<br />
palliative care are at increased risk for pressure ulcer<br />
development related to their frail, deconditioned state.<br />
Sufficient informed clinical consensus exists in the<br />
literature to support the management of a pressure<br />
ulcer in individuals in palliative care, inspite of the<br />
ethically understandable absence of randomized<br />
controlled trials comparing various management<br />
approaches. [1] “Within palliative care, it is never going<br />
to be possible to eradicate pressure [ulcers] because<br />
of the multiple risk factors experienced by the<br />
patients.” [2] Palliative care individuals are also at risk<br />
for development of a fungating wound, and these<br />
types of wounds are difficult, at best, to manage.<br />
Methods<br />
This presentation will focus on up-to-date pressure<br />
ulcer and fungating wound prevention and treatment<br />
strategies in individuals in palliative care. The 2009<br />
NPUAP-EPUAP Pressure Ulcer Prevention and<br />
Treatment Guidelines [3] as well as the most up-todate<br />
literature will provide a framework for the<br />
presentation related to pressure ulcers. [4] The most<br />
current up-to-date literature related to treatment of<br />
fungating wounds will frame this section. Patient<br />
scenarios will be addressed and analyzed.<br />
Results<br />
Specific guideline recommendations for prevention<br />
and treatment of pressure ulcers in palliative care<br />
individuals will be provided for attendees. Specific care<br />
recommendations, based on current literature and<br />
practice, will be presented for fungating wound care in<br />
palliative care individuals.<br />
60<br />
Discussion<br />
Prevention and treatment of pressure ulcers and<br />
fungating wounds in palliative care individuals includes<br />
patient and risk assessment; management of<br />
pressure, shear and friction; positioning and<br />
repositioning; nutrition and hydration; care of the skin;<br />
care of the pressure ulcer and fungating ulcer; pain<br />
assessment and management; and assessment of<br />
resources for the palliative care individual. All will be<br />
discussed along with patient care scenarios.<br />
Clinical relevance<br />
The number of palliative care individuals with pressure<br />
ulcers and/or fungating wounds is growing yearly.<br />
Ensuring quality care individualized to these<br />
individuals is of utmost importance.<br />
Acknowledgements<br />
We appreciate the work of the NPUAP-EPUAP<br />
Guideline Development Group work on the 2009<br />
Pressure Ulcer Prevention and Treatment Guidelines.<br />
Conflict of Interest<br />
There is no conflict of interest for either author that is<br />
relevant to this presentation.<br />
References<br />
[1] Langemo DK, Black J. Adv Skin Wound Care.<br />
2010;23(2):59-72.<br />
[2] Walding M, Andrews C., Professional Nurse. 11(1):<br />
33-38, 1995<br />
[3] National Pressure Ulcer Advisory Panel and<br />
European Pressure Ulcer Advisory Panel. Prevention<br />
and treatment of pressure ulcers. 2009<br />
[4] Langemo DK., et al. Adv Skin Wound Care. 19(3):<br />
148-154<br />
[5] Langemo D, Brown. Skin Fails Too: Acute, Chronic<br />
& End Stage Skin Failure, Adv Skin Wound Care.<br />
2006;1994):206-211.<br />
[6] SCALE Panel (includes D Langemo). SCALE: Skin<br />
Changes at Life’s End. WOUNDS, 21(12):329-336.<br />
[7] Langemo DK (2011). Palliative Wound Care, In:<br />
Wound Care Essentials: Practice Principles, 3 rd Ed.<br />
Baranoski S, Ayello EA (Eds). Philadelphia: Lippincott,<br />
Williams & Wilkins.<br />
Copyright © 2011 by EPUAP