Interdisciplinary Protocols for Comprehensive Bedsore Prevention: Synergising Physiotherapy and Nursing Interventions
Keywords:
Bedsore, Prevention, Physiotherapy, Nursing, Interdisciplinary ProtocolsAbstract
Pressure ulcers or bedsores are localized wounding of the skin and the tissue underneath the skin caused by the long-term pressure, particularly in the region of the bony prominence. Their pathophysiology is characterized by prolonged external pressure that is higher than the capillary perfusion pressure (32 mmHg), which results in ischemia, cellular hypoxia, the build-up of toxic compounds and tissue destruction. Damage is aggravated by friction, shear forces and moisture by reducing microcirculation and skin integrity. Development of bedsores has four stages: non-blanchable erythema (Stage I), up to tissue loss through the full thickness of the bedsores, bone or muscle (Stage IV). Immobility, malnutrition, and comorbid conditions (diabetes and vascular disorders) are the key risk factors that decrease tissue resilience and healing ability. Preventive strategies must involve a multidisciplinary approach that incorporates physiotherapy to improve mobility and nursing care to maintain skin integrity, and nutrition to reduce their occurrence. Knowledge of the phases and processes involved in the development of bedsores can be used to prevent and improve patient outcomes.
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