A prospective study on the presentation and management of pressure ulcers at the Kenyatta National Hospital and Nairobi Spinal Injury Hospital.

SUMMARY

This study was carried out to determine the presentation and management of patients with pressure sores at the KNH and the National Spinal Injury Hospital. These included all patients with pressure sores that were either already admitted in the hospital or admitted during the study period. The period of study was between 1st of March and 31st December 2002.

A total of 113 patients were evaluated during the study period with 96 patients from KNH and 17 patients from the National Spinal Injury Hospital. Of the 113 patients, 77 (68.1%) were males, while the remaining 36 (31.9%) were females. The mean age of the patients evaluated was 38.1 years while the range was between 12 and 74 years.

Paraplegia was the main associated medical condition accounting for 35.4 percent of the patients. This was followed up by AIDS, which accounted for 27.4 percent.

The commonest anatomical site of pressure sores was the tronchanter, accounting for 43 percent of the sores. Of the pressure sores studied, 97.2 percent were below the umbilicus.

Grade III and IV accounted for 66.4 percent of the ulcers. Two hourly turning was the most commonly used pressure dispersion method. Gauze dressing was the most commonly used dressing method while 67.3 percent of patients had their wounds cleaned with povidoneiodine.

Fasciocutaneous flaps were the most common surgical procedures, accounting for 81.7 percent. Others were myofasciocutaneous flaps, V-Y plasty and skin grafts. Overall 59.3 percent of the surgical procedures had taken fully at one month after surgery. This was however reduced to 48.1 percent at 3 months.

There is a need to enstrengthen the management of pressure sores at both institutions with special emphasis on prevention.

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PRESSURE ULCERS PRESENTATION AND MANAGEMENT AT KENYATTA NATIONAL HOSPITAL AND NATIONAL SPINAL INJURY HOSPITAL.pdf279.69 KB