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Wound care
Pressure
Pressure ulcers are among the most serious dangers to bedbound hospital and care home patients, which makes sense if you understand how they form. Developing from the
sicker? – but one with potentially deadly consequences. If nothing else, that became clear during the pandemic, when 24% of British hospital patients contracted Covid in December 2020. On the contrary, the Centre for Disease Control and Prevention (CDC) warns that Americans suffer from a bewildering 1.7 million healthcare-associated infections every year, with surgical wounds and urinary tract infections hovering near the top of the list. These figures make a grim kind of sense. With an average of 342 stroke victims entering NHS hospitals on an average Wednesday, wards across the developed world, and many more beyond, are necessarily going to be heaving. That obviously gives opportunities for diseases to spread, especially since many patients are being admitted precisely because they suffer from some kind of infectious disease to begin with. In a sense, though, all these eminently comprehensible reasons for hospital infections make the fact that patients also suffer from avoidable, non-infectious illnesses even more shocking. This is surely most clear when it comes to pressure ulcers. Known colloquially as bed sores, they typically
W 40
hat are the dangers of spending time in hospital? It sounds like a funny question – why be admitted if you risk getting
point
pressure caused by lying on vulnerable areas, or else from friction between body and bed, millions of people suffer from the condition each year. That’s doubly frustrating given how preventable many pressure ulcers actually are – in an ideal medical world anyway. Andrea Valentino talks to Dr Marissa Carter, founder at Strategic Solutions, to learn more.
form, as the name suggests, through pressure – for instance the pressing of skin against a hospital bed. Friction and shearing – when two surfaces move in opposite directions – are frequent triggers too. But what unifies all these sparks is the fact that they can be defeated without isolating patients or making them wear masks. Remove the pressure, as the theory goes, and the pressure ulcer is far less likely to form. As so often in contemporary healthcare, theory and practice are rarely happy bedfellows, meaning the fundamental problems of pressure ulcers show little sign of abating.
Unwelcome bedfellows
Few people are better placed to understand the dangers of bed sores than Dr Marissa Carter. A student of pressure ulcers for decades, in 2000 she founded Strategic Solutions, a company that helps design clinical trials. And as Carter explains, pressure ulcers, or as she calls them ‘pressure injuries’, have become an almost unavoidable part of medical life. “There’s been a great deal of discussion on how to prevent pressure injuries,” she says. “One of the things that is really annoying is that the top view – that all pressure injuries are preventable – is not entirely true.” With the average hospital patient or care home
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