Clinical Aspects of Prevention, Therapy and Cost Effectiveness

The first clear message from the seminar has been the need to identify the patients at risk of suffering from pressure sores. These generally are those patients who cannot move themselves for one reason or another. There are certain clearly identified groups, such as the paraplegics who lack both sensation and voluntary muscle power. There are many other people who are at risk and most of them appear to be elderly. We know that older people have reduced sensation to pain, faulty postural control, less appreciation of temperature and less response to fever. We know that the older they get the more handicaps they acquire. Figures given during the seminar stated that over the age of 85, four out of five people have at least one major disability. When illness or other disability gets to the stage where the patient would apparently benefit from being moved into hospital, he or she exchanges an environment characterised by in dependence to a high degree (albeit with a degree of difficulty), good care by relatives and freedom from pressure sores, for one where restraint is imposed militating directly against long-acquired habit and custom. It is not known how many of these elderly patients get pressure sores in hospital. The figures given during the seminar put this as high as 30 per cent. It has been indicated that pressure sores if they do occur, tend to appear in the first two weeks the patient spends in this new environment. Thus, the early identification of high-risk patients and high-risk anatomical areas is of first priority.