Pressure Ulcers in the Intensive Care Unit: An Analysis of Skin Barrier Risk Factors.

OBJECTIVE: The aim of this study was to determine whether skin barrier factors were associated with the common complication of pressure ulcers (PrUs) in intensive care unit (ICU) patients. It is unclear whether skin barrier factors influence the development of PrUs.

PATIENT POPULATION: The sample was composed of 102 ICU patients (54 men, 48 women). The patients ranged in age from 23 to 88 years, with a mean age of 55.7 (SD, 19.1) years.

METHODS: Demographic variables and the score for the Acute Physiology and Chronic Health Evaluation IV were recorded on admission. The Braden Scale assessment and measurements of the skin barrier factors were performed daily. Standard care for the prevention of PrUs was strictly administered, and PrUs that developed were evaluated according to the recommendations of the US National Pressure Ulcer Advisory Panel 2007 (Note: The authors used the 2007 recommendations at the time of their study.). Data were analyzed using descriptive statistics and logistic regression.

RESULTS: The mean score for the Braden Scale was 11.2, and the incidence of PrUs was 31.4%. Lower moisture content of the stratum corneum and higher skin surface pH at the lower sacrum and hip were risk factors for PrUs, whereas scapular and heel skin barrier factors were not.

CONCLUSION: Nursing strategies aimed at preventing PrUs should place added emphasis on the lower sacral and hip regions.