A Simple Guide To Pressure Injuries, Diagnosis, Treatment And Related Conditions

By Kenneth Kee

This book describes Pressure Injuries, Diagnosis and Treatment and Related Diseases

A pressure injury (also named a bedsore, pressure ulcer, pressure sore or decubitus ulcer) is a spot of injured skin.

Pressure injuries or wounds to the skin and underlying tissue, normally develop at the bony areas of the body, and happen when one or more of these pressure forces are applied to the skin.

Pressure injuries are common in those laying on the bed especially the elderly
There are areas of friction and constant pressure on the skin blood supply
The results are breakdown of skin and ulcerations
As a result of constant skin irritations and infections

First there is redness of the irritated skin
Next the skin becomes hot and starts blistering
Then the skin bubble breaks and forms an ulcer
Pain occurs when there is damage to the muscle

The infection spread to the fat tissues causing inflammation
Finally the damage affects the bone resulting in septicemia
The bone and joint is damaged by the infection
At this stage there may be fever and general inflammation

Treatment is by debridement of the pressure injury sores and strong antibiotic
Surgical treatment and skin grafting may be necessary but traumatic
Prevention is by using talcum powder on dry skin
Together with the body being regularly turning

-An original poem by Kenneth Kee

Pressure injuries are produced when a force is applied to the skin, causing injury to the tissue.

Constant pressure on the skin happens from staying in the same position for a prolonged period of time.

When the skin is “pressed” between a bone inside the body and an external surface for long durations, the blood supply to the skin is decreased.

The skin becomes damaged when the lack of blood induces the skin cells to die.

This can happen from sitting or lying down for long durations, or from persistent use of a medical device that presses onto the skin.

Shear injury or a dragging force can happen when the head of the bed is raised and the body slides down.

The skin is stuck to the bed sheets but internal structures of the skin are injured.

When the skin is pulled or scrapes against another surface, the force produced injures the outer layers of the skin, weakening the skin and making it more susceptible to injury.

This can happen when pulling someone up a bed, and the heels are towed across the sheets.

Pressure injury happens when the pressure force is applied on the surface of the skin.

This force can be a steady pressure on an area of skin or a pulling (shearing) force between the skin and another surface.

Fluids (sweat, urine, fecal matter) that stay on the skin can induce the skin to become overly wet, which raises the risk for pressure injury development.

These injuries normally happen over the bony parts of the body (hips, heels, tailbone, elbows, head and ankles).

A pressure injury can become life-threatening if it goes on to a deep wound or becomes infected.

The most frequent areas to develop a pressure injury are:
1. Back of the head
2. Buttocks
3. Heels

Once the stage and severity of the wound is identified, it must be cleaned, normally with a saline solution.

After the wound is cleaned, it requires be keeping clean, moist, and covered with a proper bandage.

Occasionally debridement is needed to get rid of the wound of dead tissue.
1. Ultrasound: Using sound waves to remove the dead tissue.
2. Irrigation: Using fluid (often pressurized) to wash away dead tissue.
3. Laser: Using focused light beams to remove the dead tissue.
4. Biosurgery: Using maggots to eliminate bacteria from the wound.
5. Surgery: Using surgery to remove the dead tissue and close the wound.

TABLE OF CONTENT
Introduction
Chapter 1 Pressure Injuries
Chapter 2 Causes
Chapter 3 Symptoms

• Language: English
• Publisher: Kenneth Kee
• Release date: Mar 13, 2021
• ISBN: 9781005019679

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

A

Simple

Guide

To

Pressure Injuries,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2021 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Pressure Injuries, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What You Need to Treat Pressure Injuries)

This e-Book is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog: http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiography account of my journey as a medical student to family doctor on my other blog: http://afamilydoctorstale.blogspot.com.

This autobiography account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

My diagnosis and treatment capability has improved tremendously from my continued education.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Pressure injury

What Is a Pressure Injury?

A pressure injury (also named a bedsore, pressure ulcer, pressure sore or decubitus ulcer) is a spot of injured skin.

Pressure injuries or wounds to the skin and underlying tissue, normally develop at the bony areas of the body, and happen when one or more of these pressure forces are applied to the skin.

What are the causes of Pressure Injury?

Causes

Pressure injuries are produced when a force is applied to the skin, causing injury to the tissue.

Constant pressure on the skin happens from staying in the same position for a prolonged period of time.

Pressure

When the skin is pressed between a bone inside the body and an external surface for long durations, the blood supply to the skin is decreased.

The skin becomes damaged when the lack of blood induces the skin cells to die.

This can happen from sitting or lying down for long durations, or from persistent use of a medical device that presses onto the skin.

Shear

Shear injury or a dragging force can happen when the head of the bed is raised and the body slides down.

The skin is stuck to the bed sheets but internal structures of the skin are injured.

Shear happens when two surfaces travel in opposite directions.

When a bed is raised at the head, the person may slide downwards to the foot of the bed.

As the tailbone travels downwards, the skin over the tailbone may remain in place, producing pulling forces in the opposite direction.

When this happens, the blood vessels under the skin can twist and tear, decreasing blood supply to the skin and producing skin injury.

Friction

When the skin is pulled or scrapes against another surface, the force produced injures the outer layers of the skin, weakening the skin and making it more susceptible to injury.

This can happen when pulling someone up a bed, and the heels are towed across the sheets.

Pressure injury happens when the pressure force is applied on the surface of the skin.

This force can be a steady pressure on an area of skin or a pulling (shearing) force between the skin and another surface.

4. Moisture:

Fluids (sweat, urine, fecal matter) that stay on the skin can induce the skin to become overly wet, which raises the risk for pressure injury development.

These injuries normally happen over the bony parts of the body (hips, heels, tailbone, elbows, head and ankles).

A pressure injury can become life-threatening if it goes on to a deep wound or becomes infected.

Location of Pressure Injury

Pressure injuries can happen at any part of the body.

They often happen at the bony areas of the body, as shown:

The most frequent areas to develop a pressure injury are:

1. Back of the head

2. Buttocks

3. Heels

Risk Factors of Getting a Pressure Injury

The patient is at a higher risk of getting a pressure injury if the patient has:

1. Old Age

As people age, the skin naturally is thinner and more easily injured.

Skin becomes thinner and less elastic with age, raising the risk of skin breakdown.

2. Disease

Disorders that produce poor blood circulation (e.g. heart disease), sensation disorders (e.g. nerve/ blood vessel disease), or problems with moving (e.g. stroke), can raise risk of skin breakdown.

3. Obesity/Malnutrition

A person, who is underweight, decreases muscle and fat that protect the skin.

Wound healing is reduced when nutritional needs are not adequate.

Also, being overweight places excess pressure on the skin.

4. Decreased Mobility

Difficulty moving (e.g. being bed-bound or wheelchair-bound) can elevate the risk of continuous stress at pressure-prone areas of the body and elevate the risk of skin breakdown.

People in wheelchairs or bedridden are at special risk and need to be moved or turned regularly

5. Incontinence

Constant wet skin (due to prolonged exposure to urine or feces) is more prone to skin breakdown.

Prosthetic (artificial) limbs

If the device is not fitting properly, the skin can be irritated and a pressure injury can result.

6. Loss of sensation

Skin with lost sensation is at risk since they may not feel the pressure being applied to the skin.

As a result, the