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Pressure Ulcers - Preventing and Treatment

Whilst the randomised controlled trial and large sample size of 213 increase the validity of the results it can be deemed that the results are still flawed. This is due to the study conducted having changed two variables being frequency of repositioning and the position used. Therefore it can be difficult to determine whether the decrease in pressure ulcer prevalence was a direct result of the position being the thirty degree tilt compared with the ninety degree lateral position or the participants being turned every three hourly compared to six-hourly. .
             In addition to this, latter research has contested past researchers findings that the thirty degree tilt is the ideal position to reduce the prevalence of pressure ulcers. Kallman et al. (2012) results reveal that the thirty degree semi fowlers and thirty degree lateral position had the greatest decrease in blood flow in the superficial and deep tissue in comparison with the supine and ninety degree lateral position. These results are important as a decrease in blood flow to an area has been linked with the development of pressure ulcers (Kallman et al., 2012). However, the small sample size of twenty in the Kallman et al. study can be considered a limiting factor therefore further study is needed to justify these finding. Further to this, the Moore, Cowman and Conroy study which supports the thirty degree tilted position did advise that this position appeared to be technically lacking scientifically however is still effective in pressure ulcer prevention. .
             Additionally the Kallman et al. (2012) findings found that supine position resulted in an increase of blood flow in comparison to all other positions. Therefore, this decreases the risk of a pressure ulcer formation. Whilst Krapfl and Gray (2008) support this finding it is argued that this positioned is rarely utilised due to patient preference. Additionally, important consideration needs to be taken to ensure that patients are not directly repositioned on existing pressure ulcers.


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