Assessment instruments for pressure injury healing: integrative review

Authors

DOI:

https://doi.org/10.33448/rsd-v9i11.10292

Keywords:

Pressure ulcer; Wound healing; Nursing assessment.

Abstract

Objective: To identify instruments that supports the assessment of the healing of pressure injuries. Methodology: This is an integrative review conducted on the following data sources: Cumulative Indez to Nursing and Allied Health Literature (CINAHL), Scopus, Science Direct, Web of Science, Cochrane Library, Medline, Latin American & Caribbean Health Sciences Literature (LILACS), US National Library of Medicine (PubMed Central) and Biblioteca Virtual em Saúde (BVS). The following were included: Articles that answer the research question, available in full, in Portuguese, English or Spanish. Excluded: Repeated articles, literature reviews and expert opinions. Results: 279 studies were collected between 2009 and May 2020, of these 16 were analyzed. Among the seven instruments identified, the Pressure Ulcer Scale for Healing was the most frequent (36.6%). The most prevalent characteristics of the instruments were lesion size, type of tissue and amount of exudate. Regarding psychometric properties, the BWAT scale was translated and adapted to Brazilian culture, DESIGN-R had predictive validity, PUSH obtained internal and external responsiveness and HPR performed preliminary validity. None of the instruments have clinical validity. Conclusion: The results obtained revealed that the theme is little explored, especially in Portuguese-speaking countries. The lack of uniformity between the healing assessment instruments makes it difficult to standardize the parameters necessary for the assessment, to register the procedures and to compare results between researches on the same theme.

Author Biographies

Maria Alzira Rêgo Pinheiro, Universidade Federal do Rio Grande do Norte

Discente do Curso de Graduaçã em Enfermagem da UFRN.

Isabelle Katherinne Fernandes Costa, Universidade Federal do Rio Grande do Norte

Docente do Programa de Pós-Graduação em Enfermagem da UFRN

Johnata da Cruz Matos, Universidade Federal do Ceará

Doutor em Ciências e Tecnologias em Saúde

Belarmino Santos Sousa Júnior, Universidade Federal de Pernambuco

Doutorando em Enfermagem pelo Programa de Pós-Graduação em Enfermagem da UFPE.

Adriana Montenegro de Albuquerque, Universidade Federal de Campina Grande

Docente do Curso de Graduação em Enfermagem da UPCG campus Cuité

Richardson Augusto Rosendo da Silva, Universidade Federal do Rio Grande do Norte

Professor Associado da Graduação e Pós-Graduação em Enfermagem da UFRN

Iraktânia Vitorino Diniz, Universidade Federal da Paraíba

Doutoranda em Enfermagem pelo Programa de Pós-Graduação em Enfermagem da UFPB

Ana Elza Oliveira de Mendonça, Universidade Federal do Rio Grande do Norte

Doutora em Ciências da Saúde, Professor Adjunto do Departamento de Enfermagem e do Mestrado Profissional Gestão da Qualidade em Serviços de Saúde da Universidade Federal do Rio Grande do Norte.

References

Akhkand, S. S., Seide, J., Ebadi, A. & Gheshlagh, R. G. (2020). Prevalence of pressure ulcer in Iran’s intensive care units: A systematic review and a meta-analysis. Nursing Practice Today, 7(25), 12-20.

Alves, D. F. S., Almeida, A. O., Silva, J. L. G., Morais,F. I., Dantas, S. R. P. E. & Alexandre, N. M. C. (2015). Tradução e Adaptação do Bates-Jensen Wound Assessment Tool para cultura brasileira. Text & Contex Nursing, 24(3), 826-833.

Arai, K., Yamamoto, K., Suzuki, T., Mitsukawa, N. & Ishii, I. (2020). Risk factors affecting pressure ulcer healing: Impacto f prescription medications. Wound Repair Regen, 28(3), 409-415.

Azevedo, M. M., Lisboa, C., Cobrado, L., Pina-Vaz, C. & Rodrigues, A. (2020). Hard-to-heal wound, biofilm and wound healing: na intricate interrelationship. British Journal of Nursing, 29(5), 6-13.

Bereded, D. T., Salih, M. H. & Abebe, A. E. (2018). Prevalence and risk factors of pressure ulcer ir hospitalized adult patients; a single center study from Ethiopia. BMC Res Note, 11(1).

Campanili, T. C. G. F., Santos, V. L. C. G., Pulido, K. C. S., Thomaz, P. B. M. & Nogueira, P. C. (2015). Incidence of pressure ulcers in cardiopulmonary intensive care unit patients. Rev. Esc. Enferm. USP, 49, 7-14.

Cavalcanti, E. O. & Kamada, I. (2020). Medical-device related pressure injury on adults: An integrative review. Text & Contex Nursing, 29, 1-14.

Choi, E. P. H., Chin, W. Y., Wan, E. Y. F. & Lam, C. L. K. (2016). Evaluation of the internal and external responsiveness of the Pressure Ulcer Scale for Healing (PUSH) tool for assessing acute and chronic wound. Journal of Advanced Nursing, 72(5), 1134-1143.

Ferreira, E. Z., Oliveira, A. M. N., Medeiros, S. P., Gomes, G. C., Vaz, M. R. C & Ávila, J. A. (2020). Internet influence on the biopsychosocial health of adolescentes: na integratitive review. Rev. Bras Enferm, 73(2), 1-8.

Garbuio, D. C., Zamarioli, C. M., Silva, N. C. M., Kumakura, A. R. O. & Carvalho, E. C. (2018). Instrumentos para avaliação da cicatricação de lesões de pele: revisão integrativa. Rev. Eletr. Enf, 20(20), 1-16.

Gerge-Santilus, E., Tommasulo, B., Cal, C. E., Hussain, R. Mathew, N., Dlugacz, Y., … Klein, G. W. (2009). Pressure ulcer PUSH score and traditional nursing assessment in nursing home residents: do they correlate? J American Med Directors Association, 10(2), 141-144.

Groah, S. L., Libin, A., Spungen, M. Nguyen, K. L., Wood, E., Nabili, M. Barritault, D. (2011). Regenerating matrix‐based therapy for chronic wound healing: a prospective within subject pilot study. Int Wound J, 8(1), 85-95.

Guihan, M., Sohn, M.W., Bauman, W. A., Spungen, A. M., Power-Cope, G. M., Thomason, S. S. Bates-Jenses, B. M. Difficulty in identifying factors responsible for pressure ulcer healing in veterans with spinal cord injury. Archives of Physical Medicine and Rehabilitation, 97(12), 2085-2094.

Guirra, P. S. B., Gomes, J. S., Biliu, K. S., MedVed, I. V. & Almeida, V. C. (2020). Manejo do paciente com COVID-19 em pronação e prevenção de lesão por pressão. Health Residencies Journal, 1(2).

Günes, U.Y. (2009). A prospective study evaluating the Pressure Ulcer Scale for Healing (PUSH Tool) to assess stage II, stage III and stage IV pressure ulcers. Ostomy Wound Management, 55(5), 48-52.

Harris, C., Bates-Jensen, B., Parslow, N., Raizman, R., Singh, M. & Ketchen, R. (2010). Bates-Jensen Wound Assessment Tool: Pictorial Guide Validation Project. J Wound Ostomy Continence Nurs, 37(3), 253-250.

Hukuda, M. E., Veríssimo, T. A. S., Fávero, F. M., Voos, M. C. Oliveira, A. S. B. & Caromano, F. A. (2016). The method in the researches on responsiveness of scales to assessment in neurological diseases. Cad. Pós-Grad. Em Distúrbios do Desenvolvimento, 16(1), 17-24.

Iizaka, S., Sanada H., Matsui, Y., Furue, M., Tachibana, T., Nakayama, T. … Miyachi, Y. (2012). Predictive validity of weekly monitoring of wound status using DESIGN-R score change for pressure ulcer healing: A multicenter prospective cohort study. Wound Repair and Regeneration, 20(4), 473-481.

Irani, P. S. & Varaie, S. (2016). Comparison of the effectiveness of Aloe Vera Gel with 2% Nitrofurazone ointment on the healing of superficial second-degree burns. Randomise clinical trial. Iran J Med Sci, 41(3).

Jesada, E. C., Warren, J. I., Goodman, D., Iliuta, R. W., Thurkauf, G., McLaughlin, M. K. … Strassner, L. (2013). Staging and defining characteristics of pressure ulcers using photographs by staff nurses in acute care settings. J Wound Ostomy Continence Nurs, 40(2), 150-156.

Jomar, R. T., Jesus, R. P., Jesus, M. P., Gouveia, B. R., Pinto, E. N. & Pires, A. S. (2019). Incidence of pressure injury in na oncological intensive care unit. Rev. Bras. Enferm, 72(6), 1490-1495.

Karahan, A. Abbasoglu, A., Isik, S. A., Çevik, B., Saltan, Ç. Elbas, O. N. Yalili, A. (2018). Factors affecting wound healing in individuals with pressure ulcers: a retrospective stud. Ostomy Wound Manage, 64(2), 32-29.

Lagoumintzis, G., Zagoriti, Z., Jensen, M. S., Argyrakos, T., Koutsojannis, C. & Poulas, K. (2019). Wireless direct microampere current in wound healing: clinical and immunohistological data from two single case reports. Biosensors, 9(3), 1-13.

Lima, P. R., Damacena, D. E. L., Neves, V. L. S., Campos, R. B. N., Silva, F. A. A. & Bezerra, S. M. G. (2017). Ocorrência de lesão por pressão em pacientes hospitalizados: Uma revisão integrativa. Rev. Uningá Review, 32(1), 53-67.

Martins, C. O. A. & Curado, M. A. S. (2017). Observation neonatal skin risk assessment scale: statistical validation with newborns. Rev. Enferm. Referência, 4(13), 43-52.

Matsui, Y., Furue, M., Sanada, H., Tachibana, T. Nakayama, T. Sugama, J. Miyachi, Y. (2011). Development of the DESIGN-R with na observational study: na absolute evaluation tool for monitoring pressure ulcer wound healing. Wound Repair and Regeneration, 19(3).

Melo, A. F., Dantas, V. M., Chavaglia, S. R. R., Barbosa, M. H., Ferreira Júnior, M. A. & Barichello, E. (2019). Construction, validation and reliability of an instrument for evaluation and evolution of chronic wound. Biosci. J, 35(4), 1290-1299.

Nakagami, G., Sanada, H., Iizaka, S., Kadono, I., Higashino, T., Koyanagi, H., Haga, N. (2010). Predicting delayed pressure ulcer healing using thermography: a prospective cohort study. J Wound Care, 19(11), 468-470.

Nora, C. R. D., Zoboli, E. & Vieira, M. M. (2017). Validation by experts: importance in translation and adaptation of instruments. Rev. Gaúcha Enferm, 38(3).

Odom, B. H., Lowe, L., VanHoose, L., Rainey, J. & Yates, C. (2020). Examining factors that contribute to delayed wound healing in children with tracheostomy wound. Adv. Skin Wound Care, 33(3), 1-4.

Oliveira, B. G. R. B., Silva, J. A., Silveira, I. A., Santos, N. C. & Carvalho, M. R. (2019). Instrumentos de avaliação clínica para úlceras de perna. Rev. Enfermagem Atual, 87, 1-9.

Oliveira, K. D. L., Haack, A. & Fortes, R. C. (2017). Nutritional therapy in the treatment of pressure injuries: a systematic review. Rev. Bras. Geriatr. Gerontol., 20(4), 562-571.

Oxford Centre for Evidence-Based Medicine: levels of evidence (2009). Inglaterra. Produced by Phillips, B., Ball, C., Sackett, D., Badenoch, D. Straus, S., Haynes, B. Updated by Howick, J. March 2009.

Pereira, E. J. & Nogueira, M. S. (2020). The nurse’s role in preventing pressure injuries in bedridden patients: literature review. Eletronic Journal Collection Health, 49.

Rocha, S. S., Falcone, A. P. M., Pontes, E. D. S. & Rocha S. R. S. (2020). Analysis of the presence of pressure injury in hospitalized patients and the main associated comorbities. Research, Society and Development, 9(4), 1-14.

Santo, P. F. E., Almeida, S. A., Silveira, M. M. Salomé, G. M. & Ferreira, L. M. (2013). Use of the Pressure Ulcer Scale for Healing tool to evaluate the healing of chronic leg ulcers. Rev. Bras. Cir. Plast, 29(2), 133-141.

Silva, D. R. A., Bezerra, S. M. G., Costa, J. P., Luz, M. H. B. A., Lopes, V. C. A. & Nogueira, L. T. (2017). Pressure ulcer dressings in critical patients. Rev. esc. Enferm. USP, 51, 1-7.

Silva, D. R. V. P. & Moreira, K. F. G. (2020). Intervenção de Enfermagem na avaliação e tratamento de feridas em uma estratégia de saúde da família. Acervo de Recursos Educacionais em Saúde, 1-15.

Silva, P. L. N., Santos, S., Oliveira, R. S., Fonseca, J. R., Rocha, R. G. & Souza Neto, A. R. (2014). Mecanismo etiopatogênico das lesões cutâneas: uma revisão sistemática acerca dos fatores bioquímicos e imunofisiológicos do processo cicatricial. EFDesportes.com, Revista Digital, 191.

Sung, Y. H. & Park, K. H. (2011). Factors affecting the healing of pressure ulcers in a Korean acute care hospital. J. Wound Ostomy Continence Nurs, 38(1), 38-45.

Thomason, S. S., Powell-Cope, G., Peterson, M. J., Guihan, M., Wallen, E. S., Olney, M. C., Bates-Jensen, B. (2016). A multisite quality improvement project to standardize the assessment of pressure ulcer healing in veterans with spinal cord injuries/disorders. Adv. Skin Wound Care, 6, 269-276.

Woodbury, M. G., Houghton, P. E., Campbell, K. E. & Keast, D. H. (1999). Pressure ulcer assessment instruments: a critical appraisal. Ostomy Wound Manage, 45(5).

Young, D. L., Estocado, N., Fend, D., Preto, J. (2017). The development and preliminary validity testing of the healing progression rate tool. Ostomy Wound Manage, 63(8), 32-44.

Published

29/11/2020

How to Cite

PINHEIRO, M. A. R. .; COSTA, I. K. F. .; MATOS, J. da C.; SOUSA JÚNIOR, B. S.; ALBUQUERQUE, A. M. de; SILVA, R. A. R. da; DINIZ, I. V.; MENDONÇA, A. E. O. de. Assessment instruments for pressure injury healing: integrative review . Research, Society and Development, [S. l.], v. 9, n. 11, p. e65991110292, 2020. DOI: 10.33448/rsd-v9i11.10292. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/10292. Acesso em: 22 nov. 2024.

Issue

Section

Health Sciences