A influência da posição corporal no aparecimento das úlceras de pressão no indivíduo sentado

Abstract

Pressure ulcers concern patients, families and healthcare professionals. Their appearance brings serious consequences to health and expensive costs for the patient and healthcare facilities, becoming a problem that needs an urgent solution. In what concerns to patients with spinal cord injury pressure ulcers are considered to be the main consequence, given the fact that 70% develop a pressure ulcer. Intervening on the main causative agent - the pressure - has been the main goal of clinical practice and research, and repositioning the main strategy for relieving the pressure and lying down position the target of the largest number of published studies. Recently, studies in sitting posture and studies about other causes that intervene in the tissue viability, as the skin temperature and inflammatory mediators have been a special concern for the researchers. Healthy individuals do not develop pressure ulcers because they change their body position, for as long as the time goes by, what releases the pressure and avoids tissue injury. The knowledge of body adjustments performed by the healthy individual will allow that the frequency of the reposition of the sitting patient prevents the appearance of an injured tissue and that integrates the healthcare plan to individuals with limitation of mobility and sensitivity. It has been made an almost - experimental study, with 31 healthy individuals, 20 of them were female and 11 male. For an hour they remained sat over a mat with pressure sensors, as the acceleration of the trunk, the skin temperature and the discomfort were being evaluated simultaneously. Two evaluations of skin integrity were made before and after the pressure, and also two blood collections to verify the concentration of interleukin 6 (before and after the pressure). On average, the participants have made a repositioning every 4,6minutes, moving preferentially along two axes: horizontal and vertical. The results point out to an increase of 3.5 degrees average temperature. We can also verify that those who have some physical activity present lower levels of interleukin – 6, so it seems that physical activity may contribute to tissue resistance and, as such, should be part of the plan care to individuals with limited mobility and sensitivity. Future studies concerning some of these issues studied here are essential to understand the multifactorial occurrence of pressure ulcers.

Date of Award	Sept 2011
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Margarida Maria Vieira (Supervisor) & Paulo Alves (Co-Supervisor)