Pressure ulcers presentation and management at Kenyatta National Hospital and Spinal Injury Hospital

Abstract

Objective: To determine the presentation and management of patients with pressureulcers.

Design: A prospective study.

Setting: The Kenyatta National Hospital (KNH) and National Spinal Injury Hospital(NSIH).

Subjects: One hundred and thirteen patients were evaluated. Ninety six patients fromKNH and seventeen from NSIH. Patients admitted at Kenyatta National Hospital andNational Spinal Injury Hospital with pressure ulcers during the study period.

Results: Of the 113 patients, 77 (68.1%) were male and 36 (31.9%) were female. Meanage of the patients studied was 38.1 years while the range was between 12 and 74 years.Paraplegia was the main associated medical condition accounting for 35.4%, followedby HIV/AIDS with 27.4%. The most common anatomical site for pressure ulcerswas tronchanteric region with 43% of the ulcers. Pressure ulcers of grade III and IVaccounted for 66.4% of the ulcers. Two hourly turning was the most common methodof pressure dispersion used. Gauze dressing was the most common method used inwound care while 67.3% of the patients had their wounds cleaned with povidoneiodine.Fasciocutaneous flaps were the most common surgical procedure performed(81.7%) for closure of pressure ulcers. Overall, 59.3% of surgical procedures had beensuccessful at one month. This was, however, reduced to 48.1% at three months.

Conclusion: Majority of patients with pressure ulcers were in a relatively youngage group with a mean age of 38 years. Most of the ulcers were located along bonyprominence points of the pelvic girdle and the proximal femur. Most of the ulcers inthis study were treated conservatively, with only a few ulcers subjected to surgicalinterventions. For the ulcers treated with surgical interventions the early outcome wasgood, however studies need to be done to determine long term outcomes.