Prevalence of types of ulcers in hospitalized children

Introduction: Pressure ulcers are one of the most common skin and tissue disorders. 95% of sores in adults are in the lower half of the body, whereas in children under 8 years of age, the area behind the baby s head is the most common area of pressure sores. Back of head ulcers quickly become grade 3 and 4 wounds due to proximity to the bone. Another common ulcer in children, especially neonates, has been extravasation of fluid and injectable drugs at the peripheral venous catheter. Pressure ulcers and ulcers resulting from intravenous injections impose a high cost on the patient s family and care system and increase the length of hospital stay. In addition to combating the disease, the child also has to endure the pain of the ulcer and much concern to the parents. Investigating the prevalence of wounds in pediatric wards helps caregivers take effective steps to prevent them.Methodology: In this cross-sectional descriptive study, the prevalence and types of wounds in different wards of Bahrami Pediatric Hospital were investigated from June 2018 to September 2019 (16 months). The data were analyzed using descriptive statistics indices.Findings: Of the 43 cases studied, 53.5% (23 cases) had pressure ulcers and 46.5% (20 cases) peripheral venous catheter necrosis.In neonatal intensive care unit (NICU) out of 23 examined ulcers, 75% (15 cases) form necrosis of peripheral vein catheter site. The most common cause was dextrose 10% infusion (47%) and intravenous calcium (33.4%). The prevalence of pressure ulcers in the NICU was 34.8% (8 cases), half of which occurred in the back of head region (50%) and 37.5% in the auricle.In the pediatric intensive care unit (PICU) out of 15 cases, the prevalence of pressure ulcer was 52.2% (12 cases), which was higher than the NICU. 25% of cases involved the back of head region, 25% auricle and 16.7% of the sacrum area. In the PICU 15% (3 cases) of necrosis lesions was form peripheral venous catheter and the most common cause was intravenous infusion of calcium 10% (67%) In other pediatric internal sections, the prevalence of pressure ulcer is 13% (3 cases) And 10% (2 cases) of necrosis lesions form the peripheral vein catheter.Discussion: The highest prevalence of ulcers is in the NICU, with the most prevalent being necrosis due to serum dextrose 10% injections. Other studies have reported a 70% prevalence of necrosis due to drug leakage in NICUs. The most prone area of the neonate s body is the back of the head. In the PICU, the prevalence of pressure ulcers is high and most of the area involved is behind the head and auricle.Conclusion: The incidence of ulcers in hospitalized children, especially neonates, is a caring challenge and its prevention is very important. In the case of drug and serum leakage wounds, the most important task is to carefully evaluate the location of the peripheral venous catheter every hour to prevent drug and serum leaks. In the case of pressure sores education of health care providers about location differences and incidence rates of pressure ulcer in children and adults and complete and accurate evaluation of baby s skin is important.

کلیدواژه ها:

Pressure ulcer ، Pediatric Nursing ، Neonatal Intensive Care Unit ، extravasation injury ، Pediatric Intensive Care Unit