Chronic lower extremity ulcers affect approximately 2.5 million to 4.5 million people in the US. This growing clinical problem is most prominent among the elderly residents of nursing homes. In many of our cases against nursing homes where poor care has resulted in the development of decubitus ulcers, the facilities defend their inaction by arguing the resident suffered from other comorbid conditions which either caused the decubitus ulcer or prevented the ulcer from healing. A recent study conducted at Case Western Reserve University in Cleveland, Ohio reveals this defense to poor care of the elderly to be exactly what it is, “hogwash”!
Diabetes, renal disease, cardiac disease, pulmonary disease, endocrine disorders, GI disease, blood disorders, neurological disease, and smoking were not associated with poor wound healing in the study. However, diagnoses of malnutrition, infection, CVA, and dementia were important. History of stroke and presence of cognitive impairment are likely to be related to poorer functional status and reduced activity levels, making healing more difficult to achieve. Nutritional status has been linked to the development of pressure ulcers, and is considered an important factor in successful healing of chronic wounds.
If nursing homes made sure its residents received proper nutrition and repositioning, the problems with decubitus ulcers would become a thing of the past.
Read the report for yourself (requires free registration).