PAIN RELIEF AND PALLIATIVE CARE IN LEBANON PRESSURE ULCERS Prevention and Management

Pressure ulcers are a significant health care problem for institutionalized patients, especially for the geriatric population [1]. Data from the United States indicates that about 11% of all hospital admissions and up to 25% of persons in skilled care and nursing home facilities have pressure ulcers [3-5]. In certain high-risk populations such as elderly patients with femoral fractures or hospitalized patients with quadriplegia, the incidence of pressure ulcers is over 60% [6-9]. The national cost of treating pressure ulcers in the United States has been estimated at over $ 1.3 billion with the median cost of caring for a patient with a pressure ulcer in an acute care setting being $ 27,000 [2]. Pressure ulcers carry a high level of morbidity for the patient, causing pain, suffering, and prolonged hospitalization. Frustration for the patient, family and caregivers always accompany the development of such ulcers. Pressure ulcers continue to be perceived as a sign of sub-optimal health care, contributing to forge a bad reputation for involved hospitals and healthcare facilities often despite clearly unavoidable risk factors [2]. Studies have shown a clear association between development of pressure ulcers and increased mortality [10-11 ] . Although the presence of a pressure ulcer is associated with a twoto fourfold risk of dying [10-11], this increased mortality is generally attributable to underlying illness and poor functional status rather than the ulcer itself [10].