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DOI: 10.1055/s-2007-976159
© Georg Thieme Verlag Stuttgart · New York
Dekubitalulzera im höheren Lebensalter - Ausdruck fortgeschrittener funktioneller Defekte
Decubitus ulcers at an advanced age - Expression of advanced functional defectsPublication History
Publication Date:
21 March 2007 (online)
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Dekubitalulzera bei älteren Patienten sind nicht nur umschriebene Gewebedefekte, sondern meist Ausdruck fortgeschrittener funktioneller Defizite und einer begleitenden Multimorbidität. Ein Dekubitus entsteht, wenn von außen einwirkende Kräfte, meist Druck, die Ischämietoleranz der Haut und tiefer liegender Gewebeanteile übersteigen. Deshalb umfassen Prävention und Therapie von Dekubitalulzera sowohl die Reduktion externer Kräfte als auch eine Behandlung patientenbezogener Risikofaktoren. Für kein Krankheitsbild werden so zahlreiche und so heterogene Therapieansätze angeboten. Dennoch existieren nur wenige valide Studien, sodass die Grundlagen einer evidenzbasierten Dekubitustherapie kaum vorhanden sind. Im Zentrum steht die feuchte Wundbehandlung. Trotz methodischer Probleme sind weitere Studien erforderlich, um die teilweise aufwändigen Therapieverfahren für Dekubitalulzera zu validieren.
Decubital ulcers in the elderly are more than merely circumscribed tissue defects. In fact, they usually express advanced functional deficits and an associated multi-morbidity. A decubitus ulcer is usually a pressure sore due to excess external pressure exceeding the ischemic tolerance of the skin and deeper tissues. Hence, prevention and treatment of pressure sores must include not only reduction of externally exercised pressure but also treatment of patient-related risk factors. There is practically no other disease pattern for which a similar plethora of heterogeneous treatments has been suggested. However, really valid studies are few and far between, so that there are hardly any really fundamental elements of an evidence-based decubitus therapy. Moist treatment of the sore is a focal point. Further studies are mandatory despite methodical problems, for the purpose of validating present-day current and partly elaborate therapeutic procedures.
Key words
decubitus - geriatric patient - therapy - prevention - evidence-based medicine
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Korrespondenz
PD Dr. Rupert Püllen
Medizinisch-Geriatrische Klinik der Frankfurter Diakonie-Kliniken
Holzhausenstraße 72-92
60322 Frankfurt/Main
Email: rupert.puellen@fdk.info