Yanxia Jiao, Chenlu Yuan, Tong Wu, Hongyan Zhang, Yuting Wei, Yuxia Ma, Xiujuan Zhang, Lin Han, view paper on the JTV website.

Fracture patients are at high risk of developing a Pressure Injury (PI), especially when an inpatient. Notably, the authors of the paper say that there is a particular risk of PI when it comes to surgical treatment, plaster splint, and traction fixation after a fracture of the lower extremity or pelvis or lumbar thrust occurs.

The objective of this paper was to systematically evaluate the incidence of PIs in hospitalized fracture patients and to provide evidence for the prevention and treatment of PIs in this population.  A systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines.

A total of 7906 articles were screened, and 18 studies with 8956 patients were ultimately involved. The review found that the pooled incidence of PIs in the fracture patients was 20.4% (95%CI: 14.9 to 25.8), and the incidence of PIs only in spinal and hip fracture patients was 23.9% (95%CI: 19.6 to 28.2). The incidence of PIs in 65 years or over was significantly high (23.3% [95%CI: 15.3 to 31.2]). The most affected body sites were sacrococcygeal regions (56.7%) and heels (19.9%).

The review also found that most common stages of PIs were stage 2 (62.2%) and stage 1 (17.4%).  The review suggests that PIs remain a significant burden for healthcare systems worldwide and highlights the need for additional efforts in developing and implementing patient safety initiatives. The review recommends that more needs to be done to reduce the incidence of PIs in this at risk population.

In addition more research is needed that improves the understanding of characteristics of PIs among fracture patients and to identify ways to prevent them effectively through introducing guideline based practice protocols to improve the implementation of preventive strategies.