Chronic wounds in persons living with dementia: An integrative review.
Justine S Sefcik, Elease J McLaurin, Ellen J Bass and 1 others
PMID 35043568WHAT IT FOUND
Most published evidence on chronic wounds in dementia describes pressure injuries in nursing homes and hospitals, not home care, and rarely reports tested treatments.
Clinicians have little evidence for wound care when dementia symptoms interfere.
Key findings
01Thirty-three of 36 reviewed papers focused on pressure injuries; only one paper described a chronic coccygeal ulcer.
02Five publications described wound care interventions, and these were case studies or a quality improvement report.
03Nursing homes and hospitals were the most common settings, with 16 and 11 studies respectively, and only one case study was set in the home.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only English publications were searched, and the search terms may have missed relevant studies. Thirty-six articles were heterogeneous in samples, focus and outcomes, so the review could not combine results statistically. The included literature contained no randomized controlled trials or systematic reviews of clinical interventions, and many studies were observational, case reports or quality improvement reports. Wound details were often missing, including wound stage, location, size and whether a skin tear became chronic. Dementia stage was not always reported, and some studies did not separate people with dementia from people without dementia. Race, ethnicity and skin tone were rarely reported, and no publication reported skin tone. Home wound care for people with dementia was almost absent, with only one home case study and no adult day care or assisted living data.
Declared interests
The authors declare that they have no conflict of interest.
The easy way to misread this
Do not read the case studies and quality improvement reports as evidence that these wound care treatments work for people with dementia. The review found no randomized trials of wound interventions, and it did not test whether any treatment improved healing.