Patients admitted with decubital lesions: the experience of the Milanese hospital in Garbagnate

Patients may develop a pressure sore while in hospital, but some are admitted with a pressure sore. In Garbagnate hospital all patients are assessed for the risk of pressure sores. The ad hoc forms of patients with multiple lesions, in very poor conditions and with "sentinel" symptoms such as poor hygiene, malnutrition, bruises, are specifically assessed and further data from the head nurse and the family are collected to understand and reconstruct the patients' stories. From January 1999, 26 patients with pressure sores were admitted; 80% were over 75 years: 42.4% came from their homes and 7 from nursing homes. Half of the patients presented severe malnutrition. All the cases had some common characteristics: lack of well defined management of pressure sores; delays in the requests for special mattresses due to lack of attention or bureaucratic problems; or use of ineffective treatments or medications; lack of contacts between hospital and district, leading to a fragmented patient care. Two of the 26 cases are presented and their significance discussed in details.