As we approach the year 2020 the use of Photobiomodulation Therapy (PBM) is reaching record high usage in treatment of musculoskeletal and soft tissue injury.
Another common application of PBM includes the treatment of pressure sores. Pressure sores are a significant healthcare problem in the United States today. All patients with limited mobility regardless of cause are at high risk for the development of pressure ulcers. Cost of treatment for pressure ulcers is rising throughout the United States as more and more patients are developing these wounds. Complications of pressure ulcers are common. Mortality is increasing.
In 2019, greater than one million patients per year develop pressure ulcers. Twenty-three (23) percent of these pressure ulcers develop in skilled care and nursing homes. Eleven (11) percent occur in acute care settings like hospitals. The remaining twenty (20) percent occurs during home care.
Pressure ulcers are a significant healthcare problem in the United States today with over one million acute care and nursing home patients being affected.
Among patients who are at highest risk for pressure ulcers are those patients with limited mobility. Prevalence and incidents in high risk patients is high with over sixty (60) percent quadriplegic patients developing skin wounds followed by over fifty (50) percent baby boomers experiencing femoral fractures; followed by thirty (30) to forty (40) percent of critical patients admitted to the ICU.
Orthopedic patients especially those who are immobilized secondary to a mechanical fall with fracture appear to be at greater risk than those admitted for elective orthopedic surgery. A 1994 report by Ross Products determine that the national cost of pressure ulcer treatment exceeds 1.335 billion. The cost in a long term care facility for treatment of pressure ulcers were $459 with Stage II wounds while $743 for Stage II and Stage IV wounds. Treatment of pressure sores can cost between $5,000 and $50,000 per wound. Importantly, each wound that a patient experiences particularly in a long term care setting and/or intensive care center setting can result in complications including death.
More outcomes of patients experiencing decubitus ulcers as part of their rehabilitation and restoration have increased incidents of complications. Increased use of healthcare resources. Other complications associated with pressure ulcers include infection, pain, depression and humiliation. Pressure ulcers can be long term often taking months to resolve. Additionally, pressure ulcers increase use of healthcare resources and prevent patients from getting the rehabilitation that they often need. Patients with pressure ulcers require 50% more nursing time; remained hospitalized for significantly longer periods of time and are associated with higher hospital charges than those without sores.
Finally, pressure sores are associated with increased mortality. Every year an estimated 60,000 people die from complications related to pressure sores. One study by Ross Products found that out of almost 20,000 people over age 60 with a sore admitted to one of fifty one nursing homes 88% had a greater death rate by one year than those with no sores. Those already residing in the homes had 129% greater death rate by one year than those patients who did not have wounds.
Photobiomodulation is an effective tool for preventing decubitus ulcers when used as part of a prevention program. Photobiomodulation is an excellent tool for healing decubitus ulcers of all stages. I strongly encourage each of you to consider the use of photobiomodulation therapy in the prevention of skin breakdown over boney prominences and use of photobiomodulation therapy at the first sign of any skin breakdown or decubitus ulceration formation. Effective pressure avoidance and treatment is best achieved through a team approach involving patients, their families, care givers and healthcare providers. Photobiomodulation is an important medical therapeutic tool to assist patients in avoiding skin breakdown and healing skin breakdown once it occurs.
Terrance L. Baker, MD, MS
President – NAALT