SciELO - Scientific Electronic Library Online

 
vol.4 número1Evaluación de las relaciones hematológicas inflamatorias (NLR, PLR, MLR y relación monocitos / colesterol HDL) en adolescentes obesosEl recuento de plaquetas como indicador útil de bacterias tipo Gram que causan infecciones del tracto urinario en mujeres índice de autoresíndice de assuntospesquisa de artigos
Home Pagelista alfabética de periódicos  

Serviços Personalizados

Journal

Artigo

Indicadores

Links relacionados

  • Em processo de indexaçãoCitado por Google
  • Não possue artigos similaresSimilares em SciELO
  • Em processo de indexaçãoSimilares em Google

Compartilhar


Iberoamerican Journal of Medicine

versão On-line ISSN 2695-5075versão impressa ISSN 2695-5075

Iberoam J Med vol.4 no.1 Logroño Fev. 2022  Epub 22-Jan-2024

https://dx.doi.org/10.53986/ibjm.2022.0004 

Original Article

Overview on pressure ulcers studies based on bibliometric methods

Resumen de estudios sobre úlceras por presión basados en métodos bibliométricos

Hatice Öntürk Akyüz (orcid: 0000-0002-6206-2616)*  a  , Sevil Alkan (orcid: 0000-0003-1944-2477)b  , Oruç Numan Gökçe (orcid: 0000-0002-9678-7818)c 

aBitlis Eren University School of Health Sciences, Department of Nursing, Bitlis, Turkey

bCanakkale Onsekiz Mart University Faculty of Medicine, Infectious Disease Department, Canakkale, Turkey

cCanakkale Onsekiz Mart University Faculty of Medicine, Department of General Surgery, Canakkale, Turkey

ABSTRACT

Introduction:

Pressure ulcers (PU) are a major health problem, causing increased health costs as well as workload of health workers. In this study, we aimed to analyze the developments in PUs and to add perspective to future studies by examining the research articles published on PUs, which is an increasing health problem worldwide.

Material and methods:

Bibliometric analysis method was used in this study. The data was obtained by searching the Elsevier Scopus database with using the keywords “pressure ulcer” or “bedsore” or “decubitus ulcer” or “decubitus” or “pressure sore”.

Results:

4,361 articles were analyzed in terms of study criteria. The first article was published in the year 1849 and 52.94 % of articles were published after the year 2011. Most of the articles were written in English (87.6%) language. The majority 29.32%) of articles were from the United States of America (USA). USA, United Kingdom and Japan were the top three publishing countries. Most of the articles were in the area of medicine [n =2896(66.4%)] and nursing [n=1903(43.63%)]. The highest number of articles on PUs were published in the journals of Ostomy Wound Management (n=177), Journal of Wound Care (n=156), International Wound Journal (n=144), Journal of Wound Ostomy And Continence Nursing (n=141) and Journal of Tissue Viability (n=126).

Conclusions:

As the number of immobile and debiliated patients increase globally, the publications on PUs seem to be increase too. Studies outside of Europe and the USA should also be supported and the number of publications should be increased, especially from developing countries.

Keywords: Pressure ulcers; Bibliometric method; Scopus database

RESUMEN

Introducción:

Las úlceras por presión (UPP) son un importante problema de salud, provocando un aumento de los costes sanitarios y de la carga de trabajo de los trabajadores sanitarios. En este estudio, nuestro objetivo fue analizar los desarrollos en UPP y agregar perspectiva a estudios futuros mediante el examen de los artículos de investigación publicados sobre UPP, que es un problema de salud creciente en todo el mundo.

Material y métodos:

En este estudio se utilizó el método de análisis bibliométrico. Los datos se obtuvieron mediante una búsqueda en la base de datos de Elsevier Scopus con las palabras clave “úlcera por presión” o “úlcera por decúbito” o “úlcera por decúbito” o “úlcera por decúbito” o “úlcera por presión”.

Resultados:

Se analizaron 4.361 artículos en función de los criterios de estudio. El primer artículo se publicó en el año 1849 y el 52,94% de los artículos se publicaron después del año 2011. La mayoría de los artículos fueron escritos en idioma inglés (87,6%). La mayoría (29,32%) de los artículos procedían de los Estados Unidos de América (EE. UU.). Estados Unidos, Reino Unido y Japón fueron los tres principales países editores. La mayoría de los artículos fueron del área de medicina [n = 2896 (66,4%)] y enfermería [n = 1903 (43,63%)]. El mayor número de artículos sobre UPP se publicaron en las revistas de Ostomy Wound Management (n = 177), Journal of Wound Care (n = 156), International Wound Journal (n = 144), Journal of Wound Ostomy And Continence Nursing (n = 141) y Journal of Tissue Viability (n = 126).

Conclusiones:

A medida que aumenta el número de pacientes inmóviles y debilitados a nivel mundial, las publicaciones sobre UPP parecen estar aumentando también. También deberían apoyarse los estudios fuera de Europa y Estados Unidos y debería incrementarse el número de publicaciones, especialmente de países en desarrollo.

Palabras clave: Úlceras por presión; Métodos bibliométricos; Base de datos Scopus

1. INTRODUCTION

It has been defined as “localized skin and/or subcutaneous tissue damage, usually over bony prominences, caused by decubitus alone or in combination with shear and pressure” is the definition by the National Pressure Ulcer Advisory Panel (NPUAP) and the European Pressure Ulcer Advisory Panel (EPUAP) in 2009 [1]. Bedsore, decubitus ulcer, decubitus, pressure sore, and pressure ulcer (PU) are the most commonly used terms among many synonyms for this disorder caused by pressure in the momenclature of tissue integrity [1, 2].

Although decubitus ulcers are mostly preventable health problem, they have many negative consequences for the patient, hospital and healthcare workers when they develop. From the patient's point of view, these disorders not only threaten the life of the patient by affecting the physical health of the patient, but also cause psychological problems such as loss of independence and social isolation. In addition, the patient who develops PU suffers from wound care, infections, debridement and grafting-related pain; increased hospitalizations time, and causes extra costs for the health system. PUs are also an important health problem that increases the workload of healthcare professionals. There are many risk factors that will lead to the development of PUs. Immobility, nutritional disorders, lack of hygiene of the patient's bed or laundry, obesity, edema, vascular pathologies, urinary or fecal incontinence, exposure to radiation, catheterization, mechanical equipment (plaster, bandage, etc.), injuries, irritations due to friction are the most common causes [3, 4].

While the recent increase in medical care has led to an increase in human lifespan, the number of nursing patients may also have increased and PUs development can be expected to increase. It is expected that the number of scientific publications on this subject, which concerns many common areas in health (surgery, internal medicine, infection diseases, nursing, dietitianity, etc.) also increase.

In this study, we aimed to analyze the developments in PUs and to add perspective to future studies by examining the research articles published on PUs, which is an increasing health problem worldwide.

2. MATERIALS AND METHODS

Bibliometric analysis method was used in this study. The data was obtained by a search conducted on the Elsevier Scopus database (https://www.scopus.com/home.uri). The Scopus database covers approximately 36,377 titles from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in different disciplines (life sciences, social sciences, physical sciences, and health sciences).

2.1. SEARCH CRITERIA

In this study data was retriewed from the beginning of records until October 12, 2021 containing the keywords “pressure ulcer” or “bedsore” or “decubitis ulcer” or “decubitus” or “pressure sore”, typed into the search box in the title section of the basic research. Only research articles included to the study as their scientific values are higher than other publications (letters, abstracts, congress papers, reviews, case presentations did not included). The articles were sorted by the authors, journals, countries, afiliations where the studies were published, publication dates, being open access status and citing numbers.

The searches were performed at the date October 12, 2021. The search was made in single day to avoid bias, since the database is still open and has daily updates. The graphics of the Scopus database were used for visualition and additionally Microsoft Office 2010 was used to create graphics. The tables were created by the researchers on the word file.

Canakkale On Sekiz March University's online library and digital resources were used to access information.

2.2. STATISTICAL ANALYSIS

The data in the tables were given as absolute values (percentage and frequency) by using Microsoft Excell 2010. Only absolute frequencies were used. No advanced statistical method (mean, median and fashion, dispersion measures, standard deviation or statistical tests) were used.

3. RESULTS

Five thousand nine hundred thirty publications included the study according to search criteria 4,361(73.54%) of them research articles. Only research articles were analyzed in terms of study criteria. The first article was published in the year 1849 [5], but after the 1990s the number of publications has increased. 52.94 % of articles were published after the year 2011 (Figure 1).

Figure 1: Number of articles by years. 

Most of the articles were written in English (n=3820, 87.6%) language. Also Spanish (n=177, 4.08%), Japanese (n=83, 1.92%), Portuguese (n=82, 1.91%), French (n=57, 1.31%), German (n=47, 1.10%), Chinese (n=45, 1.05%), Korean (n=20, 0.48%), Italian (n=18, 0.43%) and Czech (n=10, 0.25%) were top preferred languages. The majority (n=1278, 29.32%) of articles were produced by authors from the United States of America, while United Kingdom and Japan were among the top three countries. Spain, China, Brazil, Netherlands, Australia, Germany and Sweden were also in the top ten countries in PUs publications. 995 (22.81%) of the articles were published in open access (OA) journals. 3830 (87.82%) of the publications were not funded by any institution. Most of the funding sponsors were The United States Department of Health and Human Services [n=108, 2.47%], National Institutes of Health [n =103, 2.36%] and National Institute on Aging [n=49, 1.12%]. The most frequent keywords were ‘Human’ (n=3580), ‘decubitis (n=3167), ‘Pressure Ulcer’ (n=3059). Most of the articles were in the area of medicine [n=2896 (66.4%)] and nursing [n=1903 (43.63%)].

The highest number of articles on PUs were published in the journals of Ostomy Wound Management (n=177, 4.05%), Journal of Wound Care (n=156, 3.57%), International Wound Journal (n=144, 3.3%), Journal of Wound Ostomy and Continence Nursing (n=141, 3.23%) and Journal of Tissue Viability (n=126, 2.88%).

Hiromi Sanada, from The University of Tokyo (n=68), Theo W.N. Dassen from Charité – Universitätsmedizin Berlin, German (n=45) and Junko Sugama from Kanazawa University, Japan (n=41) were the most productive researches on PUs. Most of the publications were from VA Medical Center (USA) [n=84], Universiteit Maastricht (Netherlands) [n=78] and Charité – Universitätsmedizin Berlin (Germany) [n=67] (Table 1).

Table 1. Top 10 affiliations on pressure ulcers research (n=4361). 

3.1. CITING ANALYSIS

Eight hundred forty-one of the articles were not cited yet. Gerry Bennett from Queen Mary's School of Medicine and Dentistry (London, United Kingdom) was the most cited author (Table 2).

Table 2: Citing analysis of the top cited 10 documents on pressure ulcers. 

4. DISCUSSION

The effectiveness of scientific publications can be determined by bibliometric studies. With these studies, the most productive authors, countries or afiliations on certain topics can be identified. Bibliometric analysis can be used in many areas such as medicine [16, 17]. Many studies using bibliometric analysis methods can be found in the literature [16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31]. Although PU is among the popular topics in medicine due to the increasing number of patients, recent studies using bibliometric analysis arent identified in the literature. There are only three bibliometric studies, which were published more than 10 years ago [29, 30, 31]. As the publication rates are rapidly changing the information of this studies were out of date. The aim of our study was to assess the current publication trends on PUs literature with bibliometric analysis method.

In bibliometric studies, theses or any type of documents can be examined. In our study, we evaluated research articles as they have higher scientific features.

While the Web of Science (WoS) database was the only database for bibliometric studies until the year 2004, the number of bibliometric databases increased with the establishment of the Scopus and Google Scholar in the year 2004 [32]. The Scopus database, which has the largest content for bibliometric analyses, was preferred in our study. In addition, a commonly preferred bibliometric database is the WOS database as it allows free output for visualization or mapping by using other visualization programmes. We did not use visualization and mapping techniques in this study.

Because of our study, the majority (29.32%) of articles were from the USA, United Kingdom and Japan. Spain, China, Brazil, Netherlands, Australia, Germany and Sweden were also the top ten publishing countries. No publications originating from Turkey were found in the Scopus database. As in many bibliometric analysis studies examining scientific studies, the USA was found to be the most scientifically productive country in our study [19, 20, 21, 22, 23, 30]. The reason for this can be attributed to the USA origin of the institutions that finance scientific researches in the first 3 ranks, or the fact that there is a large number of institutions as a result of the wide geographical distribution in the USA.

Halfens et al. [29] were used bibliometric study on some topic in the year 2001. This study was conducted on Medline database. In this study, the United States and European countries were found to be the most productive countries. Our results / findings are similar, but in our current suty, in which the last 20 years are added to the precious study [29], the number of publications from Japan, Israel and Brazil has increased to the top 10 ranking. This proves that the issue of PUs is a global health problem. Halfens et al. [29] compared the research subjects examined in the USA and European countries in their study. It has been determined that publications in the USA paid more attention to the treatment of PUs, dressings, the etiology of PUs and basic research, while European researchers paid more attention to the prevention of PUs. In our study, this comparison was not made. In the recent study [29], research articles were also found in only 49% of all publications. In our study, 73.54% of the publications on PUs were research articles. This can prove that the quality of studies on this subject has increased in the last 20 years.

Chen et al. [30] were found that most of the publications were in surgery and nursing areas and from the USA. Our study results were similar. Compared with this study [30], we found that the number of publications increased even more after 2011, 52.94% of the articles are dated after 2011.

The number of publications on PUs are increasing, but especially studies from development countries. Studies outside of European and the USA should also be supported and the number of publications should be increased, especially from other developed countries.

4.1. LIMITATIONS

We searched only the Scopus database, which may have led to a bias.

REFERENCES

1. Mervis JS, Phillips TJ. Pressure ulcers: Pathophysiology, epidemiology, risk factors, and presentation. J Am Acad Dermatol. 2019;81(4):881-90. doi: 10.1016/j.jaad.2018.12.069.Links ]

2. Kottner J, Cuddigan J, Carville K, Balzer K, Berlowitz D, Law S, et al. Pressure ulcer/injury classification today: An international perspective. J Tissue Viability. 2020;29(3):197-203. doi: 10.1016/j.jtv.2020.04.003.Links ]

3. Gül Ş. [Prevention of Pressure Ulcers in Patients Undergoing Surgery]. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi. 2015;1(3):54-61.Links ]

4. Mervis JS, Phillips TJ. Pressure ulcers: Prevention and management. J Am Acad Dermatol. 2019;81(4):893-902. doi: 10.1016/j.jaad.2018.12.068.Links ]

5. Jones W. On The treatment of ulcers by pressure. Lancet. 1849;53(1335):353-4.Links ]

6. Bennett G, Dealey C, Posnett J. The cost of pressure ulcers in the UK. Age Ageing. 2004;33(3):230-5. doi: 10.1093/ageing/afh086.Links ]

7. Vanderwee K, Clark M, Dealey C, Gunningberg L, Defloor T. Pressure ulcer prevalence in Europe: a pilot study. J Eval Clin Pract. 2007;13(2):227-35. doi: 10.1111/j.1365-2753.2006.00684.x.Links ]

8. Edsberg LE, Black JM, Goldberg M, McNichol L, Moore L, Sieggreen M. Revised National Pressure Ulcer Advisory Panel Pressure Injury Staging System: Revised Pressure Injury Staging System. J Wound Ostomy Continence Nurs. 2016;43(6):585-97. doi: 10.1097/WON.0000000000000281.Links ]

9. Robson MC, Phillips LG, Thomason A, Robson LE, Pierce GF. Platelet-derived growth factor BB for the treatment of chronic pressure ulcers. Lancet. 1992 Jan 4;339(8784):23-5. doi: 10.1016/0140-6736(92)90143-q.Links ]

10. Dealey C, Posnett J, Walker A. The cost of pressure ulcers in the United Kingdom. J Wound Care. 2012;21(6):261-2, 264, 266. doi: 10.12968/jowc.2012.21.6.261.Links ]

11. Yager DR, Zhang LY, Liang HX, Diegelmann RF, Cohen IK. Wound fluids from human pressure ulcers contain elevated matrix metalloproteinase levels and activity compared to surgical wound fluids. J Invest Dermatol. 1996;107(5):743-8. doi: 10.1111/1523-1747.ep12365637.Links ]

12. Dinsdale SM. Decubitus ulcers: role of pressure and friction in causation. Arch Phys Med Rehabil. 1974;55(4):147-52.Links ]

13. Allman RM, Goode PS, Patrick MM, Burst N, Bartolucci AA. Pressure ulcer risk factors among hospitalized patients with activity limitation. JAMA. 1995;273(11):865-70.Links ]

14. Blume PA, Walters J, Payne W, Ayala J, Lantis J. Comparison of negative pressure wound therapy using vacuum-assisted closure with advanced moist wound therapy in the treatment of diabetic foot ulcers: a multicenter randomized controlled trial. Diabetes Care. 2008;31(4):631-6. doi: 10.2337/dc07-2196.Links ]

15. Brandeis GH, Morris JN, Nash DJ, Lipsitz LA. The epidemiology and natural history of pressure ulcers in elderly nursing home residents. JAMA. 1990;264(22):2905-9.Links ]

16. Alkan S, Dindar Demiray EK, Yıldız E, Özlü C. Analysis of Scientific Publications on Acinetobacter bacteremia in Web of Science. Infect Dis Clin Microbiol. 2021;3(1):39-44. doi: 10.36519/idcm.2021.37.Links ]

17. Azzaza M, Melki S, Nouira S, Ben Abdelaziz A, Khelil M, Ben Abdelaziz A. Bibliometrics of Tunisian publications in "General Surgery" (Medline, 2009-2018). Tunis Med. 2019;97(7):833-41.Links ]

18. Dahdi SA, Ben Abdelaziz A, Baroumi T, Ba O, Diagana M, Dada L, et al. Bibliometry of biomedical scientific publications in Mauritania (Medline:1992-2016). Tunis Med. 2018;96(10-11):834-43.Links ]

19. Ostlie DJ, St Peter SD. The current state of evidence-based pediatric surgery. J Pediatr Surg. 2010;45(10):1940-6. doi: 10.1016/j.jpedsurg.2010.05.008.Links ]

20. Öntürk H, Dindar Demiray EK, Alkan S. Network analysis of nursing publications in the COVID 19 era. J Clin Med Kaz. 2021;18(4):27-31. doi: 10.23950/jcmk/11037.Links ]

21. Yucens M, Aydemir AN. Trends in Anterior Cruciate Ligament Reconstruction in the Last Decade: A Web-Based Analysis. J Knee Surg. 2019;32(6):519-24. doi: 10.1055/s-0038-1655764.Links ]

22. Bas K, Dayangac M, Yaprak O, Yuzer Y, Tokat Y. International collaboration of Turkey in liver transplantation research: a bibliometric analysis. Transplant Proc. 2011;43(10):3796-801. doi: 10.1016/j.transproceed.2011.09.081.Links ]

23. Ozsoy Z, Demir E. The Evolution of Bariatric Surgery Publications and Global Productivity: A Bibliometric Analysis. Obes Surg. 2018;28(4):1117-29. doi: 10.1007/s11695-017-2982-1.Links ]

24. Alkan Çeviker S, Yılmaz M, Uyar C, Dindar Demiray EK. Bibliometric analysis of scientific research on Crimean-Congo hemorrhagic fever in Turkey. D J Med Sci 2021;7(2):97-102. doi: 10.5606/fng.btd.2021.25064.Links ]

25. Jiang H, Nong B, Yang L, Zong S, Zhan X, Wei Q, et al. Assessing the evolution of scientific publications in orthopedics journals from mainland China, Hong Kong, and Taiwan: a 12-year survey of the literature. J Orthop Surg Res. 2016;11(1):69. doi: 10.1186/s13018-016-0404-z.Links ]

26. Aminian A, Daigle CR, Brethauer SA, Schauer PR. Citation classics: top 50 cited articles in bariatric and metabolic surgery. Surg Obes Relat Dis. 2014 Sep-Oct;10(5):898-905. doi: 10.1016/j.soard.2013.12.021.Links ]

27. Železnik D, Blažun Vošner H, Kokol P. A bibliometric analysis of the Journal of Advanced Nursing, 1976-2015. J Adv Nurs. 2017;73(10):2407-19. doi: 10.1111/jan.13296.Links ]

28. Blažun Vošner H, Železnik D, Kokol P, Vošner J, Završnik J. Trends in nursing ethics research: Mapping the literature production. Nurs Ethics. 2017;24(8):892-907. doi: 10.1177/0969733016654314.Links ]

29. Halfens RJ, Haalboom JR. A historical overview of pressure ulcer literature of the past 35 years. Ostomy Wound Manage. 2001;47(11):36-43.Links ]

30. Chen HL, Cai DY, Shen WQ, Liu P. Bibliometric analysis of pressure ulcer research: 1990-2009. J Wound Ostomy Continence Nurs. 2010;37(6):627-32. doi: 10.1097/WON.0b013e3181f90d2b.Links ]

31. Gupta S, Cho T. A literature review of negative pressure wound therapy. Ostomy Wound Manage. 2004;50(4A Suppl):6-8.Links ]

32. Karasözen B, Bayram ÖG, Zan BU. [Comparison of the WoS and Scopus Databases]. Türk Kütüphaneciliği 2011;25(2):238-60.Links ]

The authors declared that this study has received no financial support.

HOW TO CITE THIS ARTICLE:Akyüz HÖ, Alkan S, Gökçe ON. Overview on pressure ulcers studies based on bibliometric methods. Iberoam J Med. 2022;4(1):18-23. doi: 10.53986/ibjm.2022.0004.

Received: October 20, 2021; Revised: November 12, 2021; Accepted: November 25, 2021

*Corresponding author. E-mail address: onturk65@hotmail.com

CONFLICT OF INTERESTS

The authors have no conflict of interest to declare.

Creative Commons License This is an open access article under the CC BY license