Pressure Ulcers
Predisposing factors include friction, body habitus, moisture (incontinence), reduced activity and nutritional status (controversial topic but be aware of it). Prevention is by rotating the person every 2 hours.
Stages of pressure ulcers:
Stage 1 Intact skin with Non blanchable erythema
Stage 2 Superficial wound involving dermis-epidermis (blister or red-pink bed)
Stage 3 Full thickness skin loss with visible subcutaneous fat
Stage 4 Full thickness deep to expose muscle, tendon or bone (presume osteomyelitis)
Important points to know:
- At each dressing change irrigate or cleanse the wound.
- Debridement of necrotic tissues, if present, can be done surgical or non-surgical.
- Choose surgical if there is a large necrotic area or if infection is present.
- Choose non-surgical (like enzymatic...) if non-infected wound or patient is not a surgical candidate.
- A moderately moist wound can promote healing. Applying wet to dry can interfere with healing and has no rule in decubitus ulcers, however, excessive moisture can lead to maceration.
- Give nutritional supplements only if there is documented evidence of nutritional deficiency.
- In case of multiple ulcers, use powered surfaces like air-fluidized beds.
- Cover high-stage wounds.
Learn more about Pressure or decubitus ulcers.
This post covers the points you need to know for your board exams as well as for teaching residents on the daily rounds. Medical professionals can't use the information here to treat their patients nor people can use the information her to treat themselves. If you are having any medical issues, contact your doctor or local emergency services.