How to treat a pressure ulcer?
Regardless of the pressure ulcer category, treatment should start as soon as possible.
The two steps to pressure wound healing are:
Appropriate local care:
- Wound cleansing
- Assessment of the risk of infection. If there are signs of local infection or indications of biofilms present select an evidence based antimicrobial dressing to restore microbial balance.
- Debridement. Deslough or debride the wound selecting an appropriate treatment or dressing to aid autolysis.
- Wound dressing to reduce healing time. The ulcer should be treted locally from day 1 with a dressing that has demonstrated its efficaty in rreducing healing time in RCTs and in real-life.
Relieve or redistribute the pressure by:
Repositioning the patient every 30 mins to 2 hours depending on patient specific planned care
Using appropriate devices such as specialised bed, with a pressure relieving mattress (or chair and cushions)
Following a nutritional screening process the patient should receive an appropriate nutrition care plan (vitamins, minerals, hydration, protein intake, etc).
How to prevent a pressure ulcer?
Pressure ulcers can result in severe harm to the patient and sometimes death. Therefore it is important to attempt to prevent them from occurring.
Local policies and other guidance, such as the SSKIN bundle is an evidence-based set of interventions that help to prevent pressure damage.
- Surface: is the patient on the right surface. Ensure your patients have the right devices to relieve pressure
- Skin inspection: systematically examine the areas of the body on which a pressure ulcer is likely to develop (at risk pressure zones). Early inspection means early detection - educate patients and caregivers on what to look for.
- Keep you patients moving: mobilise the patient, even if it means asking a nurse or a physiotherapist.
- Incontinence: your patients need to be clean and dry to minimise and avoid moisture related skin damage. Avoid the use of rough fabrics to dry the skin. Advise to change the sheets daily.
- Nutrition & Hydration: make sure your patients have the right diet and supplements if required. The patient needs to be well hydrated.
DID YOU KNOW? International Stop the Pressure Day
Every year, the EPUAP holds the Stop Pressure* Ulcer Day on every 3ʳᵈ Thursday in November with the objective to raise awareness on pressure ulcers.
*The European pressure Ulcer advisory panel
Pictures are courtesy of EPUAP