Pressure ulcer prevention

Successful treatment

By: Mölnlycke Health Care, December 8 2011Posted in: Pressure ulcer prevention

Patients at high risk of developing pressure ulcers can be identified before ulcers occur if risk is assessed. However, it is now recognized that there are situations whereby a pressure ulcer is unavoidable. Review the key elements of pressure ulcer treatment.

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Learn more about treatment strategies

Patients at high risk of developing pressure ulcers can be identified before ulcers occur if risk is assessed, whilst it is now recognized that there are situations whereby a pressure ulcer is unavoidable.

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Key elements in treatment

Key elements in treatment adapted from National Pressure Ulcer Advisory Panel and European Pressure Ulcer Advisory Panel. Prevention and treatment of pressure ulcers: clinical practice guideline. Washington DC: National Pressure Ulcer Advisory Panel; 2009.1

  • Classify the ulcer – Use a validated tool, educate the health care team as to specific techniques required when caring for dark pigmented patients and to differentiate from other wounds.
  • Assess and monitor healing – Assess ulcer at a minimum weekly, monitor healing using a validated healing tool, modify treatment protocols when progress is not as expected.
  • Ensure nutritional requirements are assessed and met with nutritional support and dietician referral.
  • Assess pain – Pain can occur both during procedures and at rest. Use a validated pain assessment tool such as a visual analogue score.
  • Ensure adequate pain relief strategies are implemented

Note: Pain assessment tools can be accessed in the pain awareness zone of
www.less-pain.com.

  • Choose a suitable support surface and take care when positioning patients. Be aware of the special requirements of patients in critical care or those with spinal cord injury and obesity.
  • Dressing selection – Base selection upon specific nature of the individual wound. Consider exudate level, condition of wound bed, infection, location and condition of surrounding skin. Adopting a moist environment is essential for optimal healing. Also consider choosing dressings which offer minimization
    of pain and trauma such as soft silicone dressings.
  • Assess and treat infection.
  • Consider use of specialist therapies, such as NPWT.
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Assessment of pressure ulcers

Various characteristics of a pressure ulcer are important, both in understanding the depth and degree of tissue damage and defining principles of care including dressing selection.

The following elements should be assessed:

  • Stage
  • Location
  • Size (length, width, depth)
    (photography may be prove useful)
  • Is undermining present?
  • Sinus tract/ tunneling
  • Necrotic tissue/slough presence
  • Granulation tissue presence
  • Exudate
  • Pain – Has pain assessment be conducted and pain relief strategies implemented
  • Peri wound skin condition

References

  1. National Pressure Ulcer Advisory Panel and European Pressure Ulcer Advisory Panel. Prevention and treatment of pressure ulcers: clinical practice guideline. Washington DC: National Pressure Ulcer Advisory Panel; 2009.
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