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

  • 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.