What Are the Clinical Practice Guidelines for Treatments for Pressure Ulcers?

Pressure ulcers, sometimes called bedsores, develop on bony areas that experience pressure when individuals lie down for extended periods of time, such as during hospitalizations or illness. Commonly affected areas include the scalp, back, tailbone, hip or heel, according to eMedicine.

Pressure Reduction

• An important step in treating pressure ulcers is to reduce the pressure causing the sore to develop. Patients should turn frequently to reduce the pressure incurred by lying prone. Those able to move independently should shift every 10 minutes; nurses should move immobile patients to a new position every 2 hours. Special bedding may reduce the pressure exerted on ulcers and improve treatment outcomes.

Tissue Debridement

• Pressure sores are open wounds with active bacterial infection. Debriding, or cutting away, the affected tissue reduces infection and promotes healing. Medical staff should carefully remove dead or dying tissue from the pressure ulcer. Some bleeding will occur as the tissue is cut away, and staff should monitor the patient carefully to prevent cutting away healthy tissue in addition to infected tissue.

Wound Care

• Keep the pressure sore clean by cleaning it frequently with a saline or antibiotic solution. Cleaning the pressure sore prevents the bacterial infection from spreading and the wound from growing. Pressure sores normally ooze pus and fluid, making clean dressings highly important. Change the wound dressings several times per day to ensure the pressure sore is kept clean.

Surgery

• Severe pressure ulcers may require surgical intervention, though this is reserved as a last resort treatment option. Ulcers that are nonresponsive to pressure reduction, wound debridement and frequent dressing changes may require a more extensive intervention. Surgery for pressure ulcers is more invasive than normal wound debridement. The surgeon cuts extensively to remove dead skin as well as healthy surrounding tissue, preventing the ulcer from spreading. Surgery requires anesthesia and involves a longer recovery than typical pressure ulcer debridement.