Pressure Ulcer Care

Pressure Ulcer Care

As the name implies, pressure ulcers result when pressure—applied with great force for a short period or with less force over a long period—impairs circulation, depriving tissues of oxygen and other life-sustaining nutrients. This process damages skin and underlying structures. Untreated, resulting ischemic lesions can lead to serious infection.

Most pressure ulcers develop over bony prominences, where friction and shearing force combine with pressure to break down skin and underlying tissues. Persistent pressure on bony prominences obstructs capillary blood flow, leading to tissue necrosis. Common sites include the sacrum, coccyx, ischial tuberosities, and greater trochanters. Other common sites include the skin over the vertebrae, scapulae, elbows, knees, and heels in bedridden and relatively immobile patients.

Successful pressure ulcer treatment involves relieving pressure, restoring circulation, promoting adequate nutrition and, if possible, resolving or managing related disorders. Typically, the effectiveness and duration of treatment depend on the pressure ulcer’s characteristics.1 (See Staging pressure ulcers.)

Ideally, prevention is the key to avoiding extensive therapy. Preventive measures include off-loading pressure, maintaining adequate nourishment, and ensuring mobility to relieve pressure and promote circulation.2 Performing a risk assessment is necessary to implement effective prevention strategies.2 (See Braden scale: Predicting pressure ulcer risk, pages 602 and 603.)

When a pressure ulcer develops despite preventive efforts, treatment includes methods to decrease pressure, such as frequent repositioning to shorten pressure duration and the use of special equipment to reduce pressure intensity. Treatment also may involve pressure-reducing devices, such as special beds, mattresses, mattress overlays, and chair cushions.

Jul 21, 2016 | Posted by in NURSING | Comments Off on Pressure Ulcer Care

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