PRESSURE ULCER Decubitus Ulcer or Bedsore A lesion caused by unrelieved pressure that destroys involved tissue from lack

of blood supply usually occur from bony prominences

MANAGEMENT AND TREATMENT OPTIONS OF PRESSURE ULCER 1. 2. 3. 4. 5. Good nutrition and adequate hydration Position change every 2 hours Wound care Prevention of infection Debridement (removal of dead tissue)

Common Pressure Points SUPINE POSITION a. b. c. d. e. f. g. h. Occiput Scapula Spinous process Sacrum Greater trochanter Lower leg Lateral malleolus heels PRONE POSITION a. b. c. d. ears thighs knees iliac crest SITTING POSITION a. b. c. d. scapula sacrum ischial tuberosity heels

WAYS OF DEBRIDEMENT 1.) MECHANICAL by mechanical means o Ex: Wet-Dry Dressing : Whirlpool (Hydrotherapy) 2.) AUTOLYTIC - application of synthetic dressing that allows eschar to self-digest wound 0 exudates 3.) ENZYMATIC OR CHEMICAL for chronically ill or cant tolerate surgery, use enzymes to digest necrotic tissue, complete debridement occurs 10-14 days 4.) SHARP DEBRIDEMENT with use of a scalpel or scissor in removing necrotic tissue. Done in septic or with cellulitis which requires rapid debridement 5.)

PRESSURE ULCER STAGING STAGE 1 light pigmented skin non blanchable red warm to touch may be firm or boggy in consistency edema STAGE 2 loss of epidermis which may penetrate the dermis but not into the dermis appears like a blister or shallow crater with erythema wound is moist, pink, and painful but free of necrotic tissue STAGE 3 full thickness skin loss extending the dermis and subcutaneous tissue, with small crater unless covered with eschar, necrotic, exudative, undermining sinus tract formation and or infection wound base is pain free STAGE 4 deep tissue destruction, subcutaneous, fascia, muscles, joints and bone with deep crater. It includes necrotic tissue drainage, undermining sinus tract formation and or infection wound base is pain free