Caring for & Treating Pressure Ulcers
With early treatment, pressure ulcers can be prevented. After an ulcer progresses to a more serious stage, it becomes hard to treat and can lead to complications. Most stage 1 and stage 2 pressure ulcers will heal within several weeks with proper treatment. However, stage 3 and 4 pressure ulcers can take months or even years to heal and may require surgery. Even though progress is slow, continued care and treatment can prevent complications such as further tissue damage, infection, and pain.
Caring for and treating pressure ulcers is not easy and is often a team effort. The nurse and doctor will examine the ulcer and recommend a treatment plan for the patient. The first step in treating a pressure ulcer in any stage is to relieve the pressure. Strategies to reduce pressure include repositioning and providing support surfaces. A person with pressure ulcers needs to be repositioned regularly and placed in correct seating positions to prevent the patient from exacerbating the pressure on the ulcer. People using a wheelchair should change position on their own every 15 minutes and should have assistance changing positions every hour. People confined to a bed should change positions every two hours. Lifting devices are often used to avoid friction during repositioning. Special cushions, pads, mattresses, and beds can help a person lie in a more appropriate position. These support surfaces relieve pressure on the existing sore, keep bony areas from touching each other, and protect vulnerable skin from damage.
A different treatment method involves the removal of damaged tissue around the pressure ulcer. To heal properly, wounds need to be free of dead and infected skin tissue. The tissue removal procedure, known as surgical debridement, prevents the spread of infection and promotes healthy living tissue growth. Removal methods depend on the severity of the wound, but typically involve loosening, cutting away, and removing dead or infected skin tissue.
Further interventions include cleaning and dressing of the pressure ulcer wounds to prevent infection. More importantly, the ulcer and the skin around it must remain clean, which can be done by cleaning or rinsing the area with normal saline solution and gently dabbing the area with a clean gauze tab. A dressing promotes healing by keeping a wound moist. Different dressings are used to treat pressure ulcers. It is important to remember to change the dressing as often as the doctor or nurse recommends in order to prevent further infection. If the pressure ulcer is not healing, the doctor may prescribe medicine to apply directly to the ulcer or may even administer antibiotics to the patient.