Treatment for pressure ulcers can vary, depending on the grade of the ulcer. Treatment options may include regularly changing your position, orusingspecial mattresses and dressings to relieve pressure or protect the skin. In some cases, surgery may be needed.
Pressure ulcers are a complex health problem arising from many interrelated factors. Therefore, your care may be provided by a team comprising different types of healthcare professionals. This type of team is sometimes known as a multidisciplinary team (MDT).
Your MDT may include:
It's important to avoid putting pressure on areas that are vulnerable to pressure ulcers or where pressure ulcers have already formed. Moving and regularly changing your position helps to prevent pressure ulcers developing and relieves the pressure onthe ulcers that have developed.
After your risk assessment is completed, your care team will draw up a "repositioning timetable", which states how often you need to be moved. For some people, this may be as often as once every 15 minutes. Others may need to be moved only once every two hours.
The risk assessment will also consider the most effective way of avoiding putting any vulnerable areas of skin under pressure whenever possible.
You may also be given training and advice about:
There are a range of special mattresses and cushions that can relieve pressure on vulnerable parts of the body. Your care team will discuss the types of mattresses and cushions most suitable for you.
Thosethought to be at risk of developing pressure ulcers, or who have pre-existing grade one or two pressure ulcers, usually benefit from aspecially designed foam mattress, which relieves the pressure on their body.
People with a grade three or four pressure ulcer will require a more sophisticated mattress or bed system. For example, there are mattresses that can be connected to a constant flow of air, which is automatically regulated to reduce pressure as and when required.
Specially designed dressings and bandagescan be used to protect pressure ulcers and speed up the healing process. Examples of these types of dressings include:
Topical preparations, such as creams and ointments, can be used to help speed up the healing process and prevent further tissue damage.
If you have a pressure ulcer, you will not routinely be prescribed antibiotics. These are usually only prescribed to treat an infected pressure ulcer and prevent the infection from spreading.
Antiseptic cream may also be applied directly to pressure ulcers to clear out any bacteria that may be present.
Certain dietary supplements, such as protein, zinc and vitamin C, have been shown to accelerate wound healing.
If your diet lacks these vitamins and minerals, your skin may be more vulnerable to developing pressure ulcers. As a result of this, you may be referred to a dietitian so that a suitable dietary plan can be drawn up for you.
In some cases, it may be necessary to remove dead tissue from the ulcer to help stimulate the healing process. This procedure is known as debridement.
If there is a small amount of dead tissue, it may be possible to remove it using specially designed dressings and paste. Larger amounts of dead tissue may be removed using mechanical means. Some mechanical debridement techniques include:
A local anaesthetic will be used to numb the area of skin and tissue around the ulcer so that debridement does not cause any pain or discomfort.
Maggot therapy, also known as larvae therapy, is an alternative method of debridement. Maggots are ideal for debridement because they feed on dead and infected tissue without touching healthy tissue. They also help to fight infection by releasing substances that kill bacteria and stimulate the healing process.
During maggot therapy, the maggots are mixed into a wound dressing and the area is covered with gauze. After a few days, the dressing is taken off and the maggots are removed.
Many people may find the idea of maggot therapy off-putting, but research has found that it is often more effective than more traditional methods of debridement.
It's not always possible for a grade three or four pressure ulcer to heal. In such cases, surgery will be required to seal the wound and prevent any further tissue damage occurring.
Surgical treatment involves cleaning the wound and closing it by bringing together the edges of the wound (direct closure), or by using tissue moved from a nearby part of the body (flap reconstruction).
Pressure ulcer surgery can be challenging, especially because most people who have the procedure are already in a poor state of health. There is a risk of a large number of possible complications occurring after surgery, including:
Despite the risks, surgery is often a necessity to prevent life-threatening complications, such as blood poisoning and gangrene (the decay or death of living tissue).
Pressure ulcers, sometimes known as bedsores or pressure sores, are an injury that affects areas of the skin and underlying tissue.
Depending on the severity of a pressure ulcer, symptoms can include red or discoloured skin, itchy skin, blisters or an open wound.
Pressure ulcers are caused by sustained pressure being placed on a particular part of the body. This pressure interrupts the blood supply to the affected area of skin.
Pressure ulcers are easily diagnosed by looking at them. However, health professionals prefer to prevent ulcers developing in the first place, so it's important to assess a person's risk of developing them.
Treatment options for pressure ulcers include regularly changing position, special mattresses and dressings, and, in severe cases, surgery.
Even with the best possible medical care, complications can arise from grade three or grade four pressure ulcers and can be occasionally life-threatening.
As part of your treatment plan, your care team will discuss with you the best way to prevent pressure ulcers. This may include changing position, checking your skin and a healthy diet.