25th July 2023

Management

Pressure ulcers are difficult to heal, painful and can negatively impact the patient’s quality of life. Management includes good nutrition, appropriate wound management, adequate pressure distribution (suitable mattresses and repositioning) and analgesia. Key management points include:

• Moist wound environment encourages ulcer healing. Hydrocolloid dressings and hydrogels can help facilitate this. Discourage the use of soap as it can cause drying of the wound.
• Wound swabs are not routinely done as most pressure ulcers are colonised by commensal bacteria (polymicrobial).
• Decision to treat with systemic antibiotics is based on clinical judgement, i.e., spreading cellulitis, underlying osteomyelitis, clinical evidence of sepsis
• Consider referral to Tissue Viability Nurse (TVN).
• Surgical debridement may be beneficial for selected wounds.
• Do not routinely offer nutritional supplements to patients with adequate nutritional status to prevent pressure ulcers.