Sacral Decubitus Ulcers Flashcards
stage 1 ulcer
intact skin non blanchable and localized redness
stage 2 ulcer
- see hair follicles shallow open ulcer red pink wound without sloughing, possible intact or ruptured blister
stage 3 ulcer
full thickness skin loss with possible visible subcutaneous fat no exposed bone tendon or muscles
stage 4 ulcer
full thickness skin loss exposed bone tendon muscle
Unstageable ulcers
full thickness skin loss ulcer base covered by slough and or eschar that needs removal to stage
Heel ulcers are managed differently because:
limited thickness of subcutaneous tissue and proximity of the underlying bone. Removing tissue around the heel can increase risk for osteomyelitis.
heel ulcers management
stable (dry adherent, intact without erythema or fluctuance) eschar on the heels serves as a natural protective cover that should not be removed. Treat with conservative measures like pressure redistribution, pain control and optimized nutrition.
how to prevent future ulcers
proper positioning to redistribute the pressure is the most intervention to increase tissue perfusion, improve healing, and prevent future ulcers. orthotic device, foam boot and for adequate pressure relief. iodine paint to keep area dry or enzymatic debriding agents can be used. also need adequate caloric intake for proper wound healing.
role for hyperbaric oxygen therapy for treatment of sacral decubitus ulcers?
no, not used and not enough evidence showing support.
when do we use antibiotics for pressure ulcers?
only give IV antibiotics for signs of systemic infection with fever, erythema, purulent drainage. Most ulcers will have colonization with bacteria
when is surgical debridement recommended for pressure ulcers?
only for pressure ulcers with clinical evident infection, extensive tissue necrosis, failure to improve with conservative therapy. Not recommended for heel pressure ulcers.
all pts who have a ulcer with infection should get antibiotics and
debridement it will remove necrotic tissue and accumulated debris which will decrease bacterial load and stimulate wound epithelization if there’s necrotic tissue - grey slough and foul smelling drainage should get this done.
what to do for an ulcer that doesn’t heal?
which is the best dressing for a sacral decubitis ulcer?
hydrocolloid or foam dressing- this is a mixture of adhesive absorbent polymers and a gelling agent wit ha film covering to make them water and gas permeable.
dressing interacts iwth the wound fluid to form a gel.
superior to standard gauze dressings in reducing ulcer size in low quality studies.
why are hydrocolloid dressings better for patients who have sacral decubitis ulcers?
they promote wound healing by enhancing fibrinolytic activity and growth of granulation tissue by inhibiting bacterial overgrowth through their physical barrier activities.
also convenient ot use because require infrequent dressing changes and are easy to apply.
foam dressings are sheets of foam polymers and are used primarily for heavily exudative wounds.
