Pressure ulcers

Question 1

Why do pressure ulcers develop

Answer 1

Pressure ulcers develop in patients who are unable to move parts of their body due to illness, paralysis or advancing age.

Question 2

Where do pressure ulcers typically develop

Answer 2

develop over bony prominences such as the sacrum or heel

Question 3

Factors predisposing to the development of pressure ulcers

Answer 3

malnourishment
incontinence
lack of mobility
pain (leads to reduction in mobility)

Question 4

The “Waterlow score” is used to screen for patients who are at risk of developing pressure areas. What factors does it consider?

Answer 4

• BMI
• nutritional status
• skin type
• mobility
• continence

Question 5

How are pressure ulcers graded?

Answer 5

Grade 1 Non-blanchable erythema of intact skin.

Grade 2 Partial thickness skin loss involving epidermis or dermis, or both. Superficial ulcer/blister

Grade 3 Full thickness skin loss involving necrosis of subcutaneous tissue that may extend down to underlying fascia.

Grade 4 Extensive destruction, tissue necrosis/ damage to muscle/bone

Question 6

Management of pressure ulcers

Answer 6

• moist environment encourages ulcer healing (Hydrocolloid dressings and hydrogels)
• wound swabs should not be done routinely as majority are colonised with bacteria.
• referral to the tissue viability nurse
• surgical debridement may be beneficial for selected wounds
• antibiotics if systemically unwell