Pressure Ulcers

Question 1

Pressure ulcers develop in patients who are unable to move parts of their body due to:

Answer 1

illness, paralysis or advancing age.

Question 2

Pressure ulcers typically develop over

Answer 2

bony prominences such as the sacrum or heel.

Question 3

Which factors predispose to the development of pressure ulcers?

Answer 3

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

Question 4

What is the name of the score used to screen for patients who are at risk of developing pressure areas?

Answer 4

Waterlow score

Question 5

Name some factors featured in the Waterlow score?

Answer 5

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

Question 6

Roughly, what are the gradings of pressure ulcers?

Answer 6

Grade 1= non-blanchable erythema of intact skin
Grade 2= partial thickness skin loss involving epidermis or dermis or both
Grade 3= Full thickness skin loss involving damage to or necrosis of subcutaneous tissue that may extend down to, but not through, underlying fascia
Grade 4= extensive destruction, tissue necrosis, or damage to muscle, bone or supporting structures with or without full thickness skin loss.

Question 7

Management of pressure ulcers

Answer 7

• a moist wound environment encourages ulcer healing. Hydrocolloid dressings and hydrogels may help facilitate this. The use of soap should be discouraged to avoid drying the wound
• wound swabs should not be done routinely as the vast majority of pressure ulcers are colonised with bacteria. The decision to use systemic antibiotics should be taken on a clinical basis (e.g. Evidence of surrounding cellulitis)
• consider referral to the tissue viability nurse
• surgical debridement may be beneficial for selected wounds