Pressure Ulcers

Question 1

Wound Management

Answer 1

1. Priority: relieve pressure - consider use of an alternating pressure mattress
2. Treat predisposing factors (malnutrition, vitamin deficiencies, anaemia, diabetes)
3. wound care

clean the skin with normal saline, wound debridement if >2 = 2 grade presure ulcer and nectrotic tissue: important as dead tissue acts as a barrier against tissue repair, apply dressing, avoid topical antibiotics

Question 2

Grade 1 Management

Answer 2

• Thin hydrocolloid dressing
  
  • Gel forming agents with part on wound remaining moist and therefore easily removed
  • reduces friction

Question 3

Grade 2 Management

Answer 3

If slough:

• debridement with hydrogel if shallow, minimally ecudating.dry ulcer (hydrophillic polymers), hydrolloids
• if moderate/heavy exidate: alginates sich as sorbsan (unsuitable for dry wounds)

Question 4

Grade 3 Management

Answer 4

Increase absorbency (can apply more than one dressing) or increase frequency of dressing changes

Question 5

Grade 4 Managment

Answer 5

Increase absorbency
Negative Pressure Wound Therapy: consider as adjuvant therapy if multiple dressings needed as large amounts of exudate
Rule out osteomyelitis if bone exposure

Question 6

Traffic Colours: Assesment

Answer 6

Red - Pale pink to beefy red, granulation tissue

• management - protect wounds, maintain warm moist environment, protect periwound

Yellow- moist yellow slough, may vary in adherence

• debride nectrotic tissue, absorb drainage, protect peri-wound

black - thick, black, adherent eschar

• debride necrotic tissue