Pressure ulcers/injuries are among the most costly and prevalent conditions faced by health care professionals. It is estimated that in the United States alone, pressure injuries cost up to $11.6 billion each year with an estimated per-injury cost of $20,900 to $151,700.¹ The elderly, individuals with chronic conditions such as diabetes, and those with limited mobility are significantly more likely to develop pressure injuries than other patients. It is extremely important that health care professionals understand best practice treatments to help reduce the severity and longevity of these wounds.

Although preventing pressure injuries before they develop by recognizing risk factors and taking a proactive approach is more effective than any post-development treatment, understanding steps to take after the development of a pressure injury is critical.² By learning accepted approaches to consistent skin care, managing pressure injuries according to evidence-based practices, implementing preventive measures (redistribution mattresses, cushions, offloading devices), and selecting advanced wound care dressings, health care clinicians can better promote rapid healing, reducing the risk of infection, and improving patient comfort.²

5 Steps to Effective Pressure Ulcer/Injury Treatment

Assessment – Patients with pressure injuries should be regularly assessed and monitored to identify any complications and prescribed an effective method of treatment. Assessing wound healing progress is imperative to the treatment plan.

Wound Pain Management – Managing wound pain is one of the most important components of comprehensive treatment. Health care professionals should take an initial pain assessment to determine the necessary course of action to help the patient remain comfortable. Avoiding positions that increase pressure, such as using a lift to minimize friction when repositioning, can help prevent painful flare-ups. Pain management should be regularly assessed.

Turning and Positioning – Turning and positioning are major components of pressure injury prevention and also play a major role in pressure injury treatment. Health care professionals should use proper positioning techniques to avoid putting extra pressure on areas of existing injury, regardless of the support surface. This can help prevent exacerbation of any associated discomfort and help the wound heal more quickly.²

Effective Wound Bed Preparation – Wounds should be regularly cleansed and debrided to promote rapid healing and reduce the risk of complication, such as infection. Cleansing helps remove any foreign matter and allows the health care professional to make a more accurate assessment of the healing progress. Use a pH-balanced solution and antiseptic if risk of infection is suspected. Debridement can also help remove necrotic tissue and promote wound healing if warranted.²

Choose Effective Wound Dressings Pressure injuries require dressings that can keep the wound moist, manage exudate, reduce the risk of infection, and prevent the ingress of foreign material (particularly in the case of incontinent patients). Hydrocolloid, hydrogel, alginate, foam, and antimicrobial dressings can each provide benefits depending on the particular wound and stage of healing. Health care professionals should also make efforts to decrease the frequency of dressing changes, thereby reducing discomfort for patients, cost, and time. Secure, gentle, waterproof medical adhesives should be used for this purpose.² Pressure injuries are prevalent and can result in serious complications for patients. Complications include localized infection, cellulitis, osteomyelitis, sepsis, and even death. By taking a comprehensive, proactive approach to treatment and using modern wound care techniques, nurses, and other health care professionals can help reduce costs, save time and improve patient outcomes.²

References:

1. Preventing Pressure Ulcers in Hospitals. Agency for Healthcare Research and Quality. https://www.ahrq.gov/professionals/systems/hospital/pressureulcertoolki…. Published April 2011. Updated October 2014. Accessed October 24, 2017.

2. National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers: Quick Reference Guide. Emily Haesler, ed. Cambridge Media: Osborne Park, Western Australia; 2014.