PRESSURE ULCER

(Decubitus Ulcers)

Ulcer of the skin and/or subcutaneous tissue caused by ischaemia secondary to extrinsic pressure or shear

Management

Non-drug treatment

  • Debridement of necrotic tissue
  • Clean with normal saline
  • If able, encourage patients to raise themselves off the seat and shift their weight every 15-20
    minutes or to take short walks
  • Repositioning of those who cannot move themselves frequently, determined by need and
    skin status
  • Inspect skin every time the patient’s position is changed
  • Maintain optimal hydration and hygiene of skin
  • Avoid trauma, by not dragging patient
  • Good nutrition for those with good prognosis to maintain normal serum albumin
  • Educate patient caretakers on risk factors for developing pressure ulcers, how to inspect and
    care for skin, and inform health care professional
  • May need skin grafting and flaps; refer to hospital

Medicines

  • Give antibiotics if there is evidence of surrounding cellulitis
  • Control pain
  • Control odour with topical metronidazole powder or gel until there is no foul smell
  • If patient has sepsis, give parenteral antibiotics