Conservative Therapy of Pressure Ulcers Using Physical Methods (Review)

Abstract

In Russia and European countries, the incidence of pressure (decubitus) ulcers in sedentary patients with severe comorbidities, spinal trauma, and cerebral accident sequelae varies from 3 to 40 %, reaching 80 % in the chronic critical illness. The final result of conservative treatment of pressure ulcers (PU) with adequate correction of comorbidities and proper care of the immobilized patient depends largely on the choice of local interventions. Aim of the review: to demonstrate the range of effective methods of physical treatment of pressure ulcers suitable for conservative treatment. Materials and methods. We selected and analyzed 80 scientific publications. Sources were selected from the PubMed, Scopus, and RSCI databases of medical and biological publications. The following methods were covered: negative pressure wound therapy, ultrasonic methods, hydrosurgical treatment, plasma flows, laser therapy (including low-level laser therapy), «hardware» acceleration of regenerative processes, including electrical stimulation, as well as a combination of these methods. Results. The variety of physical methods of wound treatment, on the one hand, provides an opportunity to select an individual therapy program. On the other hand, each method has its own limitations and contraindications. That is why in practice various combinations of these methods are reasonable. Conclusion. For several objective reasons, no reduction of PU incidence in clinical practice is expected. Therefore, studying the issues of evidence-based clinical effectiveness and economic feasibility of various conservative techniques of decubitus treatment to find best solutions in this area is warranted.