General Principles of Pressure Ulcer Management

Abstract

Despite considerable research in management of pressure ulcers over the last decades, substantial issues remain unresolved. Pressure reduction is thought to be critical in healing of pressure ulcer. With the possible exception of air-fluidized beds, one type of pressure-reducing device has not been shown to be superior to another. Nutritional support is a cornerstone of clinical care and should be optimized in all persons, including persons with pressure ulcers, consistent with medical goals and patient wishes. Revisions in the staging system for pressure ulcers have resulted in more precision for clinical description and may help guide choice of therapy. However, new categories of staging may be more difficult for non-wound care specialists. Diagnosing clinical infection in pressure ulcers remains problematic and rests on careful clinical observation. The Pressure Ulcer Scale for Healing tool adequately assesses pressure ulcer status and has proved sensitive to change over time.KeywordsPressure ulcerChronic woundPressure reductionPressure ulcer nutritionWound assessmentPressure ulcer stagingPUSH toolWound infection