Pressure Ulcer Healing and Treatments

(Content lasted reviewed - July 19, 2000)

You may wish to also review Questions # 309 (non-sterile dressings), 310 (non-sterile gloves), and 311 (cross-contamination) under the Wound Infection and Infection Control section of Frequency Asked Questions.

Question # 401

What is the first step in addressing a non-healing wound?

The first step in managing a non-healing wound is to debride the wound of necrotic tissue and/or slough if present. If the non-healing wound is clean, the AHCPR guideline on pressure ulcer treatment recommends treating the pressure ulcer with topical antibiotics. If the ulcer does not respond within two weeks, other reasons for the ulcer's failure to respond need to be explored.

Question # 402

What other patient conditions should be assessed and documented when a wound fails to heal?

Other patient conditions may be contributing to lack of healing progress such as poor nutritional status and/or poor circulation. Nutritional status can be assessed and documented through laboratory values (e.g., albumin level and CBC) and dietary intake. Interventions should be taken to correct nutritional or intake problems if they are consistent with overall patient treatment goals. The circulatory status of lower extremity wounds should be assessed through palpation/doppler of pulses (popliteal, dorsalis pedis, posterior tibial), capillary refill, and skin temperature (warm, cool).

You may wish to consult the following source(s):

Bergstrom, N., Allman, R. M., Alvarez, O. M., Bennett, M. A., Carlson, C. E., Frantz, R. A., Garber, S. L., Jackson, B. S., Kaminski, M. V., Kemp, M. G., Krouskop, T. A., Lewis, V. L., Maklebust, J., Margolis, D. J., Marvel, E. M., Reger, S. I., Rodeheaver, G. T., Salcido, R., Xakellis, G. C., & Yarkony, G. M. (1994). Treatment of Pressure Ulcers. Clinical Practice Guideline, Number 15. AHCPR Publication No. 95-0652. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services. December 1994.

Question # 403

How should red, excoriated sacral areas due to incontinence be treated?

Reddened, excoriated areas due to incontinence need to be protected from moisture. This can be accomplished by frequent toileting and/or brief changes, the use of absorbent undergarments, and the use of moisture barriers applied to the skin after each incontinent episode. These areas should not be treated with moist dressings. The goal is to keep the area dry. You may wish to consult the following source(s):

Bergstrom, N., Allman, R. M., Alvarez, O. M., Bennett, M. A., Carlson, C. E., Frantz, R. A., Garber, S. L., Jackson, B. S., Kaminski, M. V., Kemp, M. G., Krouskop, T. A., Lewis, V. L., Maklebust, J., Margolis, D. J., Marvel, E. M., Reger, S. I., Rodeheaver, G. T., Salcido, R., Xakellis, G. C., & Yarkony, G. M. (1994). Treatment of Pressure Ulcers. Clinical Practice Guideline, Number 15. AHCPR Publication No. 95-0652. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services. December 1994.