J Korean Med Assoc.  2015 Sep;58(9):786-794. 10.5124/jkma.2015.58.9.786.

Prevention and treatment of pressure ulcers

• Pak CS
• Heo CY

• KMID: 2195090
• DOI: http://doi.org/10.5124/jkma.2015.58.9.786

Abstract

Repeated or chronic pressure on the eminent part of the body will cause circulation disorder to the affected part of the body. The lack of circulation will result in damage and necrosis of the tissue. This phenomenon is defined as pressure sore. Due to growth of aging population and chronic disease, incidence and prevalence rate is in-creasing rapidly. This leads to increased duration of hospital stay, and medical expenditure. Hence, prevention of pressure sore and appropriate treatment is essential in order to diminish distress of the patient and health care provider. Prevention of pressure sore can be accomplished by frequent position change of the patient, skin care, and appropriate nutrition care. Frequent position change is known to be the most important and effective method to prevent pressure sore. Skin care can be achieved by choosing proper dressing material, management of exu-date, and protection of the tissue around the wound. In addition, appropriate nutrition care in order to correct protein-calorie imbalance should also be performed. Necrotic tissue can cause inflammation, and it can also be a good source of bacterial growth. Therefore, debridement of necrotic tissue is most fundamental and essential part in the treatment of pressure sore. Meanwhile, when the patient is not a candidate for surgical treatment due to poor general condition, many methods of dressing can be performed. Recently, dressing material with silver component, and vacuum assisted closure dressing is being performed frequently. In case of surgical treatment, after debridement of necrotic tissue, reconstruction can be performed by split-thickness skin grafting, full-thickness skin grafting, or primary closure. However, majority of reconstruction is performed by flap surgery. Rotation or advancement flap is usually performed.

Keyword

Pressure ulcer; Prevention; Bed sore

MeSH Terms

Aging
Bandages
Chronic Disease
Debridement
Health Expenditures
Health Personnel
Humans
Incidence
Inflammation
Length of Stay
Necrosis
Negative-Pressure Wound Therapy
Pressure Ulcer*
Prevalence
Silver
Skin Care
Skin Transplantation
Wounds and Injuries
Silver

Figure

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  Figure 1 (A) Pressure ulcer stage I. (B) Pressure ulcer stage II. (C) Pressure ulcer stage III. (D) Pressure ulcer stage IV.

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  Figure 2 Position in bed. (A) Supine position, (B) prone position, (C) semi-flower position, and (D) 30°tilting position.

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  Figure 3 Position in chair. (A) Combination of sitting and supine position and (B) sitting position (90°)-high pressure.

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