TREATMENT OF PRESSURE ULCERS ACCORDING TO STAGES

The treatment of pressure ulcers depends on its stage, presence, or absence of infection, and the patient’s physical and psychosocial condition.

Stage I

Stage I usually heals with early interventions and proper care, including

• • Pressure redistribution
• • Prevention of shear and friction
• • Moisture maintenance
• • Periodic assessment of skin
• • Pain management
• • Prevention and treatment of infection
• • Keep area clean
• • Massage is contraindicated

Stage II

Promoting wound healing and preventing further skin damage is the main goal of this stage’s treatment plan.

• • Similar steps are taken as mentioned in Stage I, with a focus on infection prevention by using moist dressing such as transparent hlm to maintain a clean wound bed.
• • Nutritional status should be reevaluated and supplements can be started.
• • Surgical treatment is not indicated and debridement is rarely required.

Stage III

The wound bed should be clean and moist to prevent infections and promote granulation. Monitor closely for local or systemic infection and continue the measures described in Stage I plus debridement, if indicated. Autolytic or enzymatic debridement is recommended for light to moderate exudates. Surgical debridement is necessary if there is necrotic tissue and infection.¹⁹ If the ulcer is covered with necrotic tissue, wound gel can be used. For wound beds without necrotic tissues, foam dressings and cavity hllers are recommended. An alginate dressing is appropriate to use if excessive exudate is present. Stage III ulcers usually heal spontaneously with appropriate cleaning; when treated conservatively, they have a recurrence rate of 32%-77%. Surgical management can reduce the rate of recurrence in some patients.²⁰