Review of the Current Management of Pressure Ulcers

Abstract

Significance: The incidence of pressure ulcers is increasing due to our aging population and the increase in the elderly living with disability. Learning how to manage pressure ulcers appropriately is increasingly important for all professionals in wound care. Recent Advances: Many new dressings and treatment modalities have been developed over the recent years and the goal of this review is to highlight their benefits and drawbacks to help providers choose their tools appropriately. Critical Issues: Despite an increased number of therapies available on the market, none has demonstrated any clear benefit over the others and pressure ulcer treatment remains frustrating and time-consuming. Future Directions: Additional research is needed to develop products more effective in prevention and treatment of pressure ulcers.

Keywords: pressure injury; pressure ulcer; wound dressings.

George P. Yang, MD, PhD

Figure 1.

Illustration of locations of pressure ulcers in supine patients. To see this illustration in color, the reader is referred to the web version of this article at www.liebertpub.com/wound

Figure 2.

Illustration of different stages of pressure ulcers. From left to right. Top diagram showing pressure ulcers Stage I: skin intact. Stage II: partial skin loss. Stage III: full-thickness skin loss, subcutaneous tissue exposed. Stage IV: muscle, tendon, bone or organs exposed. Bottom diagram showing unstageable pressure ulcer with tissue damage hidden from observer by eschar over entire wound. Deep tissue injury hidden from observer by intact skin appears as a bruise from above.

Figure 3.

Algorithm for help in choosing an appropriate class of dressings for pressure ulcer management. *Gauze dressings can be used if limited options available require more frequent dressing changes.