10. PRESSURE ULCER

In this blog post, I will talk about pressure ulcers, because I have seen many ulcers in my stays clinics. And it seems a very common problem in hospitals.

The ulcers for pression are areas of damaged skin caused by staying in one position for too long.₁

Pressure ulcer staging:   http://woundconsultant.com/sitebuilder/staging.pdf

Stage I: epidermis without damage and erythema of skin that it doesn`t dissapear to eliminate the pressure

Stage II: Partial-thickness skin loss including epidermis.

Stage III: Full-thickness skin loss involving subcutaneous tissue. The lession doesn`t affect the fascia.

Stage IV: Full thickness sin loss involving subcatenous tissue, muscle and bone. The lession affects the fascia.

To avoid the risk of pressure ulcers using the Norton scale and braden

http://www.nutrition411.com/wrc/pdf/w0513_norton_presure_sore_risk_assessment_scale_scoring_system.pdf

Another rating system getting more and more popularity is the Braden Scale, created in the USA, more recent  and precise than the Norton scale, which evaluates factors such as sensory perception, skin wetness, nutrition and such.

Pressure ulcers are a variety of treatments.

Depending on the stage of the ulcer, the ulcer tissue, and if there is infection or not, I use some dressings and others.

In my view, the key will not occur this in preventing ulcers.

• Change position at least every 2 hours to relieve pressure.
• Use items that can help reduce pressure -- pillows, sheepskin, foam padding, and powders from medical supply stores.
• In the zones with more risk.

• Eat well-balanced meals that contain enough calories to keep you healthy.
• Drink plenty of water (8 to 10 cups) every day.
• Exercise daily, including range-of-motion exercises.
• Keep the skin clean and dry.
• After urinating or having a bowel movement, clean the area and dry it well. A doctor can recommend creams to help protect the skin

This is the best treatment for pressure ulcers

Bibliography:

1 Medline. Ulceras por presión. Medline plus.[Revisado el 25 de mayo del 2013] Disponible en: http://www.nlm.nih.gov/medlineplus/spanish/pressuresores.html

2. Bluestein D, Javaheri A. Pressure ulcers: prevention, evaluation, and management. Am Fam Physician. 2008