17. Dressings for Pressure Ulcers

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Chapter 17: Dressings for Pressure Ulcers

Pressure ulcers, also known as bedsores or pressure sores, are injuries to the skin and underlying tissues caused by prolonged pressure on a specific area. This is common in people with reduced mobility, such as patients who are bedridden or in wheelchairs. Proper treatment of these ulcers is essential to prevent serious complications such as infections and tissue necrosis.

The treatment of pressure ulcers involves a multifaceted approach that includes changing the patient's position, proper nutrition and, of course, the use of appropriate dressings. This chapter will focus on the last part - dressings for pressure ulcers.

Choosing the Bandage

Choosing the appropriate dressing is crucial for effective healing of pressure ulcers. The type of dressing to use depends on several factors, including the stage of the ulcer, the presence of infection, and the amount of exudate. Some of the commonly used dressings include hydrocolloids, foams, alginates, hydrogels, and silver dressings.

Hydrocolloids and Foams

Hydrocolloids are occlusive dressings that form a gel when they come into contact with wound exudate, creating a moist environment that promotes healing. They are ideal for stage I and II pressure ulcers and can also be used on stage III and IV ulcers with mild to moderate exudation.

Foam dressings are highly absorbent and can be used on moderately to heavily exuding pressure ulcers. They also provide pressure-relieving padding, making them a suitable option for stage III and IV pressure ulcers.

Alginates and Hydrogels

Alginate dressings are made from brown seaweed and are highly absorbent, making them suitable for highly exuding pressure ulcers. They also form a gel in the presence of exudate, which helps maintain a moist environment for healing.

Hydrogels are dressings that contain a large amount of water or gel. They are ideal for sloughing or necrotic pressure ulcers as they help to soften dead tissue and maintain a moist environment for healing. However, they are not suitable for highly exuding ulcers.

Silver Bandage

Silver dressings are used to treat pressure ulcers that are infected or at high risk of infection. Silver has antimicrobial properties that help prevent and treat infections.

Considerations when Applying Dressings

Before applying the dressing, the pressure sore should be properly cleaned to remove debris and bacteria. Normal saline is usually used for cleaning as it is gentle on the wound tissues.

When applying the dressing, it is important to ensure that it covers the entire ulcer and extends beyond the edges of the wound. This helps protect the wound from contamination and maintain a moist environment for healing.

Dressages should be changed regularly to maintain an optimal healing environment. The frequency of dressing changes depends on the type of dressing and the amount of exudate. For example, foam and alginate dressings may need to be changed daily if the ulcer is exuding heavily, while hydrocolloids and hydrogels may last for several days before needing to be changed.

In conclusion, the correct choice and application of the dressing are key components in the management of pressure ulcers. When choosing a dressing, it is important to consider the stage of the ulcer, the presence of infection and the amount of exudate. Proper application and regular dressing change is also crucial to promoting effective ulcer healing.

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