Preventing and Managing Pressure Ulcers

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Preventing and Managing Pressure Ulcers
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What is a pressure ulcer and what causes one?

• A p 1314 localized areas if tissue necrosis
  that develop when soft tissue is compressed
  between a boney prominence and an external
  surface for prolonged period of time.

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National Pressure Ulcer Advisory Panel 1998

• Stage I change in skin temp
• tissue consistency (bogy or firm)
• sensation (pain, itching)

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Figure 34.1 Four stages of pressure ulcers. (1
of 4)
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Stage II

• Stage II partial-thickness skin loss of
  epidermis or dermis. Is superficial and looks
  like an abrasion, blister or shallow crater.

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Figure 34.1 Four stages of pressure ulcers. (2
of 4)
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National Pressure Ulcer Advisory Panel 1998

• Stage III full thickness loss involving damage
  or necrosis of subcutaneous tissue that may
  extend down to but not through underlying fascia.
  Deep crater with or without undermining of
  adjacent tissue.

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Figure 34.1 Four stages of pressure ulcers. (3
of 4)
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National Pressure Ulcer Advisory Panel 1998

• Stage IV full-thickness skin loss with extensive
  destruction, tissue necrosis, or damage to
  muscle, bone or supporting structures.
  Undermining and sinus tracts may be present.

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Figure 34.1 Four stages of pressure ulcers. (4
of 4)
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Figure 34.2 Body pressure areas in A, supine
position B, lateral position C, prone position
D, Fowlers position.
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Pressure ulcers

• When a stage IV ulcer begins to heal is it
  classified as a stage III?

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Assess for risk factors A p1314

• Level of mobility
• Bowel and bladder control
• Sensation
• Nutritional status
• Check serum albumin levels, glucose levels
• Hgb hct affects tissue oxygenation perfusion
  of nutrients.

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Assess for risk factors A p1314

• Elevated temperature
• Assess weight
• Assess hydration level

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Assess for risk factors A p1314

• Assess for edema
• Assess whether pt has equipment/material in
  prolonged contact with skin
• Assess skin for early signs of breakdown/progressi
  on of tissue healing.

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Equipment needed for prevention of pressure
ulcers.

• Pillows
• Rolled-up blankets/towels
• Egg-crate mattress
• Specialty beds if ordered
• Heel and elbow protectors
• Lotion and powder as needed
• Soap and water.

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Figure 34.11 Some frequently used dressing
materials.