Pressure Ulcers - Time to Intervene

We have discussed how difficult it is to assess and manage patients with chronic pressure ulcers.

The highlights of our discussion:

• Many patients develop pressure ulcers for multiple reasons;
• Infection, ischemia, and mechanical factors all need to be considered;
• The patient's total situation needs to be assessed - can they mobilize appropriately?  Is there adequate perception of injury or pressure?  Do they have the resources they need to take care of themselves, and the ulcer, adequately? Are there people looking out for them?

This article is a great review from the BMJ on the entire topic. 

The issue of managing chronic ulcers gets even more complicated when we consider the possibility of underlying osteomyelitis.  The evidence based examination for osteomyelitis is found here.  Another review of osteomyelitis is found here.

The bottom line - managing chronic ulcers takes multiple disciplines, and takes time.  Given the tremendous morbidity they cause, the huge effort it takes to deal with them is a very worthwhile investment in patients' quality of life.