Key elements in treatment

Key elements in treatment – adapted from National Pressure Ulcer Advisory Panel and European Pressure Ulcer Advisory Panel. Prevention and treatment of pressure ulcers: clinical practice guideline. Washington DC: National Pressure Ulcer Advisory Panel; 2009.1

  • Classify the ulcer – use a validated tool, educate the health care team as to specific techniques required when caring for dark pigmented patients and to differentiate from other wounds
  • Assess and monitor healing – assess ulcer at a minimum weekly – monitor healing using a validated healing tool – modify treatment protocols when progress is not as expected
  • Ensure nutritional requirements are assessed and met with nutritional support and dietician referral
  • Assess pain – pain can occur both during procedures and at rest- use a validated pain assessment tool such as a visual analogue score
  • Ensure adequate pain relief strategies are implemented
    Note pain assessment tools can be accessed in the pain awareness zone of
    www.less-pain.com
  • Choose a suitable support surface and take care when positioning patients –be aware of the special requirements of patients in critical care or those with spinal cord injury and obesity
  • Dressing selection – base selection upon specific nature of the individual wound – consider exudate level, condition of wound bed, infection, location and   condition of surrounding skin. Adopting a moist environment is essential for optimal healing. Also consider choosing dressings which offer minimisation
    of pain and trauma such as soft silicone dressings
  • Assess and treat infection
  • Consider use of specialist therapies – such as NPWT