Treatment
A number of guidelines and protocols are available on the treatment of pressure ulcers.
A good reference guide is the NPUAP guideline Prevention and Treatment of Pressure Ulcers: Quick Reference Guide*)
If a pressure ulcer does not heal properly, the cause must be investigated and treatment adjusted accordingly.
The following scheme was derived from the NPUAP guideline:
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Causes of non-healing, or not properly healing, pressure ulcers |
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External causes |
Internal causes |
Causes in the pressure ulcer itself (treatment) |
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Pressure forces Shear Moisture |
Decreased oxygen supply • anaemia, or other blood disorders • low blood pressure, or antihypertensives • diabetes • lung diseases • smoking
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The wound is not sufficiently cleaned and still contains necrosis or pus.
The wound is clean but the dressing material absorbs too much moisture so that the wound is too dry.
The wound is clean but the dressing material absorbs too little moisture so that the wound is too wet.
Infection around the wound.
Osteomyelitis under the wound. |
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Increased oxygen demand • fever
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Others • protein deficiency • medicines such as corticosteroids or cytostatics • aging • dehydration • weight loss |
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Discussing the treatment of all these causes of poor wound healing is beyond the scope of this website. The table above is just a tool to examine these causes systematically. If alternative dressing materials are considered, it is important to follow the specifications and instructions of the manufacturer. The experts who have drawn up the guidelines do not endorse the use of any specific products for specific categories of pressure ulcers.
*) National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers: Quick Reference Guide. Emily Haesler (Ed.). Cambridge Media: Osborne Park, Western Australia; 2014.
