Treatment - Pressure ulcers

Treatments for pressure ulcers (bedsores) include:

• changing position
• using special mattresses to reduce or relieve pressure
• dressings to help heal the ulcer

Surgery may sometimes be needed.

Changing position

Moving and changing your position helps to relieve the pressure on ulcers that have already developed. It also helps prevent pressure ulcers forming.

Your care team will draw up a repositioning timetable. This shows how often you need to move, or be moved if you're unable to do so yourself.

For some people, this may need to be every 15 minutes. Others may need to be moved only once every 2 to 4 hours.

You may also be given advice about:

• correct sitting and lying positions
• how you can adjust your sitting and lying positions
• how to support your feet to relieve pressure on your heels
• any special equipment you need and how to use it

Mattresses and cushions

Your care team will recommend a specially designed static foam or dynamic mattress if you're at risk of ulcers.

If you have a more serious ulcer, you'll need a more advanced mattress or bed system. Fo example, a mattress connected to a pump that delivers a constant flow of air into the mattress.

There is also a range of foam or pressure-redistributing cushions available. Ask about the types most suitable for you.

Dressings

Specially designed dressings can be used to protect pressure ulcers and speed up the healing process.

Alginate dressings

Alginate dressings are made from seaweed and contain sodium and calcium, and speed up the healing process.

Hydrocolloid dressings

Hydrocolloid dressings contain a gel that encourages the growth of new skin cells in the ulcer, while keeping the surrounding healthy skin dry.

Other dressing types

Foams, films, hydrofibres or gelling fibres, gels and antimicrobial dressings may also be used.

Gauze dressings are not recommended for the prevention or treatment of pressure ulcers.

Creams and ointments

Antiseptic or antibiotic creams/ointments are not usually recommended for treating pressure ulcers. You may need barrier creams to protect skin that's damaged or irritated by incontinence.

Antibiotics

Your care team may prescribe antibiotics to treat an infected ulcer or if you have a serious infection, such as:

• blood poisoning (sepsis)
• bacterial infection of tissues under the skin (cellulitis)
• infection of the bone (osteomyelitis)

Diet and nutrition

Eating a healthy, balanced diet that contains enough protein and a good variety of vitamins and minerals can speed up the healing process.

If your diet is poor, a dietitian can give you a diet plan.

Being dehydrated can slow down the healing process so it's important to drink plenty of fluids.

Removing damaged tissue

It may be necessary to remove dead tissue from the pressure ulcer to help it heal. This is known as debridement.

If there's a small amount of dead tissue, it may be removed using specially designed dressings.

Larger amounts of dead tissue may be removed using:

• high-pressure water jets
• ultrasound
• surgical instruments, such as scalpels and forceps

A local anaesthetic is used to numb the area around the ulcer so debridement does not cause you any pain.

Surgery

Severe pressure ulcers might not heal on their own. Surgery may be needed to seal the wound and minimise the risk of infection.

Surgical treatment involves cleaning the wound and:

• closing it by bringing the edges of the ulcer together
• using tissue from healthy skin nearby to close the ulcer

Pressure ulcer surgery can be challenging. Most people who have the procedure are already in a poor state of health.

Risks after surgery include:

• implanted skin tissue dying
• blood poisoning
• infection of the bone (osteomyelitis)
• abscesses
• deep vein thrombosis
• pulmonary embolism

Ask your surgeon about the benefits and risks of surgery if it's recommended for you.