The basics of
wound care are cleaning, covering, and keeping slightly moist to provide the
best chance for wound healing.
A stage 1 pressure sore still has the skin intact. Keep it
clean, do not allow moisture such as body fluids to stay on the skin, and
protect the skin with a mild cream or lotion. Special creams or lotions called
moisture barriers are also available. These are very good if there are problems
with bowel or bladder control and a person is often wet from body
To help prevent infection and promote healing, dead tissue
is debrided (removed) often, usually by your doctor or another health
professional. If there is dead tissue in the pressure sore, it gives bacteria a
good place to grow and can cause infection. Dead tissue in the wound can also
slow the growth of healthy tissue.
Sometimes it is best to leave the dead
tissue or scab in place and let it act as a sort of bandage. Your doctor may do
this if the tissue is very stable or if the sore is not likely to heal.
The pressure sore must be cleaned every time
the bandage (dressing) is changed. Saline (a saltwater solution available at
the drugstore) is often used for cleaning, but there are many cleansing
products for wounds. Your doctor will recommend a cleansing solution for you. Do not use
cleansers made for healthy skin on open wounds. And avoid antiseptic solutions such as Betadine, Hibiclens, or hydrogen peroxide. These can damage new and normal tissue. Do not wash with water from a well if you or the person you are caring for has an open wound. Most tap water is safe, but follow the advice of your doctor or nurse. In some cases, it may be okay for you to use tap water to cleanse the wound.
doctor will recommend a bandage (dressing) for the pressure sore. There are
many types of bandages. The general idea is to keep the wound a little moist
and not let it dry out between bandage changes, and to keep the moist part of
the bandage right down in the sore, placed loosely against the healing tissue.
Over time, your doctor may use several different types of bandage, as the
pressure sore heals. The moist bandage is covered with a dry bandage to help
keep the sore clean and to keep the healthy skin around the pressure sore
Several other treatments are sometimes used in treating
pressure sores. These are found most commonly in clinics that specialize in
treating serious wounds. Researchers continue to study these and other
treatments for pressure sores and other wounds. Some insurance will not cover
the newer treatments without special approval. Treatments include:
Electrical stimulation. Gentle electrical
current is used in and near the wound to help make tiny blood vessels and new
Negative-pressure wound therapy (sometimes called
"vacuum-assisted closure"). A sterile sponge or a special gauze that fights germs is placed in the sore and covered
with a sticky bandage that does not allow any air in. The small vacuum is then
turned on and kept on at all times until the next treatment. The vacuum pulls
drainage from the wound
and gently pulls the blood supply close to the surface of the sore to bring
nutrients to the sore and to make new tissue grow.
oxygen therapy. The person is put in a chamber where he or she breathes oxygen at high pressure. This treatment may be used to increase the oxygen level in the blood so
more oxygen reaches skin and tissues, which can prevent tissue death, promote
healing, and help fight infection. This treatment is not approved for treating
the pressure sores themselves, but it is approved for conditions that can occur
with pressure sores, such as bone infection (osteomyelitis)
or a surgical closure of the sore that is not healing.
factor. Proteins that help new cells grow are applied to the pressure
Ultrasound. Sound waves that humans can't hear are used to create vibration and heat in the tissues. Ultrasound is being studied as a way to clean wounds and to help with healing.
grafts or surgical flaps are sometimes needed. Skin
grafts help new skin grow at the site of the sore if the wound extends into
muscle and deeper tissues. The wound may be surgically closed to promote
healing after a skin graft.