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Skin Problems & Treatments Health Center

Pressure Sores - Treatment Overview

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Protect and treat the sore area

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 fluids.
  • 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.
  • Your 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 dry.
  • 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 tissue grow.
    • 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.
    • Hyperbaric 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.
    • Growth factor. Proteins that help new cells grow are applied to the pressure sore.
    • 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.
  • Skin 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.
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WebMD Medical Reference from Healthwise

Last Updated: February 22, 2013
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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