From the Guidelines
The recommended treatment for a stage 1 pressure ulcer on the buttock focuses primarily on pressure relief and skin protection, with the application of a moisture barrier cream containing zinc oxide or dimethicone to protect the skin from moisture and friction, as supported by low-quality evidence from studies such as 1 and 1.
Key Components of Treatment
- Reposition the patient every 2 hours to relieve pressure on the affected area, using pillows or foam wedges to maintain proper positioning.
- Use pressure-redistributing surfaces such as specialized mattresses, cushions, or overlays.
- Keep the skin clean and dry, using mild cleansers (not harsh soaps) and patting the area dry gently.
- Maintain adequate nutrition and hydration to support skin healing, possibly with protein supplements if needed, as recommended by 1 and 1.
Importance of Early Intervention
Regularly assess the ulcer for signs of deterioration, as early intervention prevents progression to more severe stages. Stage 1 pressure ulcers are characterized by intact skin with non-blanchable redness in a localized area, and proper treatment at this stage can lead to complete healing while preventing complications. Daily documentation of the ulcer's appearance helps track healing progress and identify any concerning changes promptly, as noted in 1 and 1.
From the Research
Topical Medicine for Stage 1 Buttock Ulcer
- There is no clear evidence to support the use of specific topical medicines for stage 1 buttock ulcers 2, 3.
- Some studies suggest that fatty acid-containing treatments may reduce the incidence of pressure ulcers, but the evidence is of low certainty 2.
- Silicone dressings may also reduce pressure ulcer incidence, but again, the evidence is of low certainty 2.
- Other topical agents, such as dimethyl sulfoxide (DMSO) cream, have been shown to potentially increase the risk of pressure ulcer incidence 2.
- Hydrocolloid dressings have been studied for their effectiveness in preventing and treating pressure ulcers, but the evidence is mixed, with some studies showing no superiority over conventional care 4, 5.
Treatment Options
- The use of botulinum toxin type A has been reported to be effective in treating a chronic buttock ulcer in a patient with spastic paraplegia, by reducing recurrent muscular spasms that hampered the healing of the ulcer 6.
- Systemic therapies, such as oral pentoxifylline, have been shown to be effective in improving and healing venous leg ulcers, but there is limited evidence for their use in pressure ulcers 3.
- Antimicrobial dressings, antiseptics, and antibiotics should only be used for patients with infected wounds, to prevent bacterial resistance 3.
- Nutritional supplementation has not been clearly shown to prevent or manage chronic ulcers 3.