From the Guidelines
Treatment for small pressure sores involves keeping the area clean and protected while promoting healing, and the American College of Physicians recommends using protein or amino acid supplementation, hydrocolloid or foam dressings, and electrical stimulation as adjunctive therapy to reduce wound size and accelerate wound healing. The approach to treating small pressure sores includes several key steps:
- Gently cleaning the wound with mild soap and water or saline solution, then patting it dry carefully 1
- Applying a protective dressing such as a hydrocolloid, foam, or transparent film dressing to maintain a moist healing environment while protecting against contamination 1
- Changing dressings as recommended, typically every 1-3 days depending on drainage 1
- Relieving pressure on the affected area by repositioning every 2 hours and using pressure-redistributing devices like specialized mattresses or cushions 1
- Ensuring adequate nutrition with sufficient protein, calories, vitamins (especially C and zinc) to support tissue repair 1
- Monitoring the wound for signs of infection such as increased pain, redness, warmth, swelling, or foul odor, which would require medical attention 1 This approach works because keeping the wound clean prevents infection, moist wound healing promotes cell migration and tissue regeneration, while pressure relief prevents further tissue damage and allows blood flow to deliver oxygen and nutrients needed for healing. Some key points to consider when treating small pressure sores include:
- The use of protein or amino acid supplementation to reduce wound size 1
- The use of hydrocolloid or foam dressings to reduce wound size and promote complete wound healing 1
- The use of electrical stimulation as adjunctive therapy to accelerate wound healing 1
- The importance of relieving pressure on the affected area to prevent further tissue damage and promote healing 1
- The need for adequate nutrition to support tissue repair and promote healing 1
From the Research
Treatment for Small Pressure Sores
To treat small pressure sores, several strategies can be employed, including the use of dressings, topical agents, support surfaces, and repositioning. The following points outline the key considerations:
- Dressings and Topical Agents:
- The use of dressings such as alginate, hydrocolloid, and protease-modulating dressings, as well as topical agents, has been explored in the treatment of pressure ulcers 2.
- However, the evidence regarding the effectiveness of these interventions is of low or very low certainty due to the high risk of bias and imprecision in the studies.
- Protease-modulating dressings may increase the probability of pressure ulcer healing compared to saline gauze, but the evidence is not conclusive 2.
- Support Surfaces:
- Support surfaces, including foam mattresses and overlays, can help reduce pressure on the skin and promote healing 3, 4.
- The use of higher-specification foam mattresses rather than standard hospital foam mattresses is recommended for people at high risk of developing pressure ulcers 3.
- However, the relative merits of different support surfaces, including alternating-pressure and constant low-pressure devices, are unclear due to the low certainty of the evidence 3, 4.
- Repositioning:
- Repositioning is a crucial aspect of pressure ulcer prevention and treatment, with more frequent repositioning (every 2-3 hours) potentially reducing the odds of pressure ulcer development by 25% compared to less frequent repositioning (every 4-6 hours) 5.
- The use of a turning team may also reduce the incidence of pressure ulcers, with a 51% reduction in the odds of pressure ulcer development compared to usual care 5.
- Overall Approach:
- Given the low certainty of the evidence for many interventions, treatment decisions should be based on individual patient needs, wound symptoms, clinical experience, patient preference, and cost 2.
- Further research is needed to determine the most effective treatments for pressure ulcers and to inform clinical practice 2, 6.