From the Guidelines
For treating bed sores, I recommend using hydrocolloid or foam dressings to reduce wound size, as supported by the American College of Physicians guideline 1. When it comes to ointments, there is no specific recommendation from the provided evidence, but in general practice, antimicrobial and moisture barrier ointments can be beneficial.
- Bacitracin or Neosporin can help prevent infection in stage I or II pressure ulcers.
- More advanced ulcers may require prescription options like silver sulfadiazine (Silvadene) or medical-grade honey products (Medihoney). It's essential to apply these ointments after gently cleaning the wound with saline solution or mild soap and water, then cover with an appropriate dressing like hydrocolloid, foam, or alginate depending on the wound's drainage level.
- Change dressings and reapply ointment 1-3 times daily based on the severity of the sore. Beyond topical treatment, pressure relief is crucial -
- Reposition the person every 2 hours,
- Use pressure-redistributing surfaces,
- Ensure adequate nutrition with sufficient protein, vitamins C and E, and zinc to support healing, as protein supplementation has been shown to reduce wound size 1. The American College of Physicians also recommends using electrical stimulation as adjunctive therapy to accelerate wound healing 1. Bed sores develop when prolonged pressure cuts off blood supply to tissues, causing cell death, so prevention and treatment must address the underlying pressure issue while supporting tissue repair with appropriate ointments and dressings.
From the Research
Treatment Options for Bed Sores
- Silver sulfadiazine cream is a commonly used treatment for pressure ulcers, as it has been shown to reduce bacterial counts and promote wound healing 2
- Silver mesh dressing is another option, which has been found to be effective in controlling infection and promoting wound healing, with a lower cost compared to silver sulfadiazine cream 3
- Debridement and cleansing are also important steps in the treatment of pressure ulcers, as they help to remove devitalized tissue and bacteria, promoting optimal wound healing 4
Key Considerations
- The goal of treatment should be to control infection, promote wound healing, and improve the patient's general condition 3
- A comprehensive assessment and treatment plan should be devised, taking into account the patient's individual needs and risk factors 5
- The use of silver sulfadiazine cream or silver mesh dressing can be effective in reducing bacterial counts and promoting wound healing, but the choice of treatment should be based on the individual patient's needs and circumstances 3, 2
Cost and Effectiveness
- The cost of treatment using silver mesh dressing has been found to be significantly lower than using silver sulfadiazine cream 3
- The effectiveness of different treatments can vary depending on the individual patient and the severity of the pressure ulcer, and should be carefully evaluated and monitored 3, 2