National Clinical Guideline Centre (UK)
. Date of publication 2014 Apr 1;volume ():.
1. The Prevention and Management of Pressure Ulcers in Primary and Secondary Care.
National Clinical Guideline Centre (UK).
London: National Institute for Health and Care Excellence (UK); 2014 Apr.
National Institute for Health and Clinical Excellence: Guidance .
Prevention of pressure ulcers usually involves an assessment to identify people
most at risk of pressure ulcers, such as elderly, immobile people or those with
spinal cord injury. Assessments are most commonly carried out using specific
pressure area risk scores (for example, the Braden or Waterlow scales for
predicting pressure sore risk or the, Glamorgan scale for paediatric pressure
ulcers). Pressure ulcers are assessed, and potential treatment options include
wound dressings, debridement, physical therapy, antibiotics and antimicrobials.
Mobilising, positioning and repositioning interventions, and support surfaces are
used in combination with other wound management strategies. Nutritional
assessment is usually carried out so that nutritional deficiencies can be
addressed. Surgical interventions for debridement or to obtain coverage with skin
flaps may be performed in some patients. If poor circulation is a contributory
factor, vascular surgical intervention may be used. Infection may also be treated
if it is a contributory factor to the persistence of the ulcer or is causing
systematic illness or cellulitis. There is variation in the consistency of
approach to pressure ulcer prevention, and to treatment and care of established
pressure ulcers across the NHS in both secondary and primary care. There is a
need for guidance to rationalise the approaches used for prevention, treatment
and care of pressure ulcers, and to ensure practice is based on the best
available evidence.
PMID: 25340232
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