Stroke Training and Awareness Resources (STARs)

Prevention and treatment of pressure ulcers

The most important way to prevent ulcers is to relieve the pressure on the tissues for long enough, and at frequent enough intervals, to allow the tissues to receive an adequate blood supply (Warlow et al 2019).

Prevention of pressure ulcers
This can be achieved by:
  • Regular turning/positioning of the patient
  • Regularly changing the patient’s situation e.g. time spent in bed/time spent in chair
  • Use of appropriate continence products
  • Use of appropriate skin cleansing, moisturisers and barrier products
  • Utilise passive and active pressure relieving mattresses and cushions
    • Passive systems include: padded mattresses, polystyrene bead system, foam mattresses, roho cushions, gel pads
    • Active systems include: ripple mattresses and cushions, low air loss systems and more sophisticated forms of specialist equipment
Treatment of pressure ulcers
For those with established pressure ulcers, pressure relief appears to be the most important factor in promoting healing which can be achieved by using the methods/equipment as per table above. Additionally you should consider:
  • Optimising the patient’s general condition e.g. good diet, adequate hydration
  • Analgesia – this should be adequate to prevent patient distress and the development of spasticity
  • Antibiotics – if local/systemic infection present
  • Use of appropriate dressings and products
  • Debridement – necrotic tissue should be removed
  • Skin grafting – to achieve skin coverage
  • Electrotherapy to promote healing

Reference:

  • Warlow’s Stroke: Practical Management, 4th Edition (2019) Graeme J. Hankey (Editor), Malcolm Macleod (Editor), Philip B. Gorelick (Editor), Christopher Chen (Editor), Fan Z. Caprio (Editor), Heinrich Mattle (Editor).

 

Further reading:

Prevention and Management of Pressure Ulcers (2020) available at:  Healthcare Improvement Scotland.

Tubaishat, A, Papanikolaou, P, Anthony, D, Habiballah, L (2017). Pressure ulcers prevalence in the acute care setting: a systematic review. Clinical Nursing Research, 27 (10), pg 1-28.

NB: You should check your local area for protocols and guidelines.

Page last reviewed: 21 Apr 2021