Pressure Sores (Decubitus)

Why do Pressure Sores occur?

The development of a pressure sore has many reasons. There are a number of external (environment) and intrinsic (patient) risk factors that favor the occurrence of decubitus ulcers:

  • Extrinsic risk factors such as pressure, friction or moisture act from the outside and are of outstanding importance in prophylaxis.
  • Intrinsic risk factors, such as reduced 

spontaneous mobility, reduced protective sensitivity, skeletal deformities or arterial occlusive diseases are patient-related and usually have to be considered as given.

What Forms of Pressure Sores are there?

To classify a pressure sore defect the following criteria should be specified;

1) localization

2) size/volume

3) Depth extent (EPUAP classification)

4) Condition of the wound (classification according to Seiler)

6) Etiology

What are the consequences of pressure sores?

Pressure sores present a great challenge because they:

  • occur at any age, from newborns to the elderly
  • are constantly increasing in medical and economic importance
  • affection of the patient by 
    • pain
    • smell (odor)
    • loss of fluid and protein through the wound
    • functional impairment
    • mental impairment
  • affection of people around the patient (→ physical and mental stress)

How can you treat a decubitus?

First contact: Patient with pressure sores are initially seen by Plastic Surgery. Prof. Dr. Robert Hierner is an internationally renowned specialist in the field of diagnosis and therapy of pressure ulcers.

Multidisciplinary Wound Care Team: Depending on the initial Wound examination, further specialties are consulted for individually tailored diagnostic and treatment. Wound Care in Dubai is proud to offer all necessary diagnostic tools and treatment options (“all under one roof”)

Pressure sore management is carried out by a multidisciplinary treatment team with a common language for diagnosis and documentation and a so-called “integrative pressure sore therapy concept”, which is based on;

Avoidance/prevention of decubitus

The best treatment for pressure ulcers is to avoid them (prevention). The following principles have proven themselves:

  1. Pressure ulcer risk assessment using scores/scales
  2. skin care
  3. Elimination or reduction of risk factors
  4. Guidance on personal hygiene
  5. Consistent therapy of contractures
  6. Optimization of nutrition
  7. Guidance on self-reliance

Control

The Decubitus Evaluation System (DES) has proven itself for standardized control and standardized documentation

Treatment

If there is a manifest decubitus, this first means that the measures to avoid it (prevention) were not sufficient. Decubitus therapy is based on:

– Systemic wound therapy

– Optional additional therapy

– Local wound therapy

prevent pressure sores