Question
A long standing bed ridden patient presented with the following condition over the heel region.What would be the grade of this condition?
A. I
B. II
C. III
D. IV
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Correct Answer » B Explanation |
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Ans:B. II.
The patient in question is suffering from Pressure Ulcer.
BED SORE/ PRESSURE SORE
- These can be defined as tissue necrosis with ulceration due to prolonged pressure. Less preferable terms are bed sores, pressure ulcers and decubitus ulcers.
- If external pressure exceeds the capillary occlusive pressure (over 30 mmHg), blood flow to the skin ceases leading to tissue anoxia,necrosis and ulceration .
- Prevention is obviously the best treatment with good skin care, special pressure dispersion cushions or foams, the use of low air loss and air-fluidised beds and urinary or faecal diversion in selected cases. The bed-bound patient should be turned at least every 2 hours.
Pressure sore frequency in descending order
- Ischium
- Greater trochanter
- Sacrum
- Heel
- Malleolus (lateral then medial)
- Occiput
Staging of pressure sores
- Stage 1 Non-blanchable erythema without a breach in the epidermis
- Stage 2 Partial-thickness skin loss involving the epidermis and dermis
- Stage 3 Full-thickness skin loss extending into the subcutaneous tissue but not through underlying fascia
- Stage 4 Full-thickness skin loss through fascia with extensive tissue destruction, maybe involving muscle, bone, tendon or joint.
Treatment:
- For stage 1 and 2 pressure injuries, wound care is usually conservative (ie, nonoperative)
- Pressure reduction – Repositioning and use of support surfaces
- Wound management – Débridement, cleansing agents, dressings, and antimicrobials
- For stage 3 and 4 lesions, surgical intervention (eg, flap reconstruction) may be required, though some of these lesions must be treated conservatively because of coexisting medical problems [3]
- Approximately 70%-90% of pressure injuries are superficial and heal by second intention