Pressure ulcers (decubitus ulcers, pressure sores, bedsores) are localized injuries to the skin and/or underlying tissue, usually over a bony prominence, as a result of pressure, or pressure in combination with shear and/or friction. A number of contributory factors whose significance is still to be elucidated are associated with pressure ulcers. The best method of fighting bedsores is prevention. Assessment of the patient’s risk of developing pressure ulcers should be conducted on admission to the ward, and daily during the performance of nursing procedures. The treatment of existing bedsores should include, first and foremost, establishing the prime wound care objectives and assessing whether local and systemic factors affecting wound healing could be improved so that continuity of the skin is re-established and pressure ulcers healed. Under the auspices of the Polish Society of Wound Healing, a panel of experts developed clinical practice guidelines for the prevention and treatment of pressure ulcers, which was published in the Journal of Wound Management in 2010, among other sources. Standardized tools – pressure ulcer risk assessment scales – can be used to evaluate the patient’s risk of developing pressure sores. The most commonly used tool is the 2014 International NPUAP (National Pressure Ulcer Advisory Panel) pressure ulcer classification system. Recommendations concerning pressure ulcer care are changing, as guidelines on chronic infected wound management are regularly updated. The TIME framework focuses on the use of local antimicrobial preparations and implementation of an algorithm for discriminating between available preparations, i.e. Lavasept® solution, antiseptics, antibiotics and different types of dressing. Protection of new cellular structure should guide dressing selection. Dressings stimulating collagen production and enabling non-traumatic wound care are recommended. Adjuvant therapies in pressure ulcer management include a variety of methods, some of which are still in the research stage: use of cold plasma (still in the research stage), hyperbaric chamber (it has been proven that tissue oxygen saturation has a positive impact on the healing process by enhancing collagen production), use of fibroblast growth factors, ultrasounds, phototherapy and laser biostimulation.
Keywords: pressure ulcer, prevention, risk assessment, treatment guidelines, care principles
Słowa kluczowe: odleżyna, profilaktyka, ocena ryzyka, wytyczne leczenia, zasady pielęgnacji