Risk groups The risk group “decubitus ulcer” (ICD-10: L89.-) indicates the possibility that a particular condition – for example, disease, laboratory diagnosis, use of a drug – may be associated with the risk of micronutrient deficiency: Retinol Iron Selenium Zinc* Therapy For the therapy of “decubital ulcer” (ICD-10: L89.-), the following micronutrients (vital substances) are … Pressure Ulcer: Micronutrient Therapy
For decubiti of stage 2 or greater in which cure cannot be achieved by conservative therapy, surgical debridement (wound debridement, i.e., removal of dead (necrotic) tissue from ulcers) should be performed.If this also does not produce a good result, plastic surgical reconstruction may be considered.
To prevent pressure ulcers, attention must be paid to reducing individual risk factors. Behavioral risk factors Diet Micronutrient deficiency (vital substances) – see Prevention with micronutrients. Immobilization / lack of movement Underweight (BMI < 18.5) Other risk factors Acute diseases, unspecified General dystrophy Chronic diseases, unspecified Ill-fitting aids such as prostheses. Preventive measures For immobile … Pressure Ulcer: Prevention
The following symptoms and complaints may indicate a pressure ulcer: Leading symptoms Redness of intact skin that cannot be pushed away. Skin discoloration Overheating Edema Hardening of the skin Pain in the affected area * * Initially, the pain is easily localized by the patient and can be self-terminated by changing position. However, during the … Pressure Ulcer: Symptoms, Complaints, Signs
Pathogenesis (development of disease) Prolonged exposure to pressure, friction, shear forces, or a combination of these factors results in inadequate blood flow to the affected area. Consequences include: Reduced blood flow to the tissue Reperfusion injury Disruption of lymphatic drainage This leads to ulceration (ulceration), possibly the formation of necrosis (local tissue death). Etiology (causes) … Pressure Ulcer: Causes
Stages of pressure ulcer Stage Description Grade 1 Redness that cannot be pushed away; skin intact; discoloration, hyperthermia, edema (water retention/swelling), induration possible (ICD-10 L89.0) Grade 2 Damage to the epidermis (upper skin) and/or dermis (leathery skin); superficial ulcer (sore) presenting as a blister or skin abrasion (ICD-10 L89.1) Grade 3 All skin layers affected; … Pressure Ulcer: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing) of the skin [leading symptoms. Skin discoloration Edema Hardening of the skin] Decubital ulcers occur primarily on bony prominences – the following sites are commonly affected: Coccyx Heel Trochanter … Pressure Ulcer: Examination
Pressure ulcers are diagnosed by history and physical examination.
Therapy target Pain relief Therapy recommendations Analgesia (pain management) See also under “Other therapy.” Active substances (main indication) for systemic therapy Nonacidic analgesics (pain relievers) – e.g., acetaminophen. Non-steroidal anti-inflammatory drugs (cortisone-free anti-inflammatory drugs) – e.g. acetylsalicylic acid (ASA). Opioid analgesics – e.g., morphine. Antidepressants – amitriptyline Antiepileptic drugs – gabapentin Lidocaine gel or morphine … Pressure Ulcer: Drug Therapy
Pressure ulcers are diagnosed by history as well as physical examination.
General measures For existing pressure ulcers: Pressure relief through positioning measures Wound cleansing – seems to play only a minor role. Aim for normal weight!Determination of BMI (body mass index, body mass index) or body composition using electrical impedance analysis. Fall below the BMI lower limit (from the age of 45: 22; from the age … Pressure Ulcer: Therapy
Medical history (history of illness) represents an important component in the diagnosis of pressure ulcers. Family history Social anamnesis Current anamnesis/systemic anamnesis (somatic and psychological complaints). Do you have any pain? If yes, when does the pain occur? Where is the pain localized? Have you noticed any skin changes/skin defects? Do you have any functional … Pressure Ulcer: Medical History
