Treating Stage III Pressure Ulcers - PolyMem

1 6 OSTOMY wound MANAGEMENT AUGUST 2009 most important approach in managing Stage III pressureulcers is a complete assessment of total patient needs. Assess-ment usually includes wound type, location, measurement, andduration; nutrition; mobility; mental status; social and financialsupport; medications; oxygenation needs; Pressure distribution;lab data; and comorbidities. Appropriate and effective dressingselection should take into account the amount and type ofdrainage, undermining, tunneling, type and amount of necrotictissue, edema, signs and symptoms of bacterial burden, and pain. If the wound bed is partially or completely covered withnecrotic tissue, wound gels may be utilized to soften, liquefy, andloosen the nonviable tissue. Once the wound bed is free of debrisand necrotic tissue, foam dressings and foam cavity fillers (forwounds with depth) assist with maintaining a moist environ-ment, provide thermoregulation for the wound and surroundingtissue, provide absorbency for draining wounds, minimize pain,and improve patient comfort level utilizing nonadherent prop-erties and long wear time (up to 7 days between dressing changesdepending on amount of draining).

2 Alginate dressings, which have many of the same propertiesas foam, are another choice for Stage III Pressure Ulcers . Bothdressing types maintain a moist wound environment and maybe used for tunneling and undermining. Like foam, alginates pro-vide moderate absorbency, do not adhere to the wound base, andprovide some pain control. However, alginates have a shorterwear time, requiring more frequent dressing changes and a sec-ondary dressing. When making dressing decisions, clinicians should rememberthat dressings that maintain thermoregulation and homeostasiscan increase the proliferation of new cells and decrease pain as-sociated with dressing changes. Also, wounds with tunneling orundermining should never be overpacked in order to avoid in-terfering with healing. Overpacking can cause added pressuredamage and can limit blood flow to the management of Stage III Pressure areas involves thecombined effort of the practitioner and the patient, as well as thecorrect product.

3 PEARLS FOR PRACTICET reating Stage III Pressure UlcersSusan E. Nelson, RN, MSN, WCC, CLNC, Regional Nursing Department Chair Ivy Tech Community College Anderson, Indiana Commentary from Ferris Mfg. Corp. PolyMem QuadraFoam dressings are the singlesolution that delivers maximum value when man-aging Pressure Ulcers . No generic versions of Poly-Mem QuadraFoam dressings are available. In a representative case study,1 PolyMem dress-ings were used exclusively on a profoundly mal-nourished (450 kcal/day intake), 90-year-oldwoman with end- Stage Alzheimer s disease. Thebedridden patient had an odiferous, painful, eschar-covered Stage III scapula Pressure ulcer . The clini-cian reported the patient s persistent wound painwas eliminated along with the wound odor whenthe PolyMem dressings were initiated. The autolyt-ically disolving eschar was absorbed into the dress-ing and removed at each dressing change; thiseliminated the need for all other traditional debride-ment strategies.

4 The continuous cleansing proper-ties of the dressings made dressing changes easyfor the family members because they did not needto cleanse the wound bed during dressingchanges. The wound closed in 6 months. Reference1. Agathangelou C. Unique dressing provides nutrients forwound closure in a profoundly malnourished presented at National Pressure ulcer AdvisoryPanel 11th Biennial Conference. Arlington, VA. February27 29, your Pearls for your Pearl is selected for publication, you will receive cashhonoraria or a free copy of Chronic wound Care your Pearls to the for Practice is made possible through the support of Ferris Mfg. Corp, Burr Ridge, IL ( ). The opinions and statements of the clinicians providingPearls for Practice are specific to the respective authors and are not necessarily those of Ferris Mfg. Corp., OWM, or HMP Communications. This article was not subjectto the Ostomy wound Management peer-review process.

5 December 7: Stage IIIscapula wound . All debridement providedby 30: Closedwound. PolyMem usedto closure.