2. PREVENTION AND
CARE OF PRESSURE
SORE

5. DEFINITION

Pressure ulcers are localized areas of necrotic soft
tissue that occur when pressure applied to the
skin over time is greater than normal capillary
closure pressure which is about 32 mm hg

6. RISK FACTORS

7. CLINICAL
MANIFESTATION

Contd..

8. STAGES

9. MANAGEMENT

10. STAGE-1
Pressure to be removed
 Nutritional electrolyte balances are maintained
 Friction and shear reduced
 Avoid moisture to the skin


11. STAGE -2

Wash with sterile saline solution

Avoid antiseptic solution

Semi permeable occlusive dressing

Minimizing the loss of fluid and proteins

12. STAGE 3 AND 4

Drain the necrotic tissues and cleaned /debrided

Topical treatment is prescribed


New granulation tissue must be protected

Prevent further trauma pressure

13. SURGICAL
MANAGEMENT
Debridement
 Drainage
 Bone resection
 Skin grafting


14. NURSING MANAGEMENT

15. PREVENTION
Change position at least every 2 hours to relieve
pressure.
 Use items that can help reduce pressure -pillows, sheepskin, foam padding, and powders
from medical supply stores.
 Eat well-balanced meals that contain enough
calories to keep you healthy.


16. CONTD….
Drink plenty of water (8 to 10 cups) every day.
 Exercise daily, including range-of-motion
exercises.
 Keep the skin clean and dry.
 After urinating or having a bowel movement,
clean the area and dry it well. A doctor can
recommend creams to help protect the skin.


17. COMPLICATION
autonomic dysreflexia
 bladder distension
 osteomyelitis
 pyarthroses
 sepsis
 amyloidosis,
 anemia, urethral fistula, gangrene and very rarely
malignant transformation


18. NURSING INTERVENTION

20. BIBLIOGRAPHY
Lewis “medical surgical nursing” sixth edition
Mosby publication (2000) vol 2page no 1207-1208
 Brunner and sudharth “medical surgical nursing”
12th edition Lippincott publication (2010)page no 185190
Net references
www.google.pressure sore.com
www.wikipedia.pressure sore.com
www.google pressure sore prevention. com
