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Pressure Ulcer

Marzena Gieniusz, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • A localized area of skin or underlying tissue injury resulting from pressure and/or shear

  • Classified in stages according to the National Pressure Ulcer Advisory Panel (NPUAP):

    • Stage ...

DIAGNOSIS

HISTORY

  • Risk factors

  • Nutritional assessment (1)

  • Pain assessment (1)

  • Date of ulcer diagnosis

  • Treatment course

PHYSICAL EXAM

  • Full skin examination on initial contact and repeatedly throughout visits

  • A...

TREATMENT

GENERAL MEASURES

  • Comprehensive initial assessment of the patient

  • Pressure reduction/redistribution (4)[A]

  • Nutritional support (e.g., protein containing supplements) (5)[B]

  • Wound assessment and t...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Weekly assessment by nurse with wound experience; biweekly assessment by physician 

Patient Monitoring

  • Home health nursing

  • Change plan of care if no improvement in 2...

REFERENCES

1
Haesler E, ed. Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline. Osborne Park, Western Australia: Cambridge Media; 2014.
2
Pieper B, ed. Pressure Ulcers: Prevalence, ...

ADDITIONAL READING

  • Jamshed N, Schneider E. Is the use of supplemental vitamin C and zinc for the prevention and treatment of pressure ulcers evidence based? Ann Long-Term Care Med.  2010;18(3):28...

CODES

ICD10

  • L89.95 Pressure ulcer of unspecified site, unstageable

  • L89.91 Pressure ulcer of unspecified site, stage 1

  • L89.92 Pressure ulcer of unspecified site, stage 2

  • L89.93 Pressure ulcer of unspecifie...

CLINICAL PEARLS

  • Create assessment and prevention protocols for all patients.

  • Identify risk factors, reduce pressure, maximize nutrition, regular skin checks, and assess and treat wound appropriately.

  • Al...

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