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Pressure Ulcer

Ramanpreet Grewal, MD Reviewed 06/2022
 


BASICS

DESCRIPTION

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

  • Usually over a bony prominence (eg, sacrum, calcaneus, ischium)

  • Classified in stages according...

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 visit...

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...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

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

Patient Monitoring

  • Home health nursing

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

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. Pres...

ADDITIONAL READING

  • Qaseem  A, Humphrey  LL, Forciea  MA, et al; for Clinical Guidelines Committee of the American College of Physicians. Treatment of pressure ulcers: a clin...

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/redistribute pressure, maximize nutrition, regular skin checks, and assess and treat wounds ap...

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