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Treatment of Pressure Ulcers FREE

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The full report is titled “Treatment of Pressure Ulcers: A Clinical Practice Guideline From the American College of Physicians.” It is in the 3 March 2015 issue of Annals of Internal Medicine (volume 162, pages 370-379). The authors are A. Qaseem, L.L. Humphrey, M.A. Forciea, M. Starkey, and T.D. Denberg, for the Clinical Guidelines Committee of the American College of Physicians.

Summaries for Patients are a service provided by Annals and the ACP Center for Patient Partnership in Healthcare to help patients better understand the complicated and often mystifying language of modern medicine.

Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians.

Ann Intern Med. 2015;162(5):I-38. doi:10.7326/P15-9010
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What are clinical guidelines, and what do they mean for me?

The American College of Physicians (ACP) developed a clinical guideline for the treatment of pressure ulcers. Members of ACP are internists (physician specialists in the care of adults). Clinical guidelines are recommendations that provide clinicians with research-based advice to help them deliver the best possible care to patients. The ACP reviewed studies on the benefits and harms of treatment options for pressure ulcers.

What are pressure ulcers?

Pressure ulcers, also known as “bed sores,” are wounds to the skin or the tissue under the skin. They can happen when a person spends a long time in the same position, such as in a hospital or long-term care setting. Pressure ulcers can be very painful and slow to heal, and they increase the risk for infection. They are common where skin is close to the bone, such as the back, the shoulders, the hips, and over the tailbone. Risk factors for pressure ulcers include older age, black race or Hispanic ethnicity, low body weight, mental or physical impairments, incontinence, diabetes, and malnutrition.

What did the authors find?

The authors reviewed research on the benefits and harms of treatment options for pressure ulcers. They found that certain nutritional supplements and special bandages can help to heal pressure ulcers. They also found that electrical stimulation can help to speed up healing. Many other treatment options did not have enough research and data for the authors to determine whether they worked.

What does ACP recommend that patients and doctors do?

1. Nutritional supplements of protein or amino acids should be given to help heal pressure ulcers. This treatment may not work for all patients.

2. Hydrocolloid and foam dressings should be used for pressure ulcers. These are special bandages that can be left on for several days. They were found to be better than gauze bandages in reducing the size of pressure ulcers.

3. Electrical stimulation should be used along with standard treatment to help heal pressure ulcers. Electrical stimulation involves applying small amounts of electricity near the wound area to help speed up healing.

Questions for my doctor

• How long will it take for my pressure ulcers to heal?

• What can I expect from electrical stimulation therapy?

• How can I keep my wounds from getting infected?

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