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How to Treat Acute Phase Pressure Ulcers with Necrotic Tissue
Author(s) -
Tsukada Kunio,
Tokunaga Keiko,
Nagano Midori
Publication year - 2005
Publication title -
wound repair and regeneration
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.847
H-Index - 109
eISSN - 1524-475X
pISSN - 1067-1927
DOI - 10.1111/j.1067-1927.2005.130116at.x
Subject(s) - medicine , silver sulfadiazine , necrosis , debridement (dental) , necrotic tissue , surgery , surgical debridement , wound healing
Aim: Most acute phase pressure ulcers have necrotic tissue. Choices to treat such ulcers are controversial. The aim of this study is to help produce a guideline to treat acute phase pressure ulcers with necrosis. Methods: Records of patients who acute phase ulcers with necrosis were retrospectively reviewed and their primary treatments and outcomes were studied. Ninety‐seven ulcers of 86 patients for 3.5 year period were included. Pictures of all ulcers were taken throughout the treatment periods. Results: Thirteen Stage II ulcers with black or yellow necrosis were treated with hydrocolloid dressings. All of them had excellent results. Forty of 76 Stage III ulcers had yellow necrosis. Hydrocolloid dressings were selected for 24 of them. Two of them became worth. Silver sulfadiazine cream was used for 5 ulcers and the results were relatively good. Fifteen of 36 ulcers with black necrosis were treated with hydrocolloid dressings. Two of them became worth. Thirteen ulcers with black necrosis were resected surgically at the beginnings of the treatments. One of them bled and became worth. Only one of eight Stage IV ulcers had yellow necrosis and it was treated with hydrocolloid dressing and result was good. Remaining five ulcers with black necrosis were resected with good results. Conclusions: The primary choice for treating Stage II pressure ulcers with any type of necrosis is hydrocolloid dressings. We recommend hydrocolloid dressings for Stage III and IV ulcers without local symptoms of infection. Then after providing autolysis, surgical debridement should be done. If the patient is malnourished or is under poor pressure release, silver sulfadiazine cream may be recommended.