Q: Is every sore a pressure ulcer?
A: Not necessarily!
Extensive work is done in assessment, identification and treatment of a pressure ulcer to understand the patient‘s needs and avoid F-Tag 314.
The key to success is to have the skin assessment at the initial assessment. It is a good practice to use standardized tools, such as the Braden Scale, to assess the nutritional status, cognitive status, swallowing difficulties, dental status, medications, comorbidities and immobility that could prevent wound healing.
Many patients have venous, arterial or neuropathic diseases that may affect the circulation in the lower extremities, consequently leading to ulcers. Patient history also should be acquired. Ballet dancers and soldiers may end up with undesired foot problems due to prolonged standing or uncomfortable footwear use in the past.
Another key factor is that older adults may not have access to fresh fruits or vegetables, which can lead to nutritional deficiencies and avoidable skin breakdown. That can occur in areas of previously healed ulcers due to decreased tensile strength of scars.
The location of the wound with associated symptoms is an important aspect of initial assessment. For example, arterial ulcers are punched out and circular with mild drainage, while venous ulcers are shallow with ragged edges and profuse drainage. Neuropathic ulcers are painless for the most part, though they may have associated neuropathic symptoms in other parts of the body. Frequently, there are multiple factors that lead to wound formation. While a few may be modifiable, many are not.
In conclusion, it is essential to know the medical, cultural, economic, educational and psychosocial background of one’s patient. This will allow a thorough person-centered understanding and therapeutic healing with the patients.
Please send your wound care-related questions to Dr. Naqvi at [email protected].
From the October 2023 Issue of McKnight's Long-Term Care News
