What are the ACP guidelines for prevention, and treatment of pressure injuries (pressure ulcers)?

Updated: Mar 26, 2020
  • Author: Christian N Kirman, MD; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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Answer

The 2015 American College of Physicians (ACP) clinical practice guidelines for risk assessment, prevention, and treatment of pressure ulcers included the following recommendations and statements [78, 79] :

  • Perform a risk assessment to identify patients who are at risk of developing pressure ulcers
  • Choose advanced static mattresses (made of foam or gel that stays put when a person lies down) or advanced static overlays (a material attached to the top of a mattress such as sheepskin or a pad filled with air, water, gel, or foam) in patients who are at an increased risk of developing pressure ulcers
  • ACP recommends against using alternating-air mattresses or alternating-air (also called dynamic) overlays in patients who are at an increased risk of developing pressure ulcers
  • Use protein or amino acid supplementation in patients with pressure ulcers to reduce wound size
  • Use hydrocolloid or foam dressings in patients with pressure ulcers to reduce wound size; the evidence also showed that hydrocolloid dressings are better than gauze for reducing wound size and resulted in similar complete wound healing as foam dressings
  • Although radiant heat dressings accelerated wound healing, there was no evidence they were better than other dressings for improving complete wound healing
  • Use electrical stimulation as adjunctive therapy in patients with pressure ulcers to accelerate wound healing; the most common adverse effect for this stimulation was skin irritation, and frail elderly patients were more susceptible to harms from electrical stimulation
  • Those at higher risk for pressure ulcers include blacks or Hispanics and those with lower body weight, cognitive or physical impairments, and other comorbid conditions that affect soft tissue(eg, incontinence, edema, malnutrition, and diabetes)

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