What are the AHCPR guidelines for managing existing 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

Guidelines developed by the Agency for Healthcare Policy and Research (AHCPR) Pressure Ulcer Panel for managing existing pressure ulcers include the following:

  • Use positioning devices to raise a pressure ulcer off the support surface; if the patient is no longer at risk for pressure ulcers, these devices may reduce the need for pressure-reducing overlays, mattresses, and beds; avoid using donut-type devices [108]
  • Assess all patients with existing pressure ulcers to determine their risk for developing additional pressure ulcers; if the patient remains at risk, use a pressure-reducing surface [31, 119, 120, 121]
  • If patients can assume a variety of positions without bearing weight on the lesion and without “bottoming out,” a static support surface should be used [96, 98, 101, 122]
  • If the patient cannot assume a variety of positions without bearing weight on the ulcer, if the patient fully compresses the static support surface, or if the pressure ulcer does not show evidence of healing, a dynamic surface should be used [96]
  • Finally, if the patient has large stage III or stage IV pressure ulcers on multiple turning surfaces, a pressure-relieving product is warranted [7, 55, 96, 101, 122, 123]

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