Diagnosis and management of pressure ulcers.
Pressure ulcers represent a significant health issue and cost for the growing number of elderly and debilitated patients. The plastic surgeon, as part of the wound care team, has the ultimate responsibility of forming a plan to allow for the eventual closure of the wound. This plan should start with breaking the cycle and eliminating the risk factors that led to the development of the wound. Simultaneously, the surgeon should order an MRI and erythrocyte sedimentation rate and take a bone biopsy to diagnose the extent of the wound and the bacteria present. If more than 10(5) bacteria are present, surgical debridement should be performed, followed by 6 weeks of intravenous antibiotics. Once the bacterial load has been lessened, a 6-week course of Regranex should be applied. Finally, after the wound bed has been prepared adequately, definitive surgical closure should be planned and performed.
Levi
Benjamin
B
Division of Plastic and Reconstructive Surgery, University of Michigan, Ann Arbor, MI, USA. blevi@med.umich.edu
Rees
Riley
R
D043925:Angiogenesis Inducing Agents / Q000627:therapeutic use; D000077214:Becaplermin; D001685:Biological Factors / Q000627:therapeutic use; D003646:Debridement; D006801:Humans; D010982:Platelet-Derived Growth Factor / Q000627:therapeutic use; D003668:Pressure Ulcer / Q000175:diagnosis* / Q000188:drug therapy / Q000628:therapy*; D020574:Proto-Oncogene Proteins c-sis; D012720:Severity of Illness Index
D043925:Angiogenesis Inducing Agents; D001685:Biological Factors; D010982:Platelet-Derived Growth Factor; D020574:Proto-Oncogene Proteins c-sis; D000077214:Becaplermin