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# Treatment of Pressure Ulcers

*AHCPR Clinical Practice Guidelines, No. 15*

Treatment of Pressure Ulcers Guideline Panel.

Agency for Health Care Policy and Research (AHCPR)1994 Dec

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## Abstract

This *Clinical Practice Guideline* offers a comprehensive program for            treating adults with pressure ulcers. The recommendations are intended for clinicians            who examine and treat individuals in all health care settings. 

The guideline was developed by a panel of experts and is based on the best available            scientific evidence and clinical expertise. The recommended treatment program focuses on            (1) assessment of the patient and pressure ulcer, (2) tissue load management, (3) ulcer            care, (4) management of bacterial colonization and infection, (5) operative repair in            selected patients with Stage III and IV pressure ulcers, and (6) education and quality            improvement. 

Accurate, ongoing assessment of the ulcer is essential. Of equal importance are the            assessment and management of the individual's overall health, including physical,            psychosocial, and nutritional status. Pain should be assessed and managed. Management of            tissue loads (i.e., pressure, friction, and shear), through vigilant use of positioning            techniques and appropriately selected support surfaces, is critical. 

Ulcer care includes (1) debridement of necrotic tissue and debris, (2) wound cleansing            using saline and avoiding antiseptics, and (3) application of dressings that maintain a            clean, moist environment while keeping the surrounding skin dry. Education and quality            improvement are integral to an effective pressure ulcer treatment program. 

## Contents

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                        - Treatment of Pressure Ulcers Guideline Panel
                        - Guideline Development and Use
                        - Foreword
                        - Panel Members
                        - Acknowledgments
                        - Executive Summary
                        - 1. Overview                           -     Introduction 
                          -     Definitions 
                          -      Incidence and Prevalence 
                          -     Methodology for Guideline Development 
                          -     Strength-of-Evidence Ratings 
                          -     Economic Impact and Public Policy Implications    
                          -     Followup Activities 
                          -      Organization of the Guideline 
                          -      Clinical Algorithm
                        - 2. Assessment                           -     Assessing the Pressure Ulcer 
                          -     Assessing the Individual With a Pressure Ulcer
                        - 3. Managing Tissue Loads                           -     While in Bed 
                          -     While Sitting
                        - 4. Ulcer Care                           -     Debridement 
                          -     Wound Cleansing 
                          -     Dressings 
                          -     Adjunctive Therapies
                        - 5. Managing Bacterial Colonization and Infection                           -     Pressure Ulcer Colonization and Infection 
                          -     Infection Control
                        - 6. Operative Repair of Pressure Ulcers                           -     Patient Selection 
                          -      Controlling Factors That Impair Healing 
                          -     Operative Procedures 
                          -     Postoperative Care
                        - 7. Education and Quality Improvement                           -      Education 
                          -     Quality Improvement
                        - Acronyms
                        - Glossary
                        - Contributors
                        - Attachments
                        - Availability of Guidelines
                        - References

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#### Suggested citation:

Bergstrom N, Bennett MA, Carlson CE, et al. Treatment of Pressure Ulcers. Clinical            Practice Guideline, No. 15. Rockville, MD: U.S. Department of Health and Human Services.            Public Health Service, Agency for Health Care Policy and Research. AHCPR Publication No.            95-0652. December 1994.

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Bookshelf ID: NBK63898

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                    - Cite this Page Treatment of Pressure Ulcers Guideline Panel. Treatment of Pressure Ulcers. Rockville (MD): Agency for Health Care Policy and Research (AHCPR); 1994 Dec. (AHCPR Clinical Practice Guidelines, No. 15.)

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