Selection of a successful therapeutic modality must be preceded by correct evaluation, i.e., whether the sore is superficial or deep, open or closed. The treatment of superficial sores is conservative and directed toward cleanliness, relief of pressure, and exposure to air. Surgical debridement may be indicated. Proteolytic enzymes often are employed as adjunctive therapy, although there are some major drawbacks to their use. The plethora of therapeutic agents suggested for the treatment of deep pressure sores probably is related to the difficulties in achieving success.
Surgical debridement is indicated, and proteolytic enzymes are widely used.
Possible interactions. and factors leading to the inactivation of these enzymes are discussed, as is the use of various solutions, ointments, gold leaf, oxygen, dry heat, and other adjunctive devices. Of paramount importance in the management of pressure sores is the maintenance of cleanliness and dryness. To test the hypothesis that there will be a significantly greater increase in the rate of healing of decubitus ulcers in subjects who receive topical insulin therapy than in subjects who receive other forms of therapy, a pilot study was conducted, utilizing a 2-group before and after design. Data were collected on all subjects for a 15-day period. Although generalizations cannot be based on the results of 14 subjects, data analysis showed that insulin was a safe and effective agent in the healing of small, uncomplicated decubitus ulcers.