Efficacious Modality In the TREATMENT of STAGE IV PRESSURE Ulcers

Prevention of pressure ulcers (PUs), rather than treatment of pressure ulcers, is the WOC nurse’s continuous mantra. Pressure ulcers are dreaded wounds and a high priority exists to heal them.   Ramifications of pressure ulcers include individuals’ distress, soaring therapeutic costs, and breaches in patient safety and quality care. Stage IV pressure ulcers are labor intensive wounds which require dedicated and specialized management due to highly impaired healing.  There is a lack of scientific evidence elucidating which adjunctive therapies are most effective in the treatment of stage IV pressure ulcers.

Among the array of adjunctive therapies used in pressure ulcer care, the use of NPWT is often the first choice of dressing for treatment of stage IV pressure ulcers.   NPWT decreases pressure ulcer size, drainage amount and dressing changes frequency.  However, pressure ulcers may not close by secondary intention with NPTW alone.    

The author of this abstract had used Porcine Urinary Bladder Matrix (UBM) in the management of a dehisced wound on a neonate patient with favorable outcome.  As a result, this modality was selected to treat pressure ulcers in three patients with stage IV pressure ulcers.  Two patients had sacral ulcers and one had an ischial ulcer.  Prior to the implementation, ulcers were free of necrotic tissue.  UBM was placed on the ulcer twice a week and covered with secondary dressing.          

Two of the three ulcers healed with minimal scaring.  The third ulcer presented with robust granulation and closure was resolved with tissue flap. None of the patients treated reported pain or discomfort with the use of UBM.  However, hypergranulation tissue was noted which required silver nitrate treatments.  In addition the application of UBM material was effortless compared with NPWT.

The use of UBM is a safe, effective alternative therapy in the treatment of stage IV pressure ulcers.