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Current literature suggests sDTI represents early pathogenesis of full thickness Stage III of IV pressure ulcers and little that can be done to prevent the progression besides standard of care (repositioning schedules, support surfaces, topical dressing application and nutritional support)¹˒². Incorporation of NLFU has been identified in literature as an option for early intervention for improving outcomes for patients with sDTI³.
Methods/Subjects:
In June 2012, NLFU was added as an adjuvant therapy to standard of care once a sDTI was identified. NLFU made a remarkable difference by preventing the progression of sDTI and the facility added it to their standard of care for treatment of this wound type. Twenty-one patients admitted to our 40-bed acute care facility had identified sDTI. Range in age was from 42 to 81 years and included eight female and thirteen male. Sites of injury included heels, plantar foot, buttocks, ischium, sacrum, and trochanter. Once identified, NLFU treatments were added to our standard of care, which includes Braden Risk Assessment, head to toe skin assessment, turning and repositioning every two hours, moisture management, nutritional support, reduction of friction and shear, implementation of specialty support surfaces, and pain management. Patients were treated for five consecutive days, then every other day until resolved or declared as stageable, or the patient was discharged from the facility. The average treatment time of NLFU was five to ten minutes based on wound size.
Results:
All DTIs showed signs of resolving or complete resolution during the hospital admission. One sDTI opened to a Stage III but progressed rapidly toward healing. All DTI’s were intact and decreasing in size prior to discharge. Our case series demonstrates the addition of NLFU to our standard of care for deep tissue injuries is an affective early treatment intervention for the prevention of Stage III or IV pressure ulcers.