Raetz Jaqueline G M, Wick Keren H
University of Washington, Seattle, WA, USA.
Am Fam Physician. 2015 Nov 15;92(10):888-94.
Patients with limited mobility due to physical or cognitive impairment are at risk of pressure ulcers. Primary care physicians should examine at-risk patients because pressure ulcers are often missed in inpatient, outpatient, and long-term care settings. High-risk patients should use advanced static support surfaces to prevent pressure ulcers and air-fluidized beds to treat pressure ulcers. Physicians should document the size and clinical features of ulcers. Cleansing should be done with saline or tap water, while avoiding caustic agents, such as hydrogen peroxide. Dressings should promote a moist, but not wet, wound healing environment. The presence of infection is determined through clinical judgment; if uncertain, a tissue biopsy should be performed. New or worsening pain may indicate infection of a pressure ulcer. When treating patients with pressure ulcers, it is important to keep in mind the patient's psychological, behavioral, and cognitive status. The patient's social, financial, and caregiver resources, as well as goals and long-term prognosis, should also be considered in the treatment plan.
因身体或认知障碍而行动不便的患者有发生压疮的风险。初级保健医生应检查高危患者，因为在住院、门诊和长期护理环境中，压疮常常被漏诊。高危患者应使用先进的静态支撑面预防压疮，并使用气悬浮床治疗压疮。医生应记录溃疡的大小和临床特征。应使用生理盐水或自来水进行清洁，同时避免使用苛性剂，如过氧化氢。敷料应促进伤口愈合环境湿润但不潮湿。通过临床判断确定是否存在感染；如有疑问，应进行组织活检。新出现的或加重的疼痛可能表明压疮感染。在治疗压疮患者时，牢记患者的心理、行为和认知状态很重要。治疗计划中还应考虑患者的社会、经济和护理资源，以及目标和长期预后。
