Pressure ulcers: collaboration in wound care. Is there a reasonable approach?

Pressure ulcers represent a significant impact on utilization of healthcare beds, cost for the insurer, and adverse emotional impact for the family. With this in mind, one must address in an effective fashion a method of objective assessment using the current methodology to deal with risk factors in mobility, disease states, and nutrition, as well as give significant attention to prevention protocols. One should adhere to a schedule of turning the patient, sleep surfaces, and appropriate skin care while recognizing the impact of each. Finally, treatment modalities should be undertaken, not only with cost-effective issues in mind, but with ease and convenience for the healthcare provider and the least discomfort for the patient as well. One can focus on debridement by way of enzymatic, autolytic, or surgical methods, recognizing surgery as the least effective for our goals in the management of this patient. Assessment and, finally, reassessment using the available scales will allow us to provide effective healthcare in a therapeutic fashion.