🩹 Pressure Ulcer Care in Bedridden Patients and Vacuum Dressing (NPWT)
Questions and Answers (Q&A) regarding pressure ulcer care guidelines for bedridden patients, including negative pressure wound therapy (NPWT) technology, according to the standards of Pattaya 2 Elderly Care Center, Dr. Kuntipat
🩺 Part 1: Prevention and Assessment of Pressure Ulcer
Q1: How do pressure ulcers (bed sores) occur? And how can we prevent them?
A: Pressure ulcers occur when the skin and tissues are compressed for extended periods, resulting in insufficient blood supply to the area and tissue death. They often occur over bony prominences such as the tailbone, heels, hips, and back.
Prevention guidelines emphasized at the center:
Turning: Turn the patient every 2 hours regularly to reduce pressure.
Using pressure-reducing devices: Use an air mattress or doughnut cushion to distribute weight.
Skin Care: Keep the skin dry and clean, especially in cases of urinary/fecal incontinence.
Adequate Nutrition: Ensure the patient receives sufficient protein and nutrients for tissue repair and regeneration.
Q2: What are the stages of pressure ulcers, and how are they assessed at the center?
A: Pressure ulcers are divided into four main stages (according to the commonly used assessment system):
Stage 1: The skin is not open, but there is redness that does not fade when pressure is applied.
Stage 2: The outer layer of skin (epidermis) or part of the dermis is damaged, appearing as blisters or shallow abrasions.
Stage 3: The subcutaneous tissue is damaged down to the subcutaneous fat layer. Fat may be visible, but it does not reach the bone, muscle, or tendons.
Stage 4: Severe tissue damage extends to the muscle, bone, or other supporting structures.
Assessment at the Center: Nurses regularly use risk assessment tools such as the Braden Scale and evaluate wounds based on stage, depth, size, and tissue characteristics (necrosis, regenerating tissue, pus/exudate volume) to determine appropriate treatment plans.
🧼 Part 2: Vacuum Dressing (NPWT)
Q3: What is vacuum dressing (NPWT) and what stages of pressure ulcers is it used for?
A: Vacuum dressing, or Negative Pressure Wound Therapy (NPWT), is a wound care technique that uses a device to create negative pressure or vacuum on the wound area.
Method: A physician or nurse places a special sponge or mesh on the wound, covers it with an occlusive dressing, and then connects it to a vacuum device.
Usage for pressure ulcers: It is commonly used for stage 3 and 4 pressure ulcers that are large, deep, have significant exudate, or have necrotic tissue that has been removed. To promote faster wound healing.
Q4: What are the main mechanisms of action and benefits of vacuum wound care?
A: NPWT helps treat pressure ulcers through several mechanisms:
Removal of exudate and pus: The suction continuously removes excess fluid and exudate from the wound, keeping it clean and reducing the risk of infection.
Reduction of swelling: Reduces swelling around the wound, improving blood circulation.
Stimulation of new tissue formation: Gentle suction pulls the wound edges together and stimulates microcirculation, leading to faster formation of granulation tissue.
Q5: What special precautions are needed when caring for patients with vacuum wound care at the center?
A: NPWT wound care requires more delicate attention than regular wound care:
Observation of leakage: Ensure the wound dressing is tightly sealed and there are no air leaks to ensure the negative pressure works effectively.
Management of exudate: Nurses regularly record the quantity and characteristics of exudate in the canister and replace it as needed.
Pain monitoring: Inquire about and assess the patient’s pain. Because the suction may cause tightness or pain.
Wound dressing changes: NPWT dressings are typically changed every 48-72 hours (depending on physician’s orders and wound condition) using strict aseptic technique.
🌟 Part 3: Summary and Recommendations from Dr. Kuntipat
Caring for pressure ulcers in bedridden patients requires understanding, consistency, and the use of appropriate technology. Prevention is the best cure, but if an ulcer has already occurred, NPWT (Non-Performing Wound Wound Treatment) is a highly effective option to accelerate the healing of severe ulcers.
“The medical and nursing team at Pattaya 2 Elderly Care Center, Dr. Kuntipat , is well-equipped and experienced in assessing and caring for pressure ulcers at all stages, including the proper use of NPWT technology, to ensure our patients receive the highest standard of wound care and regain a better quality of life.”