Lee Physician Group - Wound Care and Hyperbaric Medicine
Pressure Wounds Require Medical Management
Our normal daily and nightly body movements protect us against excess pressure on skin surfaces. But for patients who cannot move, pressure wounds are a constant threat.
Pressure wounds can develop in as little as four hours. Patients who cannot shift their weight from areas of their body due to various medical conditions are at risk. Prevention by medical personnel is the most important aspect of care of pressure wounds.
"The cause of pressure wounds is a result of direct pressure against the skin," says James Gostigian, M.D., wound care/emergency medicine physician. "This causes a compromise in the blood circulation to the skin and the underlying tissue. This is an ischemic (lack of blood flow) event and usually occurs where there is a boney prominence that will trap the overlying tissue between the bone and the surface the body is pressing against. The skin is deprived of blood flow. Therefore, the necessary oxygen and nutrients needed to sustain cell life are gone and the cells and the tissue/skin die."
Anyone with limited mobility is at risk for developing a pressure wound. Elderly patients, people who are paralyzed or have various illnesses, and people who are in a coma are most at-risk for developing such wounds. In addition to immobility, contributing factors include diabetes, age, incontinence of urine and/or feces, poor nutrition, lack of sensory perception, smoking and obesity.
"The best method to treat a pressure wound is to seek out the assistance of a trained specialist in wound care," Dr. Gostigian says. "The combination of a dedicated staff of physicians and nurses will give you the best chance to heal these wounds. The quicker a patient gets medical care after discovery of the wound, the better the outcome. I cannot emphasize enough how important it is to have these wounds managed by medical providers who do nothing else but manage these wounds."
Pressure wounds can be prevented using a combination of measures, including:
- Use of appropriate cushions for wheelchairs
- Low air-loss mattresses
- Heel protection boots
- Frequent repositioning and shifting of the body from side-to-side to redistribute the weight from different skin surfaces
- Keeping skin surfaces moist with moisturizing lotions
Dr. Gostigian and the other physicians at Lee Physician Group Wound Care and Hyperbaric Medicine keep photographs of their patients' wounds. "It is very satisfying to see the progress of wounds from when they first come to us to the time they are healed," he says. "I particularly enjoy showing these pictures to the patients and their look of amazement as to how their wounds have healed. Each one is special and gratifying."
Wonders of Wound Healing
James Gostigian, M.D.
Wound Care and Hyperbaric Medicine
Lee Physician Group
13778 Plantation Road
Fort Myers, FL 33912