Answer:
The initial goal is to avoid any further progression of the sore by relieving the source of pressure. Wound healing will not occur in the presence of ischemia or infection.
A simple program of turning the patient at intervals will allow for recirculation in the affected areas. Dinsdale demonstrated the ability to negate the deleterious effects of pressure by relieving it for only 5 minutes every 2 hours. In addition, various available mattress systems are designed to relieve pressure, including foam, static flotation (water: 18 mm Hg heels, 19 mm Hg sacrum and 25 mm Hg trochanters while on side: pressure applied to a liquid is evenly distributed over its entire surface - Pascal’s law, cost around $2000), alternating air, low-air-loss ($20- 30, 000), and air fluidized beds. The purpose of these beds is to more evenly distribute the patient’s weight to minimize pressure in any one area. The Clinitron bed is designed with medical-grade optical beads fluidized with a constant flow of warm air. With the patient in the supine position, the Clinitron bed is the most effective at reducing the external pressure applied to the body (10 mm Hg, $65 per day). Although this bed is the most effective for reducing pressure, it does have some disadvantages. First, the bed weighs between 1700 and 2000 pounds, which may make it too bulky or heavy for caretakers of patients who are being treated at home. It is known to cause electrolyte and water losses, especially in the elderly, which may lead to hallucinations and disorientation. In addition, if any padding (pillow, foam wedges, bolster) is placed under the patient, the pressure is redistributed and end capillary pressure may be exceeded. In patients with compromised breathing, pulmonary toilet may be impaired. The presence of this expensive bed does not negate the need for good wound care. It is only to help relieve the pressure, which initiated the problem.