References

Coleman S, Gorecki C, Nelson EA Patient risk factors for pressure ulcer development: systematic review. Int J Nurs Stud. 2013; 50:(7)974-1003 https://doi.org/10.1016/j.ijnurstu.2012.11.019

Braden B, Bergstrom N. A conceptual schema for the study of the etiology of pressure sores. Rehabil Nurs. 1987; 12:(1)8-12 https://doi.org/10.1002/j.20487940.1987.tb00541.x

Norton D, McLaren R, Exton-Smith AN. An investigation of geriatric nursing problems in hospital.: Churchill Livingstone; 1962

Gould L, Stuntz M, Giovannelli M Wound healing society 2015 update on guidelines for pressure ulcers. Wound Repair Regen. 2016; 24:(1)145-162 https://doi.org/10.1111/wrr.12396

Lipsky BA, Berendt AR, Cornia PB 2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections. Clinical Infect Dis. 2012; 54:(12)e132-e173 https://doi.org/10.1093/cid/cis346

Reddy M, Gill SS, Wu W Does this patient have an infection of a chronic wound?. JAMA. 2012; 307:605-611 https://doi.org/10.1001/jama.2012.98

Conte MS, Bradbury AW, Kolh P Global vascular guidelines on the management of chronic limbthreatening ischemia. J Vasc Surg. 2019; 69:(6S)3S-125S https://doi.org/10.1016/j.jvs.2019.02.016

Gupta S, Baharestani M, Baranoski S Guidelines for managing pressure ulcers with negative pressure wound therapy. Adv Skin Wound Care. 2004; 17:1-16 https://doi.org/10.1097/00129334-200411002-00001

Kaka AS, Beekmann SE, Gravely A Diagnosis and management of osteomyelitis associated with stage 4 pressure ulcers: report of a query to the Emerging Infections Network of the Infectious Diseases Society of America. Open Forum Infectious Diseases. 2019; 11:(6) https://doi.org/10.1093/ofid/ofz406

Lam K, van Asten SAV, Nguyen T Diagnostic accuracy of probe to bone to detect osteomyelitis in the diabetic foot: a systematic review. Clin Infect Dis. 2016; 63:(7)944-948 https://doi.org/10.1093/cid/ciw445

Rennert R, Golinko M, Yan A Developing and evaluating outcomes of an evidence-based protocol for the treatment of osteomyelitis in stage IV pressure ulcers. Ostomy Wound Manage. 2009; 55:(3)42-53

Larson DL, Gilstrap J, Simonelic K, Carrera GF. Is there a simple, definitive, and cost-effective way to diagnose osteomyelitis in the pressure ulcer patient?. Plast Reconstr Surg. 2011; 127:670-676 https://doi.org/10.1097/prs.0b013e3181fed66e

Huang AB, Schweitzer ME, Hume E, Batte WG. Osteomyelitis of the pelvis/hips in paralyzed patients: accuracy and clinical utility of MRI. J Comput Assist Tomogr. 1998; 22:(3)437-443 https://doi.org/10.1097/00004728-199805000-00017

Evaluation and treatment algorithm for pressure ulcers based on the dip pressure ulcer classification

02 September 2021
5 min read
Volume 5 · Issue 4

Abstract

Pressure ulcers (PUs) continue to represent a significant cause of morbidity and expense, as well as a therapeutic challenge across medical settings. While there are several staging systems for PUs, and considerable efforts have been made to develop strategies for their prevention, there is a scarcity of research and clinical guidelines to help select therapeutic interventions for wounds of varying depth and severity. An algorithm based on the depth, infection and perfusion (DIP) classification is hereby presented to aid the clinician in the initial evaluation, classification and management of PU.

Pressure ulcers (PU) are a common healthcare problem affecting patients across hospital and community settings. Despite increasing interest in developing risk assessment tools and prevention strategies, their evaluation and management continues to be largely based on personal experience and poses a significant challenge for healthcare providers. An algorithm was created to guide clinicians in the initial evaluation and classification of PU. It also provides general management guidelines for every grade and stage of the depth, infection and perfusion (DIP) classification.

The first step in the algorithm (Fig 1) is to identify people at risk of developing a PU, such as those with reduced mobility, urinary or fecal incontinence, and those who are malnourished.1 Once identified, a risk assessment tool such as the Braden Scale for Predicting Pressure Ulcer Risk2 or the Norton Pressure Sore Risk-Assessment Scale Scoring System3 can be used to assess their risk level. Appropriate primary or secondary prevention interventions to reduce their risk of developing a first or new PU should be undertaken for every patient based on their risk level; this may include frequent mobilisation, support surfaces, nutritional consultation and continence assessment and care.4

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