When you have a disability that impacts mobility, frequent supine and sedentary positioning often apply too much pressure in one area of the body, putting the tissue at risk for developing pressure wounds.
A pressure wound occurs when blood flow is lost. Usually, it happens to a bony prominence such as the sacrum. Wounds can form in a matter of hours and can take months to heal.
Pressure wounds can be avoided by frequent repositioning or pressure shifts and using low-air loss seats and mattresses.
Pressure wounds are classified by severity with Stage Four noted as the most severe.
Early stage wounds can be treated with topical dressing such as hydrocolloid gel that promotes new skin cell growth, or alginate, made from seaweed and containing calcium and sodium to help speed up healing.
Mid-stage pressure wounds often respond to extracellular matrix (ECM) treatment which involves the application of material made up of collagen, elastic fibers, and connective tissue proteins.
Healing a pressure wound that has progressed to later stages can be more tricky, but multiple methods have proven to be successful in healing even the most severe wounds, which tunnel to the bone.
Negative pressure wound therapy has shown particular promise. The method uses a specialized dressing connected to a vacuum device to apply controlled negative pressure to the wound, promoting blood flow and tissue growth.
Skin flap surgery is another method of wound closure. A plastic surgeon will relocate a piece of tissue from a healthy part of the body to repair damaged tissue. The tissue is usually skin but can also include fat, muscle, or bone. The flap is attached to blood vessels and stitched in place.
With recent advancements in science and technology, multiple innovative methods for healing late-stage pressure wounds have emerged.
Bioengineered skin substitutes can be created now. Studies have shown these artificial skin grafts can be applied to the wound to stimulate tissue regeneration. 3D bioprinting can be customized for skin shape with cells and other materials distributed precisely.
Cold atmospheric plasma therapy uses reactive oxygen and nitrogen species to help wounds heal. The process uses a low-temperature plasma generated at atmospheric pressure. Studies have shown treatment may even be effective in treating wounds infected with multi-resistant bacteria.
Stem cell therapy studies have also shown promise to stimulate tissue repair and regeneration in the wound area. Cells are introduced to the injured area, where they stimulate the formation of new blood vessels (angiogenesis), promote cell proliferation, and encourage the production of collagen. Stem cell treatment shows positive results in clinical trials, even as a potential treatment option for chronic or non-healing pressure wounds, but it’s not yet widely adopted as a standard treatment due to ongoing research needed.
Electromagnetic therapy studies that involve applying electromagnetic fields to the wound have shown recent promise in improving blood flow and healing tissue. Working with a well-known hypothesis that suggests that human skin is electrostatic, researchers found when cells are electrically stimulated, they all align in one direction and migrate fast toward the damaged site. A recent study from the Chalmers Institute of Technology (CTH) and the University of Freiburg noted the procedure’s capacity to heal chronic wounds three times faster than other therapies.
Pressure wounds start off as small spots of discoloration. If you notice a wound forming, relieve pressure when possible. Contact a healthcare professional right away if the area doesn’t improve over 24 hours. Your primary care provider can refer you to a wound specialist.
Healthcare providers are liable for taking necessary measures to prevent pressure wounds while in healthcare facilities. If you develop a pressure wound in one of these settings, you may be entitled to sue for malpractice. Contact us to discuss your case.
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