Individualized Care Benefits Older Patients With Stage 3 Pressure Ulcers

Older patients with stage 3 pressure ulcers saw improved therapeutic wound healing with drug therapy in conjunction with individualized psychological management, nutrition, and exercise, according to study findings published in the Journal of Cosmetic Dermatology.

Researchers in China aimed to evaluate the effect of medications combined with individualized management in older patients with stage 3 pressure ulcers.

They conducted an observational case-control study at the Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin, China from August 2017 through December 2019 that included 60 patients between 60 and 95 years of age hospitalized with stage 3 pressure sores that developed outside the hospital. Exclusion criteria included malignancy, coma or impaired consciousness, and severe abnormalities of hematologic, hepatic, and renal function.

All patients received silver ion alginate and hydrocolloid and foam dressings every 3 days, and dressings were changed daily. Patients were randomly divided into the study group (N=30) who also received individualized management for nutrition, exercise, and psychological supervision. The control group (N=30) did not receive this additional management. Researchers found no statistically significant differences between groups in baseline characteristics of sex, age, site of the pressure sore, or body mass index.

Researchers compared groups before treatment and at 1, 3, and 5 weeks of treatment for changes in the pressure ulcer area and the pressure ulcer scale for healing (PUSH) score. They found no significant difference in patient PUSH scores at baseline. Over time, they found PUSH scores and pressure ulcer areas revealed a significantly decreasing trend in both groups, and they noted a significant increase in the wound healing rate (P <.05). In both groups at 1, 3, and 5 weeks, the area of pressure sores was significantly smaller than before treatment (P <.05) and in particular at 3 and 5 weeks, respectively, the study group showed the area of pressure sores to be statistically significantly smaller than that in the control group (P <.05).

Compared with the control group, the study group PUSH scores were significantly lower at all measurement times following treatment (P <.05). Investigators noted that the wound healing rate at 3 and 5 weeks, respectively, was statistically significantly faster in the study group than the control group (P <.05).

Study limitations were acknowledged as not being a randomized controlled trial, and the limited sample size conducted in a single-center facility.

Researchers concluded “the combination of individualized management based on exercise, nutrition, and psychology with pharmacological treatment can help the wound healing of elderly patients with stage III pressure ulcers and improve their treatment effect, which has a high clinical promotional value.”