S - SKIN INTEGRITY
Use a dressing that achieves a physiologic local wound environment that maintains an appropriate level of moisture in the wound bed:
- control exudate
- eliminate dead space
- control odour
- eliminate or minimize pain
- protect the wound and the periwound skin
- remove nonviable tissue
- prevent and manage infection
Avoid using daily dressing changes if at all possible by using absorbent dressings that manage exudate and odour and remain in place for as long as possible. (PU-ONF 2013, p.169; Level A)
Consider the use of antimicrobial dressings if signs of infection are present. (PU-ONF 2013, p.170; Level C)
Consider adding the following adjunctive therapies to a standard wound care program to speed healing of stage II, III, or IV pressure injuries, including electromagnetic energy IB, ultraviolet-C light lb. Consider the use of pulsatile lavage hydrotherapy debridement for Stage III & IV pressure injuries secondary to SCI. (Adapted from PU-ONF 2013, p.171; Level A)