Managing Pressure Ulcers: Tips for Wheelchair Users and Treatment Options

Regarding pressure ulcers?

Hello, doctor.
Due to certain circumstances, I need to use a wheelchair for life.
A few days ago, I developed a pressure ulcer and had it debrided by a physician without the use of antibiotics.
Currently, the wound is about the size of the first joint of my little finger and is 0.4 mm deep, located near the coccyx above the anus.
If I develop a pressure ulcer, would lying prone help with wound healing? It’s difficult for me to stay in that position because I need to use the computer, and it’s uncomfortable in the heat.
Could you also recommend a topical ointment I can use? I am currently using a burn ointment called "Zhuo Fu Xing."

julia, 40~49 year old female. Ask Date: 2021/07/06

Dr. Wu Yuxin reply Dermatology

Reducing pressure on the affected area is the most important thing.
As for medication, I cannot recommend any drugs online, as it would violate medical regulations.
You should consult your attending physician, as they are the most familiar with your condition and can help you choose the appropriate medication.

Reply Date: 2021/07/06

More Info

Managing pressure ulcers, especially for individuals who are wheelchair-bound, requires a multifaceted approach that includes prevention, treatment, and lifestyle adjustments. Pressure ulcers, also known as bedsores or decubitus ulcers, occur when there is prolonged pressure on the skin, often over bony areas, leading to tissue damage. Here are some tips and treatment options that can help manage and prevent pressure ulcers effectively.

Prevention Strategies
1. Regular Position Changes: It is crucial to change positions frequently to relieve pressure on vulnerable areas. For wheelchair users, shifting weight every 15-30 minutes can significantly reduce the risk of developing pressure ulcers. If possible, try to stand or shift your weight to one side or the other.

2. Use of Cushions: Specialized cushions designed for wheelchair users can help distribute weight more evenly and reduce pressure on the skin. Look for cushions made from materials like gel, foam, or air that provide better support and comfort.

3. Skin Care: Keeping the skin clean and moisturized is essential. Regularly inspect the skin for any signs of redness or breakdown, especially in areas that are prone to pressure ulcers. Use gentle cleansers and moisturizers to maintain skin integrity.

4. Nutrition: A well-balanced diet rich in proteins, vitamins, and minerals is vital for skin health and wound healing. Ensure adequate hydration as well, as it plays a crucial role in maintaining skin elasticity.

Treatment Options
1. Wound Care: For existing pressure ulcers, proper wound care is essential. Since you mentioned that you have already undergone debridement, it’s important to keep the wound clean and covered. Use a non-adherent dressing to protect the area and promote healing.
2. Topical Treatments: While you are currently using a burn ointment, consider discussing with your healthcare provider the use of specialized wound care products. Options may include hydrocolloid dressings, alginate dressings, or foam dressings that can provide a moist environment conducive to healing. These dressings can help absorb exudate and protect the wound from infection.

3. Avoid Prolonged Pressure: While lying prone can relieve pressure on certain areas, it may not be practical for long periods, especially if you need to use a computer. Instead, consider using a reclining wheelchair or adjustable seating that allows you to shift your position comfortably while still being able to engage in activities.

4. Consultation with Specialists: If your pressure ulcer does not show signs of improvement, consider consulting a wound care specialist or a physical therapist who can provide tailored advice and treatment options based on your specific situation.

Additional Considerations
- Monitoring for Infection: Keep an eye out for signs of infection, such as increased redness, swelling, warmth, or discharge from the wound. If any of these symptoms occur, seek medical attention promptly.

- Education and Support: Engage with support groups or resources for wheelchair users. They can provide valuable insights and tips from others who have faced similar challenges.

In conclusion, managing pressure ulcers requires a proactive approach that includes prevention, appropriate wound care, and lifestyle modifications. While it may be challenging to maintain comfort while also ensuring healing, utilizing the right strategies and products can significantly improve your situation. Always consult with your healthcare provider for personalized recommendations and to ensure that your treatment plan is effective.

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