[Treatment of decubitus ulcers in the geriatric patient]

Pressure sores (decubitus ulcers) and their treatment are a typical problem of old people in need of nursing care, after traumatization or in diseases of the peripheral nervous system. Patient instruction and appropriate schooling of nursing staff with regard to risk factors, and the use of standardized risk assessment aids, such as the Norton scale, can improve risk identification and prophylaxis, and minimize recurrent ulcers. Patients put at particular risk by paralysis, cachexia, shock, disturbed arterial perfusion, anemia, dehydration or major surgery should be bedded appropriately. In addition to the development of numerous modern wound dressings, the introduction of continuous vacuum therapy (V.A.C.) is of proven value, both as sole treatment resulting in healing and for accelerated preparation for plastic surgery. In stage 3 and 4 ulcers, plastic surgery involving displacement of tissue are usually required for permanent treatment.