Topical treatment modalities in pressure ulcers: a retrospective analysis

Pressure ulcers (PUs) are areas of localised tissue damage affecting the skin, soft tissue, muscle or underlying tissues which is caused by continuous pressure, friction or shear. Medical caregivers should primarily focus on patients at high risk of developing these injuries to prevent their development. However, once a PU has developed, different therapy options and proper surgical intervention are the main treatment options. The aim of this study was to investigate the effectiveness of PU topical therapeutic alternatives retrospectively.

In this single-centre study, the medical records of hospitalised patients with stage 2 and deeper PUs were screened retrospectively. The patients' age, sex, Waterlow score, mobilisation status, hospitalisation period, PU stage, PU stage on day of discharge, and PU therapy used were recorded. Any evidence of healing was accepted as a successful treatment outcome.

The medical records of 511 patients were screened for this study. At discharge day, 55.4% of patients with PUs did not show any evidence of healing. In suspected deep tissue injury (SDTI) PUs, there was a higher rate of therapy success (59.4% at day of discharge) (p<0.05). With regards to the hospitalisation period, when patients stayed >30 days, the rate of therapy success increased (p<0.05). The most effective topical therapy was multilayer silicone foam dressing (p<0.05). The topical application of rifamycin and povidone-iodine solution appeared to worsen the condition of the PU (p<0.05).

In patients with PUs in this study, the topical therapy was more effective in SDTIs and if the hospitalisation was of long enough duration for the treatment to take effect. Multilayer silicone foam dressing therapy was found to be the most effective.