Elderly Patient Dies From Untreated Bedsores

How much medical attention should be given to pressure ulcers in a patient who has several comorbid conditions?

The first step in resolution is to reduce or eliminate the cause, that is, pressure. A multidisciplinary approach can lead to maximum benefit for the patient. Consultations with a neurosurgeon, urologist, plastic surgeon, orthopedic surgeon, and general surgeon all may be indicated in a particular patient. A rehabilitation medicine specialist, social worker, and psychologist or psychiatrist may work together with geriatricians or internists to improve the patient's health, attitude, support structure, and living environment. When medical management has been optimized, many stage I and stage II pressure sores heal spontaneously. Stage III and stage IV ulcers, however, almost always require a surgical approach. Plastic surgeons perform most pressure sore reconstructions, and consulting a plastic surgeon with any complex or chronic wound is appropriate.