Stephen J. Schueler, M.D.

Overview Incidence Risk Factors Symptoms Evaluation Treatment debridement specialist Home Care diet pain and fever warning signs Prevention Outlook Complications Underlying Cause Anatomy

Sacral Decubitus Treatment

The treatment for decubitus ulcers depends on depth and the location of the skin ulcer. Stage I and stage II decubitus ulcers usually resolve with proper wound care. Stage III and stage IV ulcers are much more difficult to manage, and may require surgery.

The first goal of treatment is to relieve pressure on a decubitus ulcer, so that it does not worsen. It is important to reposition those who are in a wheelchair or are confined to bed. Protective pads and bandages, as well as special cushions and mattress pads, are helpful.

Wound care includes gentle cleansing, protective bandages, whirlpool baths, oral antibiotics, and topical antibiotics. Special dressings, pressurized irrigation, or surgery may be required to remove damaged tissue. In some cases, a skin graft may be necessary to cover large decubitus ulcers. Nonsteroidal anti-inflammatory medications and narcotic pain medication are used for pain.

Treatment of decubitus ulcer may include:

  • Relieving pressure:
    • Repositioning
    • Support surfaces
  • Protective bandages for ulcers
  • Protective splints for ulcers
  • Protective pads for ulcers
  • Decubitus ulcer wound care
    • Gentle cleansing and irrigation
    • Whirlpool baths
  • Debridement: removal of damaged tissue
    • Specially treated bandages dissolve dead tissue
    • Surgical: damaged tissue is cut away form the healthy tissue
  • Oral antibiotics for decubitus ulcers
  • Topical antibiotics for decubitus ulcers
    • Ointments and creams
  • Skin grafts for decubitus ulcers

Sacral Decubitus Debridement

Debridement is the removal of dead tissue. Enzymatic debridement agents are chemicals that break down dead skin.

Enzymatic debridement agents:

  • Collagenase (Santyl)
  • Fibrinolysin-deoxyribonuclease (Elase)
  • Papain (Panafil)
  • Sutilains (Travase)
  • Trypsin (Granulex)

Whirlpool baths also help remove dead tissue.

Sacral Decubitus Specialist

Physicians from the following specialties evaluate and treat decubitus ulcers:

Continue to Sacral Decubitus Home Care

Last Updated: Jun 8, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Sacral Decubitus References
  1. Brem H, Tomic-Canic M, et al. Healing of elderly patients with diabetic foot ulcers, venous stasis ulcers, and pressure ulcers. Surg Technol Int. 2003;11:161-7. [12931298]
  2. Duimel-Peeters IG, Halfens RJ, Berger MP, Snoeckx LH. The effects of massage as a method to prevent pressure ulcers. A review of the literature. Ostomy Wound Manage. 2005 Apr;51(4):70-80. [16089061]
  3. Ratliff CR; WOCN. WOCN's evidence-based pressure ulcer guideline. Adv Skin Wound Care. 2005 May;18(4):204-8. [15920372]
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