Pressure Sore Treatment Guidelines for Elderly Patients with Limited Mobility

Immediate Pressure Relief

The American College of Cardiology is not mentioned, however, reposition the patient every 2-4 hours around the clock, with pressure zone checks at each turn 1
Use the 30-degree tilt position rather than 90-degree lateral rotation, as this reduces pressure on bony prominences (relative risk 0.62, 95% CI 0.10-3.97) 1
Place the patient immediately on an advanced static air mattress or advanced static overlay—these are superior to standard hospital mattresses and reduce pressure ulcer incidence by 69% 1, 2, 3

Apply hydrocolloid dressings as first-line treatment, changing every 1-7 days based on exudate levels (typically every 1.5-3 days for moderate drainage) 2, 3
Foam dressings are an equivalent alternative to hydrocolloid for complete wound healing 2, 3

Initiate high-protein oral nutritional supplements immediately (30 energy percent protein), which reduce the risk of developing new pressure ulcers (OR 0.75; 95% CI 0.62-0.89) 4, 2
Provide protein or amino acid supplementation to reduce wound size in patients with existing pressure ulcers 2, 3

Elderly skin is friable and prone to thermal damage; take care when transferring patients, removing adherent items (diathermy pads, tape, dressings), and using contact warming devices 5
Reduced skin depth and vascularity, together with reduced muscle mass, predispose elderly patients to tissue pressure necrosis over bony protuberances such as the heel 5

Establish a multicomponent prevention and treatment program that includes standardized documentation, multidisciplinary team involvement (nursing, physicians, dietitians, physical therapists), ongoing staff education, and sustained audit and feedback 1, 2