What you use on a pressure ulcer depends on the depth of the wound, amount of drainage and type of tissue visible in the ulcer. There are six types of pressure ulcers, ranging from a stage 1, in which the epidermis, or outer layer of the skin, is intact, to a stage 4, in which there is exposed bone, muscle, ligament or tendon, according to the National Pressure Ulcer Advisory Panel. Two other stages include a suspected deep tissue injury, or DTI, in which the skin is intact but purple and bruised, and "unstageable," in which dead tissue obscures the true depth of the wound. Major categories of skin-care products include lotions, zinc oxide pastes, hydrocolloids, gels, alginates and foams, according to the New Zealand Dermatological Society.
Ulcer Depth Less Than 0.5 cm
Apply a fragrance-free lotion to a stage 1 or suspected DTI ulcer, as these both have intact skin.
Zinc oxide can be used with a dry or moist stage 2 ulcer. Gently apply a cream with 25 percent to 40 percent zinc oxide paste. No secondary dressing is required. Apply zinc oxide to the periphery of a heavily draining wound to protect intact skin from drainage.
Peel the backing from an adhesive hydrocolloid and stick dressing directly to a minimally draining stage 2 ulcer. Hydrocolloids should not be used on heavily draining ulcers.
Ulcer Depth Greater Than 0.5 cm
Squeeze an amorphous hydrogel into a lightly draining stage 3 or 4 ulcer to form a thin, dime-size layer over the tissue. Stage 3 ulcers have exposed subcutaneous tissue and stage 4 ulcers have exposed deeper structures. Stage 3 and 4 ulcers may have light to heavy drainage.
Place an alginate dressing to line the bottom of a moderate to heavily draining stage 3 or 4 ulcer. A secondary dressing may be necessary to fill in the remainder of the depth.
Apply a foam dressing to a moderate to heavily draining stage 3 or 4 ulcer.