Imaging Studies

• Imaging studies, such as CT, MRI, or bone scan, can be used to detect osteomyelitis and to determine the depth and extent of tissue destruction

Careful monitoring and preventative care of high-risk patients can begin once these patients are identified. Intrinsic, or host-related risk factors for the development of pressure sores include age greater than 75 years, limited mobility, loss of sensation, unconsciousness or altered sense of awareness, and malnutrition. Extrinsic, or envir-

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onmental risk factors include pressure, friction, shear stress, and moisture. '

Turning and repositioning the patient at least every 2 hours can reduce skin pressure and prevent pressure sores. However, because this level of care is difficult to achieve in most hospital and nursing home environments, multitudes of pressure-reducing mattresses have been manufactured. Although these can help to decrease pres-

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sure on susceptible areas, they do not negate the need for position changes. '

Maintaining a clean, dry environment can prevent skin maceration and subsequent tissue damage. This can be accomplished with frequent changes of bed sheets and clothing, thorough drying of skin after bathing, and prompt disposal of incontinent stool or urine.

Malnutrition is a significant but reversible risk factor. High-protein diets have been

shown in multiple studies to improve wound healing in patients with pressure sores. Nonpharmacologic Treatment

Pressure relief, adequate nutrition (high-protein diet), and surgical debridement or abscess drainage are the mainstays of nonpharmacologic treatment.43

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