Decubitus prevention

Most important changes

• The distinction between black, yellow and red wounds has been expanded to the TIME model, in which other factors must also be assessed to promote wound healing.
• There is more room for the use of non-adherent or absorbent wound dressings that need to be changed less frequently.
• The reluctance to use pain management has been abandoned.

Key messages

• Patients who have become bedridden or wheelchair-dependent and thereby dependent on the help of others for liying or sitting up, need pressure ulcer prevention measures as soon as possible.
• The most important preventive measures are: attention for an adequate lying or sitting position, regular change of posture and limitation of the sitting time and the use of an antidecubitus mattress or seat cushion.
• By bedridden and wheelchair dependent patients, regular inspection of preferred localizations of incubitus is important to identify (imminent) ulcer formation at an early stage and to adjust the policy accordingly.
• The policy of pressure ulcer wounds involves removal of necrotic tissue, cleaning, early recognition and treatment of wound infection, and care for adequate wound moisture.
• Research does not indicate that any particular type of wound dressing is superior. Therefore, the advice is to gain experience with a limited number of wound covers and to make regional agreements about the choice with those providing treatment (district nurses, wound care nurse specialists) and with pharmacists.