I am concerned about a sacral stage 3 decubitus. Wound bed is pale pink with no drainage. My concern is the edge surrounding the wound is white, puffy, dead skin about 1/8 of an inch back. Should the patient be sent to a wound clinic for debris enemy or this just naturally occur itself. Otherwise the nutrition is great and repositioning regularly. Just don't want to lose any ground. Thanks so much for any advice!

#Debridement not debris enemy. Darn auto correct.

So the periwound is macerted? Does this look like the 'white puffy dead skin' you are seeing?https://wocn.confex.com/wocn/2007AM/techprogram/P2467.HTM

Is the patient being followed by anyone for the treatment of the State III? If so, I'd give them a call. Often our wound docs will debride the macerated skin other times they leave it, it all depends on the doc and the wound.

Without seeing a picture of the wound, it's difficult to say anything about it.

It could be maceration, as PP said.

It could also be epibole (also spelled epiboly). That's when the edge of the wound begins to roll, and a layer of epithelial cells forms.

In effect, the body gets tricked into thinking the wound has closed. That's when you'll see a wound stall.

The edge needs to be removed so closure can begin again.

I don't know if mentioning methods of removing the wound edge would violate the TOS, so I'm going to err on the side of caution and suggest a Wound Clinic consult, and proceed from there.