More help, please..

Jailhouse RN · Apr 20, 2004

Ulcers are staged 1 -4. There are various protocols used to treat them.....Sorry I have had gastric ulcers on my mind all day ....Had a big bleed today.......First post went there.....

nurseT · Apr 21, 2004

I'm wanting to know what is the protocol for treaing an ulcer with slough/escar? Also how do you identify the presence of ulcer? Like are there any forms that you need to use?

by (ulcer with slough/eschar) Itake it you mean pressure ulcer. This type of ulcer cannot be staged due to the inability to visualize the entire wound. Slough and eschar need to be surgically debrided if there is alot. If it's minor or very small area it can be enzymatic debridement. After this is completed, the proper measurements and staging can be done to assist in decision on treatment. As far as forms... most facilities have a basic form with a blank drawing of a body. You use this to indicate where on the body the wound is located and usually a place to describe the wound, re: drainage, color, odor, size, tunneling, undermining etc. I hope that helps.

leslie :-D · Apr 21, 2004

what nurset said....you can't stage unless the ulcer is visualized in its' entirety. the goal is to remove/debride the slough/eschar so the viable tissue will facilitate healing. i'm not sure what you mean by forms but sometimes it can be difficult to differentiate a stage 2-3, or 3-4. careful measuring is essential, and well as noting periwound areas and its' margins. keep wound moist when the tissue is pink and granulating. hope this helps.

NurseEPV · Apr 21, 2004

Lol...that helps SO much! Thank you guys!

zacarias, ASN, RN · Apr 21, 2004

I'm wanting to know what is the protocol for treaing an ulcer with slough/escar? Also how do you identify the presence of ulcer? Like are there any forms that you need to use?

Another thing to keep in mind is hard eschar wounds in the foot area. You want to make sure that they have good vasculature to that area before you start debriding. Once that eschar comes off, infection or necrosis can complicate healing if the blood flow is not sufficient to heal it. If they have diabetes or not that great of blood flow, you may want to rethink removing that eschar.

If there's a big wound somewhere on a person, get a pre-albumin or even an albumin to determine their nutritional status for healing.