Talk:Pressure ulcer

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note

Someone please translate into English understandable to someone with a Master's degree or less! — Preceding unsigned comment added by 96.227.197.246 (talk) 08:47, 25 August 2013 (UTC)

Link to Shear Pressure demonstration

I'm new to posting to Wikipedia and got a nasty gram when I posted a link to a shear pressure video demonstration saying I should ask first...so I'm asking...does anyone have a problem with me posting a link to a shear pressure relief video. Shear pressure is a strong contributory factor to decubitus ulcers.

The link is: Shear Pressure Relief Video Demo

I think that'd be fine... considering I haven't found a free-domain picture of a bedsore yet, we need to have links to pictoral information about decubitus and their causes. --Allie 03:47, 6 February 2007 (UTC)

I feel VERY strongly about the posting of a lady whose unfortunate condition left her 'grafted' to a couch. I feel it is wrong medically and ethically to do this. Using the link is one thing (and I'm not sure I'm comfortable (as a physician nor as a human being) with that one. If the intent was educational then the reference would suffice; if the attempt was other than that this part of the page should be deleted. Using reference or signal cases is done in medicine with most references to identity hidden or protected.

Although C.R. is a public figure in all respects, perhaps the reference using his initials would have sufficed (done frequently in medicine). I'm not sure that reference should be used here either but will leave it and defer to others in the ethics field.

It may serve bedsores as a 'subcategory' of ulceration. Thinking about move and change DrGnu 22:27, 12 Dec 2004 (UTC)

DrGnu, I follow your logic, but the case of G.L.G. is a matter of public record and was extensively reported in international media. I added the reference as perhaps the most extreme public example of pressure sore complications. I'm not sure why C.R. should be treated any differently; though he made himself a "public figure," the precise circumstances of his demise are much less a matter of public record than those of G.L.G., so it would seem the case is stronger for removing him than it is for removing G.L.G.

Perhaps we need someone experienced in Wikipedia ethics to weigh in on whether afflicted individuals should ever be mentioned in connection with their pathologies. Do we strike even the seminal cases, such as removing Phineas_Gage from Traumatic_brain_injury and Yushchenko from Chloracne? What is the distinction? --Pontifex 21:42, Dec 13, 2004 (UTC)

I agree that including the celebrities name adds absolutely nothing of value to the article. I don't see any reason to include the names of famous patients in the article about a disease. I know that it is not legally wrong (when something is a matter of public record) but the fact that it is legal, does not make it ethical or moral. My reasoning is that it is wrong to hurt someone if it serves no value. I would probably make an exception only if the instance is for some reason news worthy. For example, maybe I would mention Yushchenko in an article about Chloracne or dioxin. I would probably mention Lou Gehrig in an article about amyotrophic lateral sclerosis, because it is often called "Lou Gehrig disease". I draw the distinction because although C.R. is a celebrity, there is nothing news worthy about him suffering from bedsores. The two cases I bring up, the person suffering from the disease is newsworty in an of itself. Morris 00:12, Dec 14, 2004 (UTC)

I agree about another weigh in from the 'medical ethics' standpoint. There are seminal cases and in the case of Lou Gehrig, the pseudonym for the disease more well known than the disease itself. I found the GLG case more 'sensational' than of any medical value. The C.R. reference is more one of 'commonality' for the public. However, I'm not sure that outside CONUS that he is as well known which of course brings us to the OTHER sets of medical pseudonyms and para-pseudonyms. I'm going to ask the medical people to take a look here. Thanks however for a rather thought provoking set of ideas. DrGnu 03:43, 14 Dec 2004 (UTC)

My 2 cents: If the sources use the full name, use the full name. If the sources use the initials, use the initials. Same for aliases or not mentioned names. But in generally i'd rather have more information than less. -- Chris 73 Talk 00:14, Dec 15, 2004 (UTC)

Chris. This is not about source and information. I suppose medicine tends to err on the side of the conservative. Exploitative Enquirer type stories, or those which exploit the point being made seem hardly informative. I'm planning to post some pictures for the site. These may cool the ardour but will be more true to the subject matter. DrGnu 02:39, 15 Dec 2004 (UTC)

I'm ambivalent. I agree that it is wrong to hurt someone if it serves no value. But since both of these people are dead, I don't see how anyone would be hurt. I only skimmed the article, but it appears to me that if the GLG case is kept, it could be written in a less sensationalistic way. Here's a rough example of what I mean: "Bedsores can cause death. In one case, blah blah ..." Maurreen 05:59, 15 Dec 2004 (UTC)

Minor technicality

The emedicine article "Pressure Ulcers, Surgical Treatment and Principles" by Wilhelmi, listed in external links of this article, mentions that the phrase 'decubitus ulcer' refers only to ulcers gotten from lying supine, so they aren't exactly synonymous with pressure ulcers, as the first sentence suggests. Anyone care to fix this minor detail? Delldot 04:14, 8 November 2005 (UTC)

Never mind, I changed it Delldot 16:25, 9 November 2005 (UTC)

Aside from using C.R.'s full name and the ethics surrounding that - does anyone think it's a little over-simplified to say he "died from a heart attack brought on as a result of an infected pressure sore." The public is aware of C.R.'s other healthcare issues, but is every reader aware of the numerous other symptoms associated, namely respiratory disorder directly related to tetraplegia, which (I'm assuming - MD's please correct me if I'm wrong) complicated overall health leading to the MI, thus leading to poor prognosis and death.

Precautions-HOME REMEDY

The very first thought in your brain, when you know a person's condition is such that there is imbobility in the body and may cause bed sores, should be to lay the person on newspaper(s).

To heal bed sores, clean thoroughly with spirit, expose to Infra-red Rays for a few minutes and then apply turmeric powder.

Alternate scales relating to pressure sores

The article already contains details of the NPUAP score of pressure sores. There are other scales as well, for example the Norton Scale. Is there a policy on what scales are mentioned when there are more than one different scales? I don't know how much the Norton Scale is used, so don't know if it justifies mentioning. Ged3000 (talk) 13:52, 18 May 2008 (UTC)

I don't think there's anything as specific as a policy related to that, but probably the way to do it would be to see what gets mentioned in the most reviews. I dealt with the same problem at concussion with concussion grading scales, of which there are dozens: it turned out that there were three main ones that kept getting mentioned in reviews, so I used those. If they're similar scales, maybe we could do a table or something just to summarize. But yeah, I think that your instinct that not every scale is necessarily worth mentioning is a good one; it seems like scale making is everyone's favorite hobby these days! ;-) delldot on a public computer talk 23:22, 18 May 2008 (UTC)

Better illustrations needed

Ewwww. That picture of Stage IV- eww. I'm not saying remove it, I'm just saying it's grosser than I expected. 216.170.23.235 (talk) 03:42, 23 October 2008 (UTC)

I would like to see a picture of each stage in the section. The ones we have a very nice, but I think the article could be improved even more by having images of the others as well. 66.177.36.135 (talk) 20:30, 27 March 2009 (UTC)Turk

Well, then why dont you lay down in your bed for a few months and see how the bedsores evolve, you can take the pictures and then upload them here (=--Josecarlos1991 (talk) 09:32, 29 April 2009 (UTC) [que gracioso eres tio!]

It's concerning to think that each of the images on the page are a considerable failing by the care services and/or the individual carers. These things don't just happen, they happen through neglect. Richard Avery (talk) 10:48, 25 January 2010 (UTC)

The pictures shown do not illustrate the stages of pressure ulcers, nor the one labeled "Stage IV decubitus" is representative of most ulcers out there. We need first stages so people know what to look for and maybe a severe one (nor so gruesome as the one that's there now) so they know what could happen if they do not seek treatment. Elazar.Pimentel (talk) 16:55, 5 October 2021 (UTC)

Prevention is all

With regard to the treatment of bedsores I was thinking that the primary treatment should be the removal of the pressure that caused the sore. If action is not taken to prevent this then no amount of 'treatment' will cure the problem. If there are no objections I could fill in the relevant information. I also think there ought to be a section about prevention of bedsores. There is a multimillion dollar/pound/euro industry around this strategy and it seems odd not to be included. The first action in any illness treatment strategy is to prevent. What thoughts? Richard Avery (talk) 08:35, 25 January 2010 (UTC)

Stage I from sedentary lifestyle

I have one of these on my buttock from sitting on the PC too much. Hurts like a bitch and I work in an office so relieving the pressure completely isn't really an option. I'll be sure to update here if it turns into a stage IV and death looks imminent. 81.155.143.202 (talk) 09:39, 21 June 2010 (UTC)

Ultrasound in treatment of pressure sores

There is evidence that ultrasound does not have a place in the treatment of pressure sores. [1], [2], Comments welcome before a decision is made about editing the article. Richard Avery (talk) 13:33, 18 August 2010 (UTC)

Does disturbing graphic image have to show when not wanted?

I was looking for information about this, but don't want to see an image of a gaping ulcer; just wanted to read about how to prevent these. Up pops a horrible image. Can you figure a way to prevent that? Put a reference with a link, or put it low on the page with a warning, or preferably the necessity to click to see it. An image that's on the page itself could be an illustration rather than a photo. I really did not want to have that etched in my memory, reading about it is bad enough. —Preceding unsigned comment added by 68.58.225.114 (talk) 11:52, 11 May 2011 (UTC)

I agree with Unsigned IP. Besides, I don't even recognize which body part is in question. It looks terrible though and gives me the idea of "look, that's the picture with the most gore I could get". Thanks... not. --Stephan Schneider (talk) 21:37, 29 June 2011 (UTC)

I agree with the above. This photo demonstrates little of medical or nursing significance. It is at the very worst end of the pressure sore spectrum of neglect (It is worth remembering that all pressure sores are the result of poor care and/or nursing neglect) and is not typical of the majority of pressure sores. I propose deletion of the image. Richard Avery (talk) 15:26, 13 July 2011 (UTC)

Including information about offensive material is part of Wikipedia's encyclopedic mission. Wikipedia is not censored. However, images that can be considered offensive should not be included unless they are treated in an encyclopedic manner. Material that would be considered vulgar or obscene by typical Wikipedia readers should be used if and only if its omission would cause the article to be less informative, relevant, or accurate, and no equally suitable alternative is available. --Wikipedia:Images

Typical visitors researching "bedsores" do not expect to see a graphic imagery of its most extreme clinical presentation. Its prominent display does not make the article more informative or relevant. A suitable public-domain substitution is available, and I have replaced the image with it. The offending image has been moved to a text-only hyperlink.

Merely that we can display an image is not an indicator that we should. -- Anonymous Coward 08:46, 26 July 2011 (UTC) — Preceding unsigned comment added by 24.5.136.74 (talk)

About the "debridement" paragraph

I suggest the last item (7) be removed as it has no citations. Numbers 5 and 6 are combined and section 4 be removed unless citations can be found for this highly unusual and probably unethical and 'treatment' Richard Avery (talk) 07:48, 22 August 2011 (UTC)

Image II now looks lke a smiley......

Is this intentional? ") — Preceding unsigned comment added by 168.250.62.193 (talk) 23:27, 28 April 2012 (UTC)

One hopes not, but it is difficult to see how it could be any other shape in this schematic representation. At least it doesn't have a couple of eyes! Richard Avery (talk) 11:26, 29 April 2012 (UTC)

Move?

The following discussion is an archived discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. No further edits should be made to this section.

The result of the move request was: page moved to pressure ulcer as the common name (or current common name at least), as indicated by the ngrams given below, and as better encompassing the article's topic per the nom. -- JHunterJ (talk) 17:02, 25 May 2012 (UTC)

---

Bedsore → Pressure ulcer –

• Bedsores, decubitus ulcers and pressure ulcers all refer to the same disease process, however the terms bedsore and decubitus ("to lie") ulcer are misleading as they refer only to ulcers caused by prolonged bed rest. Pressure ulcers can form any place on the body where the skin is subjected to continuous pressure, such as in a patient confined to a wheelchair developing ulcerations over their coccyx or ischial tuberosity. relisted - please see comment below -- Mike Cline (talk) 11:20, 18 May 2012 (UTC) relisted --Mike Cline (talk) 20:12, 10 May 2012 (UTC) 68.32.94.54 (talk) 02:32, 1 May 2012 (UTC)
• I would contest the capitalisation of "Ulcer", for a start. Noetica^Tea? 02:44, 1 May 2012 (UTC) [My note on moving this to "contested technical moves"; but I see it is now lower-cased. –N]

• I support the proposal to move to Pressure ulcer for the reasons given above. Richard Avery (talk) 13:32, 1 May 2012 (UTC)

• Support this modified proposal with lower-case "u". "Pressure ulcer" does appear to be the more accurate term. Noetica^Tea? 00:32, 2 May 2012 (UTC)

• Oppose. "Pressure sores" is the more common term. Neotarf (talk) 11:54, 2 May 2012 (UTC)
  • Could you please provide some sources to support this? Google scholar gives 22,500 hits for "pressure ulcer", compared to 12,200 for "pressure sore". Jenks24 (talk) 07:14, 4 May 2012 (UTC)

Yes I would agree the term "bedsores" is too specific, and should be moved away from that title; it strikes me that "pressure ulcer" is a medical term that would be understood by anyone working in the medical field, but for the general public the word "ulcer" might be confused with stomach ulcer. In my experience, when health care professionals explain these things to patients and families, they steer away from phrases that sound like medical jargon. But how to show that objectively and not just as my own gut reaction.....

If you search on google books for "pressure sores" you find "About 198,000 results", with plain-English descriptive phrases like "prevention", "patient support systems", "chair cushions and other devices", and "helping each of these groups to understand cause and effect". If you search for "pressure ulcer" you get "about 289,000 results", with phrases like "aetiology and pathology", "medico-legal implications", "management of bacterial colonization & infection", and "impaired blood supply". So maybe it's a matter of register, do you want the article's vocabulary on a 10th grade level or a university level. I don't feel that strongly about it personally, in fact, when I speak to medical professionals about my own health, I prefer the medical jargon. Neotarf (talk) 10:29, 4 May 2012 (UTC)

But this is a medical subject and thus should be titled appropriately, ie. ulcer, There is no reason why there should not be redirects from colloquial names. I don't think an encylcopedia should pander to the lowest common denominator when it comes to topic titles. Richard Avery (talk) 16:10, 4 May 2012 (UTC)

Per WP:COMMONNAME "Wikipedia does not necessarily use the subject's "official" name as an article title; it prefers to use the name that is most frequently used to refer to the subject in English-language reliable sources." Also from WP:TITLE guideline, "The choice of article titles should put the interests of readers before those of editors, and those of a general audience before those of specialists." BTW, "pressure sores" isn't slang. If you check google books you will see it is a perfectly serious and acceptable name used in reliable sources. [3] Neotarf (talk) 23:04, 4 May 2012 (UTC)

• Oppose. The common name is bedsore, and policy is currently to prefer this for the article title as stated above. Andrewa (talk) 17:18, 9 May 2012 (UTC)

• Comment All the comments refer to what the rules say, but what about common sense? That's why there is discussion about these moves, to inject some human thought process instead of deciding blindly by rules that may or not make sense for this topic. If the rules don't make sense, then short term, ignore them WP:IAR or long term, change the rules. BTW, I would call these "decubiti": a word that does not appear at all in the article. Neotarf (talk) 19:32, 12 May 2012 (UTC)
• Oppose, per WP:COMMONNAME. BTW, presumably guidelines reflect common sense, as I think they do in this case. I'd say WP:IAR opens the door for challenging conventions with a logical and constructed argument, but simply advocating something under its aegis is itself only following a rule. ENeville (talk) 21:33, 16 May 2012 (UTC)

• Relisting comment/request - I would have moved this to Pressure ulcer based on common name, but the alternative Pressure sore is also in play for common name. These Ngrams clearly [4], [5], [6] demonstrate that Bedsore is a distant second to Pressure ulcers/sores. Please weigh-in on one of these two alternatives: Pressure sores or Pressure ulcers. --Mike Cline (talk) 11:20, 18 May 2012 (UTC)

• Comment responding to Mike Cline's request on relisting. Thanks for your care with this RM, Mike. I submit this summary ngram on bedsores,pressure sores,pressure ulcers to supplement your three. Observations:

1. This ngram starts at 1920 and is extended to 2008 (the current ngram limit), to highlight later and current trends in usage.
2. It uses plurals, since the term is more often and canonically used that way.
3. It ignores variations in the precise form of "bedsore", such as scarcely arise for the alternatives. I present a supplementary ngram on bedsores,bed sores,bed - sores to show that the true curve for all versions of "bedsore" would be higher; but it still ranks clearly in third place. [Note: Yes, that is how a hyphen must be represented in ngram searches.]

Given the clear trend of the curves in the summary ngram, and evidence of specialist technical usage, and on a review of the detailed content of the article's content, I maintain my support for Pressure ulcer.

☺

Noetica^Tea? 00:06, 19 May 2012 (UTC)

• Comment on "pressure ulcer" vs. "pressure sore". I don't think you could go wrong with either name. The name "pressure ulcer" seems to have gotten a big boost fairly recently, coinciding with the American pressure ulcer bunch issuing new guidelines in 2007, followed by international groups doing the same. See in particular the British usage, [7]. The name "pressure ulcer" particularly irritates me since the difference in staging between Stage 1 and Stage 2 is that Stage 2 is an "ulcer", that is, the skin is broken. So that leaves Stage 1 as an ulcer that is defined by not being an ulcer. Whether the "ulcer" terminology is here to stay or not is anybody's guess, but if the ngram for the English fiction corpus is any indication, [8] it looks like it's become a more common name, and not just used by insiders. Neotarf (talk) 19:49, 22 May 2012 (UTC)

The above discussion is preserved as an archive of a requested move. Please do not modify it. Subsequent comments should be made in a new section on this talk page. No further edits should be made to this section.

This article needs wikifying

This article is full of technical jargon. It would be helpful for nonspecialist readers to understand it if there were a lot more links to other parts of wikipedia. I added a template to encourage someone to improve the wikification. — Preceding unsigned comment added by 173.66.232.53 (talk) 02:04, 10 May 2013 (UTC)

 Done. It appears that an editor has done this and removed your top-of-article flag. 5Q5 (talk) 11:25, 17 May 2013 (UTC)

Clarify "non-blanchable redness"

QUOTE from the Classification section: "Stage I: Intact skin with non-blanchable redness of a localized area usually over a bony prominence." It would help readers if an expert would add a line "Non-blanchable redness means/is . . ." Does it mean when you press on the red sore it doesn't turn white briefly; it stays red? And if it does turn white, then the red sore is not an early stage pressure ulcer, but something else? 5Q5 (talk) 11:44, 17 May 2013 (UTC)

• @5Q5: This question is nearly 9 years old now and still has not been addressed, which is terrible. My own understanding of "non-blachable redness" means that when you press on the area the redness does not go away. In fact, although I am not a doctor, I am certain this is true. I am far less certain, however, about the reciprocal (i.e., that an area of non-blanchable redness over a bony protuberance is indicative of a pressure wound, when such an area could be indicative of a number of other conditions as well) though from a medical standpoint, this certainly seems to be the assumption. And yes, the statement does suggest that if it does turn white, then the site is not indicative of an early stage pressure ulcer. A loose necktie (talk) 00:57, 29 May 2022 (UTC)

Water Tanks

In many science fiction works patients float in water tanks. In the real world this would surely prevent decubitus ulcers. So why isn't this technique used in the real world? At first I thought it may be too costly to implement but then I read an article that said conventional decubitus ulcer treatment and prevention costs tens of thousands of dollars (or euros) per patient and is barely effective, surely it must be possible to get a better health outcome per unit of currency with water tanks?89.99.122.33 (talk) 17:21, 14 August 2013 (UTC)

An interesting idea. The pressure prevention business is a very competitive market and I am sure that if this were a workable and economic proposition then someone would have tried it. There are several immediate problems that would need to be overcome. The bed/tank/frame would need to be easy to store and accessible at short notice. When a patient needs an anti-decubitus bed then the sooner the better. The amount of water required would exceed a normal bath by a factor of 2 or 3 to allow clearance under the patient, and this water would need to be warmed up before being used, and then thermoregulated while in use. There are issues of bodily stability when you float someone on water, turning to inspect or dress wounds, feeding for example, bearing in mind many of the users are likely to be frail.

I would like to see a breakdown of the figures you quote and in my nursing experience there are modern anti-decubitus beds that are very effective. I am not convinced that the better modern low-air-loss anti-decubitus beds which can be rolled up for storage and deployed in minutes with not a huge amount of instruction, could be bettered by a water bed. But I am open to appropriate suggestions. Richard Avery (talk) 14:22, 25 August 2013 (UTC)

There's also the concern, I am sure, that putting someone in a water tank to float more or less immobilizes them there, and while it might take the pressure off the wounds, the patient also needs to engage in regular physical movement to increase blood flow and retain and regain muscle mass. Imagine how weak you would be after floating in a tank of water for a week! Now imagine doing it for four weeks. You would come out unable to to lift your own arms because of atrophy. So yes, a water tank does seem to offer some significant pressure-related solutions, but it brings on a host of other potential problems for the patient which are related to healing the body generally. There is a fine balance when dealing with a chronic condition like this. I know someone who went into the hospital for cancer treatment-- they cured the cancer, but he will soon likely succumb to the pressure wounds he got while lying in the hospital bed recovering from it. It won't be the cancer that kills him, it will be an infection from his wounds in the hospital. Oh, the irony. A loose necktie (talk) 01:04, 29 May 2022 (UTC)

bedridden/ psychological-social (medical) conditions

should a subsection under "treatment" be added to explain the medical/psychological conditions that cause an individual to be bedridden? (and what can be done to alter this...perhaps this ref[9] to start?)--Ozzie10aaaa (talk) 17:09, 9 November 2015 (UTC)

• I'm all for it. A loose necktie (talk) 01:05, 29 May 2022 (UTC)

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