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Doctor insights on: Tunneling Stage Pressure Ulcers

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How do undermining and tunneling differ in regards to stage 4 pressure ulcers?

How do undermining and tunneling differ in regards to stage 4 pressure ulcers?

Semantics: The process is the same for both, pressure damageto softer tissue underlying the comparatively tough skin. Undermining leaves a shelf of skin over a cavity while tunneling is a relatively straight line as its name would suggest covering possibly a great distance under the skin. ...Read more

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Bed Sore (Definition)

A bed sore is an injury to the skin, and tissues beneath the skin, caused by pressure. They can range from a stage one pressure sore (tender, red and does not blanch) to stage four (an open wound extending down to the bone). Early stage pressure sores can respond to off-loading, while deep ulcers require debridement, dressing ...Read more


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What is the difference between undermining and tunneling in regards to stage 4 pressure ulcers?

What is the difference between undermining and tunneling in regards to stage 4 pressure ulcers?

They are the same: A stage 4 ulcer is the deepest type of pressure ulcer that forms over a pressure point due to diminished sensation and/or inability to move and relieve pressure. Examples are spinal cord injury patients or older stroke and debilitated bed-bound patients. Most vulnerable is the deepest (muscle) tissue, then the fat then the skin. This leads to the undermining seen at the base of the ulcer. ...Read more

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What is the prevalence of pressure ulcers in the U.S.?

What is the prevalence of pressure ulcers in the U.S.?

2.5 million in USA: This is an estimate and represents the number of TREATED pressure sores. The incidence is likely to be much much higher. http://www.uptodate.com/contents/epidemiology-pathogenesis-and-risk-assessment-of-pressure-ulcers?source=outline_link&view=text&anchor=H2#H2For a good summary: ...Read more

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How often do I have to get up to prevent pressure ulcers?

How often do I have to get up to prevent pressure ulcers?

Constantly: There is no specific time recommendation but you should shift every few minutes. This applies to any pressure point not just the sacrum or the heels. ...Read more

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How much pro-stat® away aday should I give my lady she is 93years old she has a small pressure ulcers on her bottom .....?

How much  pro-stat® away  aday should I give my lady she is 93years old she has a small pressure ulcers on her bottom .....?

Pressure relief: Is what is needed in addition to good nutrition. Prostat is a protein drink (good) that may help poor nutrition, but will not do anything to relieve pressure. She needs better padding, periodic offloading, and good wound care to prevent a small ulcer from becoming a much bigger problem. This may be partially failure to heal, but usually is a failure to reduce pressure on bony areas adequatelely. ...Read more

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How do pressure ulcers form?

How do pressure ulcers form?

Multifactorial: Pressure ulcers are rare, though possible in the young - as in a 10 hour back surgery. It is more common in the elderly / infirmed with issues like stroke related paralysis/paresis, cachexia, metabolic problems like diabetes and chronic illness like kidney disease. Add prolonged pressure to the above, even healthy looking tissue will breakdown and not heal properly. ...Read more

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Does being in a wheelchair cause pressure ulcers?

Does being in a wheelchair cause pressure ulcers?

Wheelchair: Not necessarily so. Your wheelchair and cushion should be assessed by someone knowledgeable with this type of equipment. For example, there are seating specialists (physical therapists) that can evaluate you and your needs and order the correct equipment. ...Read more

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How long does it take for pressure ulcers to form?

Duration for PUs: Pressure ulcers are due to 'enough' pressure to occlude the blood pressure of the microscopic capillaries. No one is sure how long it you must occlude these capillaries so that a pressure injury results in changes in the skin. It will vary from person to person because of multiple factors in addition to time: repeated episodes, moisture, nutrition, protein stores, ability to heal, diabetes mellitu. ...Read more

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Which cream can I use to treat pressure ulcers stage 2-3?

Which cream can I use to treat pressure ulcers stage 2-3?

No snake oil: First there is a very significant difference between stage 2 and 3 ulcers. Is there a 'cream' to help either? Well, in a way a debriding enzyme for a necrotic wound could be called a cream, in some cases a barrier cream may help a stage 2 wound but what treatment to use on a pressure ulcer is a very specialized area, take the wound to a wound specialist for best results. ...Read more

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What is involved in debridement of pressure ulcers, decubitus?

A cleanout and...: Often pressure sores are bottle shaped, with a small skin opening overlying a larger cavity that may extend to an underlying pressure point. This causes dead tissue to build up in the cavity, which is an excellent growing medium for bacteria. Debridement is removal of dead tissue and debris and enlargement of the skin opening: this allows easier cleaning and/or flap closure when the wound is clean. ...Read more

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What does a caregiver need to know about skin care and pressure ulcers?

What does a caregiver need to know about skin care and pressure ulcers?

Stage: - reduce or eliminate underlying contributing factors by providing pressure relief with proper positioning and support surfaces. - provide appropriate local wound care, which may include debridement for patients with necrotic tissue, based on the ulcer's characteristics. - consider adjunctive therapies, such as negative pressure wound therapy - monitor and document the patient's progress. ...Read more

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What happens when there is a debridement of pressure ulcers or decubitus?

Debridement: Debridement of a pressure sore consists of removing all dead tissue to help the wound heal. This is done with several instruments including scalpel. ...Read more

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Hi, can doctor give me an antibiotic for bed sores or pressure ulcers?

Hi, can doctor give me an antibiotic for bed sores or pressure ulcers?

Sure: But if they aren't infected it may do more harm than good. Unnecessarily using antibiotics contributes to the development of resistant bacteria and won't help heal a pressure sore. ...Read more

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What are the protein needs for adults with renal disease and pressure ulcers who are not on dialysis?

What are the protein needs for adults with renal disease and pressure ulcers who are not on dialysis?

Pressure sores: Pressure avoidance is the one 'must do' to allow sores to heal. As for diet, if you eat well you should be fine. Taking a multivitamin can only help. If you are worried about your nutritional status, see your doctor and have that evaluated. ...Read more

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I have high blood pressure, ulcers and am diabetic. Does this have anything to do with my bad breath?

I have high blood pressure, ulcers and am diabetic. Does this have anything to do with my bad breath?

Diabetes & Ulcers: It may, diabetics are more susceptible to develop gum disease than the general population. Also, ulcers and other gut problems may cause bad breath. In addition, if you are taking medication to lower your blood pressure, you may be experiencing a slight to moderate xerostomia (dry mouth). Xerostomia increases the amount of bacterial growth causing in turn bad breath. Visit your dentist and md. ...Read more

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What are the roles of various risk factors in the development of pressure ulcer?|

What are the roles of various risk factors in the development of pressure ulcer?|

Many Risk Factors: Many risk factors can augment the effects of pressure on the skin. Any factor that lowers the perfusion of blood to an affected area, for example, will augment the chances of injury; some examples in this category include peripheral artery disease and low blood pressure, which is common during septic events. ...Read more

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Dr. Scott Bolhack
2,072 doctors shared insights

Ulcer (Definition)

An ulcer is a discontinuity or a break in a body membrane that impedes the normal functioning of the organ of which that membrane is a part. Ulcers are further classified by their location. Ulcers are usually caused by infections, excessive acid production, stress, ...Read more


Ulceration (Definition)

An ulcer is a discontinuity or a break in a bodily membrane that impedes the organ of which that membrane is a part from continuing its normal functions. Ulcers are further classified by their location, for example; ...Read more