Strategies for treatment of decubitus ulcers include assessing the ulcer stage, cleaning the wound and removal of necrotic tissue, use of appropriate dressing in order to maintain the humidity of the wound and care to reduce pressure at the ulcer position The dressings used for the treatment of pressure ulcers are divided into:
- Film dressing. Transparent polyurethane films used in bedsores at 1st and 2nd stage.
- Foam dressings. These are polyurethane films which are used on 1st and 2nd stage accompanied by mean intensity secretions.
- Hydrocolloids dressings. These are dressings made from polyurethane, cellulose, gelatin and pectin. Used in bedsores 1st, 2nd and 3rd stage accompanied by medium and heavy intensity secretions.
- Algenic dressings. These are dressings containing polysaccharides. They are absorbent, forming a gel in contact with fluids of sore exudate and are used in the 2nd, 3rd and 4th stage accompanied by medium and heavy intensity secretions.
- Hydrofibre dressings. They have high absorbency when in contact with fluids of exudate they are converted to a transparent gelatinous solid dressing. Used in bedsores at 3rd and 4th stage accompanied with medium and heavy intensity secretions.
- Odour control dressings. Special dressings containing active carbon and are fixed onto normal dressings.
- Hydrogels. Gel used for autolytic removal of necrotic eschars.
In large sores with necrosis, the treatment of choice is debridement, which is performed on necrotic tissue with ease because the eschar contains no sensory fibers. Necrotic tissue is a barrier to healing, epithelialization and acts as focus of infection.
The avoidance of additional pressure on the decubitus ulcers while in the healing phase is necessary. Another method used for cleaning of necrosis is treatment with the larvae (greenbotlle), also called bio-debridement.