Other interventions for pressure injuries

Optimise the patient's general health to facilitate healing of pressure injury and improve the effectiveness of local wound therapies. Factors affecting ulcer and wound healing must be addressed. Ensure the patient is hydrated and well nourished. Adequate protein and energy intake is important; patients with stage III and IV pressure injury may require protein and other nutritional supplements–consider referral to a dietitian. After optimising protein and energy intake, consider adding arginine. Arginine (at a dose of 4.5 to 9 g daily) may be beneficial for healing pressure injuries that are stage II or more.

Additional management may include:

• adequate analgesia
• incontinence management
• optimising skin condition
• use of advanced or biophysical therapies (eg negative pressure wound therapy, ultrasound, electrical stimulation)
• rehabilitation programs (to improve physical functioning and strength)
• optimising management of comorbidities (consider specialist referral).