Thomas: Additional pressure ulcer research trials a must

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David Thomas, M.D., says little research has been done.
David Thomas, M.D., says little research has been done.

Nursing homes should adopt evidence-based approaches to pressure ulcer prevention and treatment, but significantly more research is needed to support this goal, a professor of geriatric medicine said in November.

“What we have been facing in the care of pressure ulcers in nursing home is dogma. We desperately need people in nursing homes to do clinical research,” said David Thomas, M.D., of the Saint Louis University School of Medicine, where the International Nursing Home Research Conference was held Nov. 22 and 23. 

There are only 51 research papers on pressure ulcers in world literature, Thomas said. He urged leaders at the conference to perform pressure ulcer research trials.

Investigations into certain types of wound dressings, nutritional supplements, negative pressure wound therapy and even a timeframe for turning residents haven't proven what consistently can help pressure ulcers in residents, Thomas said during his presentation. It is necessary to relieve pressure, maintain a moist wound base and relieve pain, he said. 

There's no evidence that zinc paste is effective; no difference between gold leaf or aluminum foil versus gauze; and no clear evidence that silver works, Thomas said. Even debridement lacks evidence.

Finally, there is not evidence that residents with wounds need special nutrition and that  feeding tubes make the situation worse, he believes. 


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