On June 12, I gave a medical grand rounds lecture at Trinitas Hospital in Elizabeth NJ on pressure ulcers to about 30 resident physicians and 10 attending physicians. The emphasis was on prevention and situations where prevention requires more than standard care. Pressure ulcer prevention is dependent on the team of doctors and nurses at the bedside. Wound care consultants have an obvious conflict of interest in preventing ulcers, yet hospitals are still reimbursed highly for having a wound care center and consult service. The ability to examine a pressure ulcer, just like doing a heart or lung exam is what allows a bedside medical team of young doctors in the hospital to at least not make a pressure ulcer worse before they can get expert help. This situation occurs when they are caring for a patient who comes from a nursing home or home with a pressure ulcers. I talked about how much easier it is to prevent a pressure ulcer than to treat the secondary complications such as cellulitis, osteomyelitis, sepsis and pain.
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