Editing Pressure injuries (section)

=== Surgical ===

** Debridement
*** Debride all necrotic tissue, preferably in OT in most cases
*** Obtain tissue culture
*** Bone biopsy, if involved, for confirmation of OM
*** Meticulous haemostasis is necessary, because these wounds have a propensity to bleed
*** Use outside-to-inside approach, starting from skin
*** Usually apply a VAC - quite good evidence for it in this setting
** Diversion
*** Consider for patients with longstanding and deep sacral and ischial pressure injuries
*** Can end up being permanent
*** In selected patients, can improve healing times
** Reconstruction
*** Need a stable wound bed, free of infection, with optimised medical factors before considering
*** Padding of pressure points with full thickness, well-vascularised skin
*** Fasciocutaneous flaps are often used for closure