Nursing the decubitus ulcer A case study and nursing care analysis

Wounds can often be challenging to manage, due to the different phases of healing and the complications that can occur. Veterinary nurses (VNs) can play a leading role in this aspect of patient care and in helping to ensure a successful outcome. A decubitus ulcer, also known as a pressure sore or pressure ulcer, is a wound that can develop over a bony prominence when the area is in prolonged contact with a hard surface, such as in cases of recumbent patients or patients with decreased muscle mass and mobility. These ulcers can become infected and may take a long time to heal. It is important to understand the risk factors for decubitus ulcers in order to prevent them from developing. A good nursing plan will help minimise their occurrence and, if they do develop, there are several nursing interventions that can be implemented by VNs to improve the comfort and recovery of the patient. This article focuses on the wound management of a dog with a decubitus ulcer on the olecranon, which became infected with a penicillin-resistant bacterium. The nursing challenges over the 6-month period of wound management included the immobilisation of the wound area and the treatment of a bacterial infection and further trauma due to paresis in the hindlimbs. Owner engagement was critical in this case; the owners had to adapt to a significant change to their normal life, and developed bespoke coverings to keep the patient's elbow protected at all times. Through their involvement and compliance with guidance provided by the veterinary team, the owners came to recognise the dog as their patient as well as their companion, and, over time, they assumed responsibility for managing the dog's dressings independently.