Nursing Expert Discusses Post Surgical Bedsore Development

I regularly treat and monitor surgical patients in a post-operative setting. I am the clinical nurse manager of a large orthopedic, urology, and cardiac step down unit at our facility. We see quite a few bedsores and follow a protocol for prevention, staging of current pressure ulcers, and treating the wounds. In addition, I have had numerous patients who have had Nephrectomies. I am the President of my State Board of Nursing and have been since 2012. I would need to know the exact length of stay, whether the patient was turned, if the could patient turn herself, if the patient or family refuse turning, what her nutritional status was, her weight, as well as any co-morbidities. Length of stay for my patients who have had a nephrectomy is generally 4-5 days without complications. A stage 4 pressure ulcer is full thickness tissue loss with exposed bone, tendon, or muscle. Slough or eschar may be present on some parts of the wound bed. This type of ulcer can include undermining and tunneling. The depth of a stage IV pressure ulcer varies by anatomical location. Stage IV ulcers can extend into muscle and supporting structures (e.g., fascia, tendon, or joint capsule) making osteomyelitis possible. Exposed bone and tendon is visible or directly palpable in Stage IV ulcers.