Nonsurgical Treatment of Pressure Ulcers Medication

  • Author: Christian N Kirman, MD; Chief Editor: Lars M Vistnes, MD, FRCSC, FACS   more...
 
Updated: Jan 11, 2012
 

Medication Summary

The relief of spasticity when present is essential in the treatment and prevention of pressure ulceration. The most commonly employed medications are presented here.

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Skeletal muscle relaxants (centrally acting)

Class Summary

Centrally acting skeletal muscle relaxants inhibit reflexes at the spinal level.

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Baclofen (Lioresal)

 

May induce hyperpolarization of afferent terminals and inhibit both monosynaptic and polysynaptic reflexes at the spinal level.

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Diazepam (Valium)

 

Depresses all levels of the CNS, including the limbic and reticular formation, possibly by increasing GABA activity, which is a major inhibitory neurotransmitter. Individualize dosage and increase it cautiously to avoid adverse effects.

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Skeletal muscle relaxants (direct acting)

Class Summary

Direct-acting skeletal muscle relaxants inhibit muscle contraction by decreasing calcium release from the sarcoplasmic reticulum in muscle cells.

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Dantrolene (Dantrium)

 

Stimulates muscle relaxation by modulating the skeletal muscle contractions at a site beyond the myoneural junction and by acting directly on the muscle itself. Most patients respond to a dose of 400 mg/d or less.

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Contributor Information and Disclosures
Author

Christian N Kirman, MD  Plastic Surgeon, Department of Surgery, University of California, San Francisco, Medical Center

Christian N Kirman, MD is a member of the following medical societies: Alpha Omega Alpha, American Medical Association, and North Carolina Medical Society

Disclosure: Nothing to disclose.

Coauthor(s)

Joseph A Molnar, MD, PhD, FACS  Director, Wound Care Center, Associate Director of Burn Unit, Associate Professor, Department of Plastic and Reconstructive Surgery, Wake Forest University School of Medicine

Joseph A Molnar, MD, PhD, FACS is a member of the following medical societies: American Association of Plastic Surgeons, American Burn Association, American College of Surgeons, American Medical Association, American Society for Parenteral and Enteral Nutrition, American Society of Plastic Surgeons, North Carolina Medical Society, Peripheral Nerve Society, Undersea and Hyperbaric Medical Society, and Wound Healing Society

Disclosure: KCI, Inc. Honoraria Speaking and teaching; Integra Life Sciences Honoraria Speaking and teaching; Clincal Cell Culture Grant/research funds Co-investigator; KCI, Inc Wake Forest University receives royalties Other

Specialty Editor Board

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Wayne Karl Stadelmann, MD  Stadelmann Plastic Surgery, PC

Wayne Karl Stadelmann, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Surgeons, American Society of Plastic Surgeons, New Hampshire Medical Society, Northeastern Society of Plastic Surgeons, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Nicolas (Nick) G Slenkovich, MD  Director, Colorado Plastic Surgery Center

Nicolas (Nick) G Slenkovich, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Society of Aesthetic Plastic Surgery, American Society of Plastic Surgeons, and Colorado Medical Society

Disclosure: Nothing to disclose.

Chief Editor

Lars M Vistnes, MD, FRCSC, FACS  Professor of Surgery, Emeritus, Stanford University Medical Center

Lars M Vistnes, MD, FRCSC, FACS is a member of the following medical societies: Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author Don R Revis Jr, MD, to the development and writing of this article.

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Image of advanced sacral pressure ulcer shows the effects of pressure, shearing, and moisture.
Pressure ulcers of the lateral aspect of the right foot.
Heel pressure ulcer.
 
 
 
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