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Lipodermatosclerosis — SCE Dermatology MCQ

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HardWound HealingLipodermatosclerosisSCE Dermatology

A bed-bound adult has a category 4 sacral pressure ulcer producing enough exudate to require four dressing changes daily. There is no cellulitis, sepsis or osteomyelitis. Which adjunct is consistent with NICE CG179?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Use negative-pressure therapy to reduce the dressing-change burden

Explanation lettering: E = shown as A · D = shown as C · C = shown as D · A = shown as E

A is correct. NICE does not recommend negative-pressure wound therapy routinely for pressure ulcers, but allows it when needed to reduce frequent dressing changes, as in a heavily exuding wound. Category alone is not an antibiotic indication: systemic antibiotics are reserved for sepsis, spreading cellulitis or underlying osteomyelitis. Debridement is assessed according to necrosis, wound extent, tolerance and comorbidity; autolytic methods are usual and sharp debridement is considered if delay would prolong healing. Hyperbaric oxygen is not recommended. Pressure redistribution, nutrition assessment and appropriate moist-wound care remain fundamental.

Reference: NICE CG179: pressure-ulcer management: https://www.nice.org.uk/guidance/cg179/chapter/Recommendations