New approaches to managing pressure ulcers

An ointment derived from a botanical extract may be highly safe and have a significant therapeutic benefit for treating pressure ulcers. The administration of Arnebia euchroma root ointment over a period of four weeks may result in a considerable reduction in the depth of pressure ulcers according to a double-blind randomized controlled trial. Researchers report in Dermatologic Therapy that this approach was safe but had no significant impact on the pressure ulcer scale for healing (PUSH).1 Researchers examined 20 patients with Stage I–III pressure ulcers from nursing homes and medical facilities in Sari, Mazandaran, Iran. Patients were randomly assigned to two groups between 2020 and 2021. In the intervention group, patients received Arnebia euchroma root 5% ointment. In the control group, patients received silver sulfadiazine 1%. The primary outcome was improvement in the diameter and depth of the ulcer. Outcomes were assessed before intervention and then at one, two, three, and four weeks. Patients in both groups were comparable in terms of age, sex, nutritional disorders, use of anti-bedsore mattress, disease duration, underlying diseases and pressure ulcer stage. The two groups were also comparable in terms of pain, baseline ulcer diameter, depth, and PUSH score. The ulcer depth was significantly lower in the intervention group than that in the control group (p < 0.001, standardized mean difference [SMD] = −2.43, 95% confidence interval [CI] −0.58; −1.23) after four weeks. Ulcer depth and diameter differences at other time points were not statistically significant. No side effects were observed in any of the patients.Arnebia euchroma is also referred to as “Pink Arnebia” and it is a plant belonging to the Boraginaceae family. It is native to Western and Central Asia. Historically, it has been used to treat respiratory, gastrointestinal and dermatological conditions. The authors note that currently various therapies are available for pressure ulcers. However, no single treatment has demonstrated superior effectiveness compared to others. Arnebia euchroma exhibits anti-inflammatory properties that facilitate the healing of surgical wounds and burns. A. euchroma ointment has also shown greater efficacy than silver sulfadiazine cream in treating second-degree burn wounds, according to a randomized clinical trial.2The current study revealed that after four weeks of pressure ulcer treatment with A. euchroma root 5% ointment, the ulcer depth was significantly lower compared to the control group. A. euchroma root 5% ointment showed high-grade efficacy in reducing the pressure ulcer depth. It also showed small efficacy in ulcer depth reduction after three weeks, nevertheless with no statistically significant difference compared to the control group. In terms of ulcer diameter, there was a small effect for A. euchroma root ointment beginning from the third week. Silver sulfadiazine is considered standard for burns. However, the authors note its use may be suboptimal in pressure ulcer care due to cytotoxicity and potential for delayed healing. Therese Laub, a wound care specialist and consultant in Belvidere, Il., has worked extensively in post-acute care and mobile wound management. Laub focuses on "Guidance through Collaboration," providing educational tools, policies, and strategic guidance for wound care compliance, reimbursement, and best clinical practices.“My biggest concern with the study is that it indicates the product was used on Stage 1 to 3 pressure injuries. Stage 1 pressure ulcers are not open. So, I am wondering what the indication is of the product for intact skin. Depth cannot be reduced in these ulcers. Also, the control group is using silver sulfadiazine, which is not an evidenced based treatment for Stage 3 pressure injuries,” Laub told the Medical Post. A new form of preventionNurses traditionally identify bedsores by looking for skin discolouration. However, the damage is done by the time the redness is observed. Individuals with darker skin tones have a higher prevalence of severe pressure ulcers because the discoloration is more difficult to see.Now, there is a handheld wireless wound-assessment device and it may be a game changer. The device measures surface electrical capacitance, the amount of fluid in a specific area of the skin as an indication of localized edema. “Early detection of pressure damage is critical for pressure injury prevention. The SEM Scanner improves the ability to detect early pressure damage across patients with all skin tones. This is important because the primary method of detecting pressure damage is visual skin assessment to discern erythema or discolouration with attention to areas commonly affected by pressure injuries, the sacrum and heels. Discerning skin discolouration in persons with medium and dark skin tones is difficult, even for experts,” said Barbara Bates-Jensen, who invented the SEM Scanner with her colleagues at UCLA Samueli School of Engineering in Los Angeles.Currently, the SEM Scanner is in use in hospitals in Europe, the U.K., Canada and the United States. It's estimated that it has been used on more than 1 million patients and prevented 50,000 pressure injuries. Bates-Jensen, who is a nursing professor at UCLA, said it can detect early-stage pressure injuries up to 10 days before damage is visible.“The SEM Scanner when used with a pressure injury prevention program has been effective at reducing facility acquired pressure injuries and sustaining low occurrence of facility acquired pressure injuries,” Bates-Jensen, who is also associate dean of academic affairs at the UCLA Joe C. Wen School of Nursing, told the Medical Post.References: Armaghan K, Ebrahim S, Zahra F, et al. Arnebia euchroma Root Ointment for Pressure Ulcer Healing: A Double-Blind Randomized Controlled Trial, Dermatologic Therapy, 2026, 8929348, 7 pages, 2026.Nasiri E, Hosseinimehr SJ, Zaghi Hosseinzadeh A, et al. The Effects of Arnebia Euchroma Ointment on Second-Degree Burn Wounds: A Randomized Clinical Trial, Journal of Ethnopharmacology. (2016) 189, 107–116.

New approaches to managing pressure ulcers

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