Kicking Off Our Monthly Clinical Insights
We're launching a new monthly clinical insights series, and we're starting with one of the most common — and preventable — issues we see across Corstrata consults: pressure injuries.

What We See: A Patient Example
Setting: Post-acute – home Consult Type: Store-and-forward

A bedbound patient with multiple comorbidities was noted to have a nonhealing stage 4 sacral pressure injury despite IV antibiotics and management per the wound clinic. The bedside team submitted images and measurements through a store-and-forward consult. Our clinicians quickly identified that pressure continued to be an ongoing causative factor and recommended targeted offloading strategies and DME orders for effective pressure relief. The home health team also lacked access to the primary dressing that had been ordered, which was contributing to complications, so topical therapy adjustments were recommended along with education on repositioning for offloading and pressure injury prevention and management.

Early expert input helped prevent further deterioration and avoided an unnecessary transfer back to the acute setting.

Common Myths, Challenges, and Mistakes
Myth: "Pressure injuries require in-person specialty consults to manage appropriately." Reality: Many pressure injuries can be accurately assessed, staged, and managed virtually. Virtual consults often accelerate intervention, prevent deterioration and complications, and function as an integral part of interdisciplinary team management.

Observed Common Mistake: Use of donuts for offloading. While offloading is essential to treatment and prevention of pressure injuries, it's important to use evidence-based methods and products. The 2019 (and earlier) guidelines from NPIAP, in collaboration with the European Pressure Ulcer Advisory Panel (EPUAP) and Pan Pacific Pressure Injury Alliance (PPPIA), state under "Positioning Devices": "Do not use ring or donut-shaped devices." This is labeled Strength of Evidence = C, because the edges of these devices create areas of high pressure that may damage tissue, impair circulation, and lead to edema.

What to use instead? Select a seating support cushion based on the individual's specific needs. Key principles for appropriate seating support:

Redistribute pressure, rather than creating focal pressure points
Support neutral posture and pelvic alignment
Minimize shear and friction during sitting and repositioning
Patients who sit for prolonged periods or have existing pressure injuries should be referred to a seating specialist for individualized assessment and cushion selection.

When to Consider a Corstrata Consult
New or worsening pressure injuries
Unclear staging or poor treatment response
High-risk patients and during care transitions
If you're questioning a wound, it's often the right time to consult.

Clinical Pearl
Early identification and management remains one of the strongest predictors of improved outcomes. Consistent photo documentation and timely expert review are key — particularly during transitions from acute to post-acute care.

Where Corstrata Fits
We routinely support pressure injury management across the continuum of care:

Acute Care: Early identification, staging, and treatment guidance
Post-acute & SNFs: Accurate identification, treatment optimization, and prevention of deterioration
Home Health: Accurate identification, management, and preventing avoidable readmissions
Consults can be completed via store-and-forward or live video.

Ready to bring virtual wound and ostomy expertise to your team? Reach out to the Corstrata Clinical Team to schedule a consult.