Q: What type of treatment is used for a stage 4 pressure ulcer of the coccyx, for an elderly person? We are already using an air mattress. What type of dressings, creams, and ointments should be used? Should the area be covered by gauze or left open in a hot humid climate?

A:Stage 4 ulcer needs mechanical or surgical debridement to remove necrotic tissue and eschar. This can be followed by calcium alginate dressings. If available negative pressure dressing (VAC) may help. Its best to consult a physician to see if a surgical debridement is required.