Pressure Ulcers

Also referred to as decubitus ulcers or bed sores, these are lesions caused by unrelieved pressure resulting in damage to underlying tissue. Pressure ulcers usually occur over a bony prominence such as the sacrum or heel, and are staged to classify the degree of tissue damage1. The risk for pressure ulcer development is increased for the person who is immobile and confined to a bed or chair. Pressure ulcers are classified into four categories, depending upon their severity, and are generally caused by unrelieved pressure on the bodies soft tissue.

In addition to pressure, the forces of friction and shear may contribute to wound development in the patient who is malnourished, incontinent, insensate and/or cognitively impaired. Assessment tools, such as the Norton2 or Braden3 tools, assist the clinician to identify patient factors that increase the risk for pressure ulcer development. Appropriate interventions and resources can then be targeted to intervene and reduce patient risks of pressure ulcer development or recurrence.

1. European Pressure Ulcer Advisory Panel. Pressure Ulcer Treatment Guidelines
2. Norton, D., McLaren, R., Exton-Smith, A.N. (1962) An investigation of geriatric nursing problems in hospital. Edinburgh: Churchill Livingstone
3. Bergstrom N., Braden, B. Lazuzza, A. (1987) The Braden scale for predicting pressure sore risk. Nurs Res; 36:4, 205-210

Information provided with support from the Wound Healing Research Unit, Cardiff

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