Pressure ulcer

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

Areas where bedsores occur

Progression of a decubitis ulcer

Pressure ulcer

Definition:

A pressure ulcer is an area of skin that breaks down when you stay in one position for too long without shifting your weight. This often happens if you use a wheelchair or you are bedridden, even for a short period of time (for example, after surgery or an injury). The constant pressure against the skin reduces the blood supply to that area, and the affected tissue dies.

A pressure ulcer starts as reddened skin but gets progressively worse, forming a blister, then an open sore, and finally a crater. The most common places for pressure ulcers are over bony prominences (bones close to the skin) like the elbow, heels, hips, ankles, shoulders, back, and the back of the head.

Alternative Names:

Bedsore; Decubitus ulcer

Causes:

These factors increase the risk for pressure ulcers:

Being elderly.
Inability to move certain parts of your body without assistance, such as after spinal or brain injury or if you have a neuromuscular disease (like multiple sclerosis).
Malnourishment.
Being bedridden or in a wheelchair.
Having a chronic condition, such as diabetes or vascular disease, that prevents areas of the body from receiving proper blood flow.
Urinary incontinence or bowel incontinence. (Moisture next to the skin for long periods of time can cause skin irritation that may lead to skin breakdown.)
Fragile skin.
Mental disability from conditions such as Alzheimer's disease. (The patient may not be able to properly prevent or treat pressure ulcers.)

References:

Brillhart B. Pressure sore and skin tear prevention and treatment during a 10-month program. Rehabil Nurs. 2005; 30(3): 85-91.

de Laat EH, Scholte op Reimer WJ, van Achterberg T. Pressure ulcers: diagnostics and interventions aimed at wound-related complaints: a review of the literature. J Clin Nurs. 2005; 14(4): 464-472.

Cole L, Nesbitt C. A three year multiphase pressure ulcer prevalence/incidence study in a regional referral hospital. Ostomy Wound Manage. 2004; 50(11): 32-40.

Review Date: 10/17/2005
Reviewed By: Michael S. Lehrer, M.D., Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.

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