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PRESSURE ULCER
PRESENTED BY: DR. H. NAJARI
ASSISTED PROFESSOR
DEPARTMENT OF INFECTIOUS DISEASE
QAZVIN UNIVERSITY OF MEDICAL SCIENCE
DEFINITION
• Pressure ulcer, also known as Pressure sores,
Bedsores and Decubitus ulcers, are localized
injuries to the skin and/or underling tissue
that usually occur over a bony prominence
• The most common sites are the skin
overlying the sacrum, coccyx, heels or the
hips
• Elbows, knees, ankles, back of shoulders or
cranium can be affected
CONTRIBUTING FACTORS
• Sustained pressure. pressure applied to soft
tissue resulting in completely or partially
obstructed to blood flow to the soft tissue
• Shear is also a cause, as it can pull on blood
vessels that feed the skin. Shear occur when
two surfaces move in the opposite direction
• Friction. Is the resistance to motion.it may
occur when the skin is dragged across a
surface.
RISK FACTORS
Comma &
paralysis
After surgery
Poor health and
weakness
Bed rest and wheelchair use
Difficult moving and inability to
easily change position while seated
or in bed
RISK FACTORS
• Age
• Lack of sensory perception
• Weight loss
• Poor nutrition
• Excess moisture or dryness
• Bowel incontinence
• Medical condition affecting blood flow
• Smoking
• Limited alertness
• Muscle spasms
STAGING
Bedsores fall into one of 4
stage based on their severity
management of patients
are based on the staging
STAGE I
Non-broken skin
Stage may be difficult to
detect
The skin appears red, non-blanchable
The site is tender, painful, firm, soft, warm
or cool
STAGE II
Epidermis and part dermis is damaged or lost
The wound may be shallow & pinkish or red
It look like a fluid-filled or a ruptured blister
STAGE III
Full thickness tissue loss
The loss of skin usually exposes some fat
The dead tissue
 ulcer looks crater-like
The bottom of wound have some yellowish
The damage may extend beyond the
primary wound blew layers of healthy skin
STAGE IV
• Full thickness tissue loss with exposed bone,
tendon or muscle
• The bottom of the wound likely contains dead
tissue that is yellowish or dark and crusty
• The damage often extends beyond the
primary wound layer of healthy skin
UNSTAGEABLE
• Full thickness tissue loss in which actual depth
of the ulcer is completely obscured by slough
• Yellow, brown, black or dead tissue is covered
surface of ulcer
• It is not possible to see how deep the wound is
DEEP TISSUE INJURY
• The skin is purple or maroon but the skin is
not broken
• A blood-filled blister is present
• The area is painful, firm or mushy
• The area is warm or cool compared with the
surrounding skin
• In people with darker skin, a shiny patch or a
change in skin tone may develop
COMPLICATIONS