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Pressure ulcer - Overview

Alternative Names

Bedsore; Decubitus ulcer

Definition of Pressure ulcer:

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.

Causes:

These factors increase the risk for pressure ulcers:
  • Being bedridden or in a wheelchair
  • Fragile skin
  • Having a chronic condition, such as diabetes or vascular disease, that prevents areas of the body from receiving proper blood flow
  • 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
  • Mental disability from conditions such as Alzheimer's disease -- the patient may not be able to properly prevent or treat pressure ulcers
  • Older age
  • Urinary incontinence or bowel incontinence
  • Reviewed last on: 7/11/2008
  • Michael Lehrer, M.D., Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Garcia AD, Thomas DR. Assessment and Management of Chronic Pressure Ulcers in the Elderly. Med Clin North Am. 2006 Sep;90(5):925-44.

Fonder MA, Lazarus GS, Cowan DA, Aronson-Cook B, Kohli AR, Mamelak AJ. Treating the chronic wound: A practical approach to the care of nonhealing wounds and wound care dressings. J Am Acad Dermatol. 2008 Feb;58(2):185-206.