Review article
Pressure ulcers: A review

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Abstract

This article reviews the etiology, pathology, description, risk factors, prevention, medical and surgical management, and complications of pressure ulcers. Pressure ulcers, which develop primarily from pressure and shear, are also known as decubitus ulcers, bed socres, and pressure sores. They continue to occur in hospitals, nursing homes, and among disabled persons in the community. Estimates of the prevalence of pressure ulcers in hospitalized patients range from 3% to 14% and up to 25% in nursing homes. Persons with spinal cord injury and the elderly are two groups at high risk. The most common sites of development are the sacrum, ischium, trochanters, and about the ankles and heels. Areas of ongoing research such as electrical stimulation and growth factors are discussed.

References (174)

  • R.M. Allman et al.

    Pressure sores among hospitalized patients

    Ann Int Med

    (1986)
  • A.H. Brandeis et al.

    The epidemiology and natural history of pressure ulcers in elderly nursing home residents

    JAMA

    (1990)
  • National Pressure Ulcer Advisory Panel

    Pressure ulcers

  • J Agris et al.

    Pressure ulcers: prevention and treatment

  • H.C. Trumble

    The skin tolerance for pressure and pressure sores

    Med J Aust

    (1930)
  • M Kosiak et al.

    Evaluation of pressure as factor in production of ischial ulcer

    Arch Phys Med Rehabil

    (1958)
  • M Kosiak

    Etiology and pathology of ischemic ulcer

    Arch Phys Med Rehabil

    (1959)
  • M Kosiak

    Etiology of decubitus ulcers

    Arch Phys Med Rehabil

    (1961)
  • R.K. Daniel et al.

    Pressure sores and paraplegics: an experimental model

    Ann Plast Surg

    (1985)
  • B Larsen et al.

    On the pathogenesis of bedsores

    Scand J Plast Reconstr Surg

    (1979)
  • J.B. Rueler et al.

    The pressure sore: pathophysiology and principles of management

    Ann Intern Med

    (1981)
  • R.K. Daniel et al.

    Etiologic factors in pressure sores: an experimental model

    Arch Phys Med Rehabil

    (1981)
  • G.T. Nola et al.

    Differential response of skin and muscle in the experimental production of pressure sores

    Plast Reconstr Surg

    (1980)
  • R.K. Daniel et al.

    Muscle coverage of pressure points: the role of myocutaneous flaps

    Ann Plast Surg

    (1982)
  • A.A. Barton

    The pathogenesis of skin wounds due to pressure

  • P.W. Brand

    Pressure sores the problem

  • S.M. Reichel

    Shearing force as a factor in decubitus ulcer in paraplegics

    JAMA

    (1958)
  • L. Bennett et al.

    Shear vs pressure as causative factors in skin blood flow occlusion

    Arch Phys Med Rehabil

    (1979)
  • L Bennett et al.

    Skin blood flow in seated geriatric patients

    Arch Phys Med Rehabil

    (1981)
  • S.M. Dinsdale

    Decubitus ulcers: role of pressure and friction in causation

    Arch Phys Med Rehabil

    (1974)
  • S. Lamid et al.

    Smoking, spasticity and pressure sores in spinal cord injured patients

    Am J Phys Med

    (1983)
  • R.M. Allman

    Pressure ulcers among the elderly

    N Engl J Med

    (1989)
  • J.H. Mulholland et al.

    Protein metabolism and bed sores

    Ann Surg

    (1943)
  • R Breslow

    Nutritional statis and dietary intake of patients with pressure ulcers: review of research literature 1943–1989

    Decubitus

    (1991)
  • G.D. Pinchcofsky-Devis et al.

    Correlation of pressure sores and nutritional status

    J Am Geriatr Soc

    (1986)
  • Agency for Health Care Policy and Research

    Pressure ulcers in adults: prediction and prevention

  • G.M. Yarkony

    Aging skin, pressure ulcerations, and spinal cord injury

  • A.M. Kligman et al.

    Aging of human skin

  • S.L. Garber et al.

    Body build and its relationship to pressure distribution in the seated wheelchair patient

    Arch Phys Med Rehabil

    (1982)
  • S.L. Garber et al.

    Trochanteric pressure in spinal cord injury

    Arch Phys Med Rehabil

    (1982)
  • T.P. Anderson et al.

    Psychosocial factors associated with pressure sores

    Arch Phys Med Rehabil

    (1979)
  • W.A. Gordon et al.

    The relationship between pressure sores and psychosocial adjustment in persons with spinal cord injury

    Rehabil Psych

    (1982)
  • C Thiyagorajan et al.

    Aetiology of pressure sores in patients with spinal cord injury

    Br Med J

    (1984)
  • J.R. Young et al.

    Spinal cord injury statistics

    (1982)
  • A.R. Mawson et al.

    Risk factors for early occurring pressure ulcers following spinal core injury

    Am J Phys Med Rehabil

    (1988)
  • G.M. Yarkony et al.

    Classification of pressure ulcers

    Arch Dermatol

    (1990)
  • J.D. Shea

    Pressure sores: classification and management

    Clin Orthop

    (1975)
  • National Pressure Ulcer Advisory Panel

    Pressure ulcers: incidence, economics risk assessment

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    This research supported in part by grants H133N00008 and H133B80007 from the National Institute of Disability and Rehabilitation Research, Department of Education.

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