The following disease information and images of pressure ulcers have been excerpted from VisualDx's Pressure Ulcer Staging module as a public health service.
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A pressure ulcer results when there is localized damage to the skin and underlying tissue as a result of compression between a bony prominence and an external surface. Damage is caused by the forces of pressure, shear, and friction acting individually or in combination with each other.
Pressure ulcers, previously termed as decubitus ulcers, are also commonly referred to as pressure sores and bed sores. Common sites for pressure ulcer formation are the sacrum, over the ischial tuberosity, the trochanter, and the calcaneus. Other locations are the elbow, ankle, scapula, and the occiput. However, the most common sites are the sacrum and the heels. Pressure ulcers affect from 1.5 to 3 million people in the US at an annual cost of approximately $5 billion.
Pressure ulcers occur more commonly in certain subsets of patients, such as the elderly (over the age of 70), patients who have had surgery for hip fracture, and patients with spinal cord injury. Pressure ulcers are also more common in patients who are from nursing homes and assisted living facilities or hospitalized due to some other reason.
Pressure ulcers are classified according to the extent of tissue damage (National Pressure Ulcer Advisory Panel):
Recently, 2 other stages of pressure ulcer formation have been added:
When examining the ulcer, look for and record the following:
Dark Skin Considerations:
Erythema can be subtle in darker skin and may appear as a slightly different color, or the skin may be slightly darker than normal. Discoloration, warmth, induration, or hardness of skin may be the only signs of a stage I ulcer in people with darker skin tones.
The information contained in this Web page is intended to be an adjunct to traditional medical information sources. It is not intended to be a substitute for professional medical judgment.
Authors and Editors:
Ansa Ahmed MD
Sally-Ann Whelan MS, NP, CWOCN
Lisa Wallin ANP, FCCWS
Art Papier MD