Pressure sores Flashcards
Define Pressure Sores
Pressure Sores or pressure ulcers are defined as localised injury of the skin and/or underlying tissue, usually over a bony area
results from prolonged pressure and shear
can be any size-from tiny to massive and necrotic
any while most often on bony emminences, can technically be anywhere, even mucosal areas
Aetiology and risk factors of Pressure Sores
Mix of pressure, shear, moisture and friction
Pressure is most important-either large pressure small amount of time, or small pressure, big time
Ischemia is the primary cause of tissue damage, as capillaries aren’t functioning (esp when pressure on bone)-combined with lymph draining (toxin accumulation)
deep tissue is easier damaged by pressure-can be happening before superficial opening
Risk factors:
IMMOBILITY-staying in hospital, surgery, wheelchair
age, reduced mobility, diabetic neuropathy,
sensory problems
Epidemology of Pressure Sores
between 5 to 45% of hospital patients develop them during their stay
rarer in children
Signs and Sx of Pressure Sores
usually its from seeing skin damage (open ulcer) over bony prominence
around area-nonblanching erythema, purple/marron skin,
anyone of those with tenderness, warmth, pus/exudate-infection
stage I-non blanchable erythema-purple marron with area of pain-skin intact but deep tissue damage
Stage II-patial thickness of skin open-usually small like a cut
Stage III-full thickness-can see fat but not tendon/bone
Stage IV-fulltickness with exposed tendon/muscle/bone
Investigations of Pressure Sores
CLINICAL
wound swab-for infections
ESR/WCC/CRP-suggest osteomyelitis if already pressure sore