A pressure ulcer, also known as a bedsore or decubitus ulcer, is a localized injury to the skin and/or underlying tissue that typically occurs over bony prominences as a result of prolonged pressure. These ulcers can range from mild reddening of the skin to severe tissue damage involving deeper layers, potentially leading to infections and complications. They are most commonly seen in individuals who are immobile or have limited mobility, such as those confined to bed or a wheelchair.

Several factors increase the risk of developing pressure ulcers, including advanced age, malnutrition, moisture from incontinence, and conditions that impair blood flow, such as diabetes or vascular disease. Additionally, individuals with decreased sensation or cognitive impairments may not realize when they need to change positions, further increasing their risk. Prolonged exposure to friction and shear forces can also contribute to skin breakdown.

The initial signs of a pressure ulcer may include localized redness or discoloration of the skin that does not blanch when pressure is applied. As the condition progresses, symptoms can evolve to include breaks in the skin, open wounds, and necrotic tissue. Patients may also experience pain, tenderness, and swelling in the affected area, indicating deeper tissue damage.

Pressure ulcers, also known as bedsores or decubitus ulcers, primarily occur due to prolonged pressure on the skin, particularly over bony areas such as the heels, sacrum, and elbows. Additional contributing factors include friction, moisture from sweat or incontinence, and shearing forces that occur when the skin is pulled in different directions. Individuals with limited mobility, certain medical conditions like diabetes or vascular disease, and advanced age are at increased risk due to decreased blood flow to the skin.

Diagnosis of a pressure ulcer is primarily clinical and involves a thorough assessment of the skin and surrounding tissues by a healthcare professional. The ulcer is graded based on its depth and extent of tissue damage, with standardized systems such as the National Pressure Injury Advisory Panel (NPIAP) criteria often used. Additional investigations, such as imaging or lab tests, may be warranted if infection or other complications are suspected.

Treatment for pressure ulcers begins with relieving pressure on the affected area to promote healing, which may involve repositioning, specialized cushions, and support surfaces. Wound care is essential and may include cleaning the ulcer with saline, applying dressings to protect the area, and using topical treatments to enhance healing. In severe cases, surgical intervention may be required to remove damaged tissue or to reconstruct the area.

Preventive strategies for pressure ulcers focus on reducing prolonged pressure and maintaining skin integrity. Regular repositioning of immobile patients, using pressure-relieving devices like specialized mattresses or cushions, and maintaining skin hygiene and moisture levels are crucial. Education for caregivers and patients about monitoring skin condition can also help identify early signs of pressure damage before ulcers develop.