Pressure Ulcers
Dr. Krishna G. Seshadri, MD, AB(Endocrine, Diabetes & Metabolism)*

Pressure ulcers are localized areas of tissue necrosis that tend to develop when soft tissue is compressed between a bony prominence and an external surface for a prolonged period of time. The consequences of pressure-induced skin injury range from nonblanchable erythema of intact skin to deep ulcers extending down to the bone. The common pathway that results in necrosis of the skin is unrelieved application of pressure to susceptible tissues for a prolonged period of time. The resulting ulcer imposes a significant burden not only on the patient, but the entire health care system.



Epidemiology
Among patients in acute care hospitals, prevalence rates for pressure ulcers have ranged in most studies from 3 to 14 percent, and incidence rates from 1 to 8 percent. This may be higher in bed ridden or chair bound patients,
patients with femoral fractures or patients in intensive care units.
Pathogenesis
The development of a pressure ulcer is a complex process that requires the application of external forces to the skin. However, external forces alone are
not sufficient to cause an ulcer; their interaction with host-specific factors culminates in tissue damage.