Pressure injury: update on general concepts, clinical aspects, and laboratory findings – Part I

Abstract

Pressure injuries remain a significant challenge in healthcare services. They negatively impact these services by increasing workload, financial burden, and direct and indirect costs related to detection, prevention, treatment, and rehabilitation. It is of utmost importance that dermatologists and other healthcare professionals are knowledgeable about these lesions. The first part of this review discusses the history and terminology of pressure injuries, epidemiology in different settings, from adults to pediatric and neonatal patients; etiopathogenesis, demonstrating the current scheme of the vicious cycle of ischemia and tissue death; associated risk factors, both intrinsic and extrinsic; classification of all stages of pressure injuries with clinical images; and the main anatomical areas at risk in each position ‒ lateral, seated, supine, prone, and with medical devices. Differential diagnoses were detailed, including incontinence-associated dermatitis, and the “Kennedy terminal ulcer”, providing support for proper evaluation and guidance on preventive measures and treatment, which will be further detailed in Part II of this review. The primary focus was to provide resources for healthcare professionals to holistically assess, prescribe, and monitor patients at risk for or with pressure injuries.