Pressure ulcers – prophylaxis and treatment

Abstract

Background. Pressure ulcers (decubitus) occur very frequently and are found in 10-20% of patients in health institutions. Health personnel should be well acquainted with the prophylaxis, assessment and treatment of pressure ulcers.Material and method. The article is based both on a non-systematic search in Medline and Embase using relevant search words, and on our own clinical experience.Results. Pressure ulcers are caused by mechanical pressure, traction, and/or friction on the skin and underlying tissue. Neuropathy, poor nourishment, moist skin and infection are all risk factors for the development and maintenance of ulcers. Prophylaxis and treatment should be directed at the cause and at risk factors. Pressure ulcers are graded on a scale from 0 to 4 depending on how deeply the damage extends from the skin down into the underlying tissue. Superficial pressure ulcers in the skin and subcutaneous tissue are treated by conservative wound treatment while deeper pressure ulcers that extend down to muscle and bone should be assessed for surgery.Interpretation. Pressure ulcers are common. Relief of pressure and reduction of risk factors are important in the prevention and treatment. Depending on how deep the ulcer extends, conservative ulcer treatment or surgery are alternatives.