Pressure Ulcers

Definition and Presentation

A pressure ulcer is localised injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear. A number of contributing or confounding factors are also associated with pressure ulcers; the significance of these factors is yet to be elucidated1.

Types of pressure ulcer.

Category I. Non-blanchable erythema. Intact skin with non-blanchable redness of a localised area usually over a bony prominence. Discoloration of the skin, warmth, oedema, hardness or pain may also be present. Darkly pigmented skin may not have visible blanching.

Category II. Partial thickness. Partial thickness loss of dermis presenting as a shallow open ulcer with a red pink wound bed, without slough. May also present as an intact or open/ruptured serum-filled blister.

Category III. Full thickness skin loss. Full thickness tissue loss. Subcutaneous fat may be visible but bone, tendon or muscle are not exposed. Some slough may be present. May include undermining and tunneling.

Category IV. Full thickness skin loss. Full thickness tissue loss with exposed bone, tendon or muscle. Slough or eschar may be present. Often include undermining and tunneling.

Numbers of people with pressure ulcers.

In 2007 Vanderwee and colleagues2 reported a pilot pressure ulcer prevalence survey conducted across 26 hospitals in Belgium, Italy, Portugal, Sweden and the UK. 5947 patients were included in the survey with 1078 (18.3%) having pressure ulcers. By country the proportion of patients surveyed who had pressure ulcers varied - Italy (8.3%), Portugal (12.5%), Belgium (21.0%), UK (21.9%), Sweden (22.9%).

Treating pressure ulcers

Find case studies on the successful treatment of pressure ulcers with Activa wound care ranges.