Pressure ulcers: Etiology, treatment and prevention

Frequently found on the sacrum, pressure ulcers develop due to prolonged periods of unrelieved pressure on soft tissues, but can occur anywhere there is pressure, including trochanters and especially heels. In the bedridden patient, constant pressure causes ischemia and necrosis of subcutaneous tissues and skin. Most patients are elderly, immobile and have neurologic impairments, often associated with inability to sense pain and discomfort and/or incontinence. Sacral ulcers can be treated with debridement, dressings and skin grafts. However, preventive efforts - including a regular turning schedule, proper assessments, moisturizers and adequate diet - are the most cost effective and remain the foundation of management. Pressure ulcers can occur anywhere there is pressure, including trochanters and, especially heels.