Pressure ulcers present a significant economic, quality of life, and overall health care threat.
Pressure ulcers were once a problem considered a side effect of aging have captured the attention of the medical community. Pressure ulcers now are more commonly regarded as preventable and unacceptable as they are an indicator of the quality of life.
Pressure ulcers occur on any part of the body but are commonly seen over bony prominences, such as the occiput, sacrum, elbows, heels, hips, and the ischial tuberosities. One common pressure ulcer that occurs is on the feet; due to rubbing of shoes, although most people do not recognize this as a pressure ulcer.
Pressure damages predominantly caused by prolonged and unrelieved pressure from any external object against the skin. Example bed, mattress, chair, clothing, footwear, medical devices, etc. The applied pressure occludes blood vessels, capillaries and venules, in the skin and underlying tissues, which means that there is insufficient or no blood supply to the affected tissues that then die due to lack of oxygen, that is ischemia; further, there is a formation of waste products, due to the occlusion of venules, which causes reduced tissue viability, leading to poor tissue repair.
It is similar to a boulder being placed on a hose pipe that feeds a garden; failure to remove the boulder to allow water through results in the garden drying up and dying.
Patients who are immobile or have difficulty responding independently to pressure, or those who have a neurological deficit and cannot feel the effects of pressure are at immediate risk of developing pressure ulcers.
Many factors affect an individual's likelihood of developing pressure ulcers, the more factors involved, the higher the risk, and the faster a pressure ulcer is likely to develop.
It is, therefore, essential to carry out a risk assessment that considers all potential contributory factors so that an appropriate level of care can be planned and implemented.