(Medicine of Elderly)

Overview

• Damage to the skin, usually over a bony prominence, as a result of pressure
• Constant pressure limits blood flow to the skin leading to tissue damage
• Risk Factors → immobility, recent surgery or intensive care stay, diabetes, malnutrition
• Very common in hospitals and in the elderly population
• Waterlow Score → used to screen for patients who are at risk of developing pressure ulcers. Takes into account BMI, nutritional status, skin type, mobility and continence.

Making Diagnosis

Clinical Features:

• Location → over bony prominences, typically sacrum or heel
• Focal area of nonblanchable erythema
• Evidence of decreased skin perfusion (increased CRT)
• Painful (unlike neuropathic ulcers which are painless)
• Signs of wound infection → purulent drainage, foul smell
• Stages 1-4