Pressure Ulcer

Excerpt

Pressure injuries, also termed bedsores, decubitus ulcers, or pressure ulcers, are localized skin and soft tissue injuries that form as a result of prolonged pressure and shear, usually exerted over bony prominences. These ulcers are present 70% of the time at the sacrum, ischial tuberosity, and greater trochanter. However, they can also occur in the occiput, scapula, elbow, heel, lateral malleolus, shoulder, and ear. Besides bony prominences, they can also occur due to medical or other devices, such as cell phones. Pressure injuries vary in severity and characteristics. Different medical fields have developed various classifications to improve communication. The 2 latest and most acceptable classifications were defined by the NPIAP and the International Statistical Classification of Diseases and Related Health Problems (ICD-11), released in 2019 and 2018, respectively. With the COVID-19 pandemic, pressure ulcers increased, and the national economic burden worsened, shedding light on the topic.

Jean-Martin Charcot was a French doctor in the 19th century who studied many diseases, including decubitus ulcers. He noticed that patients who developed eschar of the buttocks and sacrum died after some time. He named this lesion "decubitus ominous," which meant death was inevitable after developing this lesion.

In 2016, the National Pressure Ulcer Advisory Panel (NPUAP) released new terminology guidelines, and the preferred name is now "pressured injury" to "better reflect all forms of tissue damage, including the stage before skin breakdown." The organization also publically announced the change from NPUAP to the National Pressure Injury Advisory Panel (NPIAP).