Pressure Ulcers Epidemiology:

• Pressure ulcers are serious complications among hospitalized patients, with a prevalence of 5.8% on admission and 4.5% as hospital-acquired.
• The prevalence is higher among residents of long-term geriatric facilities, occurring in up to 30% of patients, resulting in significant financial burden ranging from $3.3 billion to $11 billion per year.

Risk Factors:

• Intrinsic risk factors include neurologic disease, motor impairment, cognitive impairment, sensory deficits, malnutrition, and hypoperfusion.
• Extrinsic risk factors include inadequate mobilization, trauma, sedation, improper positioning, moisture, and shearing forces.

Pathophysiology:

• Pressure ulcers form as a result of hypoperfusion to an area, leading to tissue ischemia and necrosis if not reversed.
• The critical duration of ischemia generally occurs between 30 and 240 minutes, but is shorter in patients with peripheral vascular disease.

Classification:

• Pressure ulcers are classified as stage I through IV, with stage I being the most superficial and stage IV being the deepest.
• Having a uniform classification system allows for standardization of wounds for research purposes and objective monitoring of the progression of the wound.

Prevention:

• Prevention should be standard practice, with initial risk assessment and standardized tools like the Braden Scale, Norton Scale, and Waterlow Scale for assessment.
• Prevention plan should include patient mobilization, positioning aids, and support services like dynamic pressure-reducing surfaces.

Dynamic Support Surfaces:

• Examples include low-air-loss beds, air-fluidized mattresses, and alternating pressure mattresses.
• Use of foam mattress overlays can reduce the risk of pressure ulcer development.

Treatment Options:

• Few treatment options have been rigorously evaluated in randomized controlled trials.