ABC of wound healing: Pressure ulcers
A pressure ulcer is defined by the European Pressure Ulcer Advisory Panel (EPUAP) as an area of localised damage to the skin and underlying tissue caused by pressure, shear, or friction, or a combination of these. Pressure ulcers are caused by a local breakdown of soft tissue as a result of compression between a bony prominence and an external surface.
They usually develop on the lower half of the body: two thirds around the pelvis and a third on the lower limbs, with heel ulceration becoming more common. Elderly people are the most likely group to have pressure ulcers; this is especially true for those older than 70 years, up to a third of whom will have had surgery for a hip fracture. Those with spinal injuries form another distinct group, in whom the prevalence is 20-30% one to five years after injury.
Most pressure ulcers arise in hospital, where