The Four Stages Of Decubitus Ulcer

According to, the European Pressure Ulcer Advisory Panel (EPUAP), National Pressure Ulcer Advisory Panel (NPUAP) and Pan Pacific Pressure Injury Alliance (PPPIA) classification system (2014) pressure ulcers are categorised into four stages depending on their severity. Stage one: skin still intact with non-blanching, redness with swelling present. Stage two: the skin breaks open or forms a blister without slough and is usually tender or painful. Stage three: pressure sore becomes worse, slough may be present and extends into the tissue beneath the skin where subcutaneous fat may be visible but bone, tendon or muscles are not exposed. Stage four: pressure sore becomes very deep reaching into the muscle or tendon causing extensive damage with necrosis. However, pressure ulcer staging is dependent on visible skin characteristics therefore misclassifying pressure-related injury can remain undetected for days or weeks before a purple discolouration of the skin appears (Mallah, Nassar and Badr, 2014).

One or two days after, sores or blisters start to appear in or on the mouth and on the hands, feet and buttocks. In some cases, a skin rash’s appearance happens before the blisters do. The blisters may break open and crust over.

A home health nurse knows that a 70-year-old male client who is convalescing at home following a hip replacement, is at risk for developing decubitus ulcers. Which physical characteristic of aging contributes to such a risk?

Fever, swelling around initial infection site, parasites in blood, sometimes asymptomatic, rarely debilitating or life threatening problems can occur.

lacerations, burns - including friction burns and scalds, drowsiness, pressure sores, cowering and flinching, unexplained hair loss,

Pressure ulcers that occur in the long term care setting are increasing in the number of incidences each year in the United States. Consequences and complications of pressure ulcer development include pain, sepsis, cellulitis, bone, and joint infections. Pressure ulcers are also associated with an increased morbidity and mortality rate, negative emotional and physical effects on patients and caregivers, and are the second leading cause of litigation in long term care facilities. The cost of treatment for pressure ulcers in the United States is estimated at 11 billion dollars annually. This has led to many programs that focus on education and intervention to prevent the development of pressure ulcers, even being addressed in public initiatives such as Healthy People 2010. Appropriate information and education for healthcare providers, patients, and families has proven to be a key factor in the prevention of pressure ulcer development. Wound management is an area of healthcare that must include a comprehensive plan for the best outcome. A care plan that includes a well-educated care team composed of various disciplines working together for holistic care of each patient has seen the best results for patients who suffer from pressure ulcers.

they can lose fingers and limbs, they can suffer cuts that become infected, and become ill from the

ulcer causes the patient to suffer with pain, disfigurement, and prevents them from their daily

The surveys were conducted between 1989 and 2005 predominantly in the US and showed an increase of 4.4% in number of nosocomial pressure ulcer prevalence rated with increase 6.3% in overall pressure ulcer prevalence rates. Nosocomial pressure ulcer prevalence rates were highest in long-term acute care facilities with anatomical location of greatest number of pressure ulcers being sacrum, hells and buttocks. The surveys also revealed that majority of Stage IV pressure ulcers were related to patients with dark skin: N=447,930 (total number of patients in survey), n1=1024 (dark skinned patients), n2 = 164 (dark skinned patients with Stage IV pressure ulcers). The incidence rates of pressure ulcers averaged at 5.4% which correlated with contributing factors of Braden Scores less than 18, serum albumin levels less than 3, fecal/urine incontinence, fragile skin and

When we find an enclosed damage to our skin as well as tissue that is usually over the skeletal protuberance caused by some sort of pressure, we call it a pressure ulcer. This may be caused by some sort of pressurized rubbing or cut. This type of ulcer is of chronic type that inherently carries impaired healing at physiological level. In this paper I am going to discuss the prevention measures of this ulcer and treatment options.

Ulcers that progress to stage two can be assessed as a wound that is shallow and looks like a ruptured blister that is pink or red in color. At stage three, the ulcer resembles a crater with a deep wound that reveals fat and possibly some yellow skin that is dead. Stage four pressure ulcers can reveal muscles and tendons; these ulcers can manifest dead, yellowish-brown crusty tissue.

A decubitus ulcer, (more commonly known as a bed sore or a pressure sore) is an open wound that forms on the skin that covers bone. Most decubitus ulcers appear on the ankles, back, hips, and butt. This ulcer is common with those people who are wheelchair bound, elderly and remain seated or still for a long period of time or are unable to move parts of their body without assistance. This is condition is treatable and has high recovery rates if diagnosed properly.

The National Institute for Health and Care Excellence (NICE) defines leg ulcer as the loss of skin on the leg below the knee or foot, which takes more than 2 weeks to heal. Venous leg ulceration is due to sustained venous hypertension, which results from chronic venous insufficiency and/or an impaired calf muscle pump. Venous leg ulcers

Heels are the most common site for pressure ulcers, and the most common site of deep tissue injury. The National Pressure Ulcer Advisory Panel (NPUAP, 2007) defines a suspected deep tissue injury as: Purple or maroon localized area of discolored intact skin or blood-filled blister due to damage of underlying soft tissue from pressure and/or shear. The area may be preceded by tissue that is painful, firm, mushy, boggy, warmer or cooler as compared to adjacent tissue. The color of the skin or tissue reflects the degree of the deep tissue injury; dark red tissue means hyperemia and means the tissue has poor circulation; as it worsens the deep tissue area turns purple which means severe tissue injury; this can progress to black color which means

Pressure Injuries—often referred to as pressure sores, bed sores, pressure ulcers or decubitus ulcers—are the injuries, sores, inflammation or ulcers in the skin over a bony prominence due to constant pressure or friction. The common sites for pressure injuries are sacrum, heels, elbows, ankles, hip, knees, occipital bones and shoulder blades (Harris, Nagy &Vardaxis, 2010, p.1404). A shearing force or a frequent pressure on a bony prominence tends to block the blood supply which leads to ischemia or cell death. Elderly, incontinent, wheelchair or bed-bound individuals are prone to pressure sores. However, it also depends on the individual’s skin integrity and weight (Brown & Edwards, 2012, p. 239). The pressure injury can affect any person of any age. Therefore, every patient requires an assessment for risks regardless of gender, age or weight. A pressure injury can develop with both the high pressure for short duration and low