Page 86 - LECTURE NOTES

4.3.9 Decubitus ulcer (bedsores, pressure sore) associated with infection

Bedsore is a special type of ulcer caused by impaired blood supply and tissue nutrition
resulting from prolonged pressure over bony or cartilaginous prominences. The skin

overlying the sacrum and hips is most commonly involved, but bed sores may also be
seen over the occiput areas, elbow, heels, ankles, scapula, medial condyle of tibia and

head of fibula. They may occur most readily in aged, paralyzed, debilitated and
unconscious patient.

Factors contributing for bed sores

Immobility, decreased sensory perception, decreased tissue perfusion and nutritional
status, friction, increased moisture of the skin

Poor nourishment, and obesity (patient have large amount of poorly vasculirized
adipose tissue)

Clinical manifestation
If a pressure area is noted, the nurse notes its size and location and use grading system

to describe its severity.

Stage I

Pressure ulcer is an area of Erythema, tissue swelling and congestion and with patient
complaining discomfort, the skin temperature is elevated because increase

vasodilatation. The redness progresses to a dusky, cyanotic blue gray appearance,

which is the result of skin capillary occlusion weakening of subcutaneous tissue.

Stage II
Pressure ulcer exhibits a break in the skin through the epidermis include the dermis,

and also necrosis of the skin wills occurre.

Stage III

Pressure ulcer extend to sub cutaneous tissue

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