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Pressure ulcer

MedGen UID:
1789997
•Concept ID:
C4554531
•
Disease or Syndrome
Synonyms: Bed Sore; Bed Sores; Bedsore; Bedsores; Decubitus Sore; Decubitus Sores; Decubitus Ulcer; Decubitus Ulcers; Injury, Pressure; Pressure Injuries; Pressure Injury; Pressure Sore; Pressure Sores; Pressure Ulcer; Pressure Ulcers; Sore, Bed; Sore, Decubitus; Sore, Pressure; Ulcer, Decubitus; Ulcer, Pressure
SNOMED CT: Pressure injury (1163214006); Pressure injury (1163215007)
 
HPO: HP:0012399
Monarch Initiative: MONDO:0004646

Definition

A type of ulcer that is caused when an area of skin is subject to pressure over a prolonged period of time, ranging in range in severity from patches of discolored skin to open wounds that expose the underlying bone or muscle. The most common sites are the sacrum, coccyx, heels and the hips. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVPressure ulcer

Professional guidelines

PubMed

The Role of Nutrition for Pressure Injury Prevention and Healing: The 2019 International Clinical Practice Guideline Recommendations.
Munoz N, Posthauer ME, Cereda E, Schols JMGA, Haesler E
Adv Skin Wound Care 2020 Mar;33(3):123-136. doi: 10.1097/01.ASW.0000653144.90739.ad. PMID: 32058438
Pressure ulcers: Prevention and management.
Mervis JS, Phillips TJ
J Am Acad Dermatol 2019 Oct;81(4):893-902. Epub 2019 Jan 18 doi: 10.1016/j.jaad.2018.12.068. PMID: 30664906
Prevention and treatment of pressure ulcers/injuries: The protocol for the second update of the international Clinical Practice Guideline 2019.
Kottner J, Cuddigan J, Carville K, Balzer K, Berlowitz D, Law S, Litchford M, Mitchell P, Moore Z, Pittman J, Sigaudo-Roussel D, Yee CY, Haesler E
J Tissue Viability 2019 May;28(2):51-58. Epub 2019 Jan 11 doi: 10.1016/j.jtv.2019.01.001. PMID: 30658878

Recent clinical studies

Etiology

The impact of two distinct endotracheal tube fixation on the formation of pressure ulcer in the intensive care unit: A randomised controlled trial.
Genc A, Yildiz T
Int Wound J 2022 Oct;19(6):1594-1603. Epub 2022 Jan 27 doi: 10.1111/iwj.13757. PMID: 35088531Free PMC Article
Pressure ulcer/injury classification today: An international perspective.
Kottner J, Cuddigan J, Carville K, Balzer K, Berlowitz D, Law S, Litchford M, Mitchell P, Moore Z, Pittman J, Sigaudo-Roussel D, Yee CY, Haesler E
J Tissue Viability 2020 Aug;29(3):197-203. Epub 2020 May 1 doi: 10.1016/j.jtv.2020.04.003. PMID: 32414554
Pressure ulcers: Pathophysiology, epidemiology, risk factors, and presentation.
Mervis JS, Phillips TJ
J Am Acad Dermatol 2019 Oct;81(4):881-890. Epub 2019 Jan 18 doi: 10.1016/j.jaad.2018.12.069. PMID: 30664905
The cost of prevention and treatment of pressure ulcers: A systematic review.
Demarré L, Van Lancker A, Van Hecke A, Verhaeghe S, Grypdonck M, Lemey J, Annemans L, Beeckman D
Int J Nurs Stud 2015 Nov;52(11):1754-74. Epub 2015 Jun 25 doi: 10.1016/j.ijnurstu.2015.06.006. PMID: 26231383
Pressure ulcer assessment.
Maklebust J
Clin Geriatr Med 1997 Aug;13(3):455-81. PMID: 9227939

Diagnosis

A Study on Pressure Ulcer: Influencing Factors and Diagnostic Techniques.
Nancy GA, Kalpana R, Nandhini S
Int J Low Extrem Wounds 2022 Sep;21(3):254-263. Epub 2022 Feb 21 doi: 10.1177/15347346221081603. PMID: 35188406
Braden Scale in pressure ulcer risk assessment.
Jansen RCS, Silva KBA, Moura MES
Rev Bras Enferm 2020;73(6):e20190413. Epub 2020 Aug 10 doi: 10.1590/0034-7167-2019-0413. PMID: 32785503
Pressure ulcer/injury classification today: An international perspective.
Kottner J, Cuddigan J, Carville K, Balzer K, Berlowitz D, Law S, Litchford M, Mitchell P, Moore Z, Pittman J, Sigaudo-Roussel D, Yee CY, Haesler E
J Tissue Viability 2020 Aug;29(3):197-203. Epub 2020 May 1 doi: 10.1016/j.jtv.2020.04.003. PMID: 32414554
Pressure Injury Prevention: A Survey.
Mansfield S, Obraczka K, Roy S
IEEE Rev Biomed Eng 2020;13:352-368. Epub 2019 Jul 5 doi: 10.1109/RBME.2019.2927200. PMID: 31283488
Pressure ulcers: Pathophysiology, epidemiology, risk factors, and presentation.
Mervis JS, Phillips TJ
J Am Acad Dermatol 2019 Oct;81(4):881-890. Epub 2019 Jan 18 doi: 10.1016/j.jaad.2018.12.069. PMID: 30664905

Therapy

Beds, overlays and mattresses for preventing and treating pressure ulcers: an overview of Cochrane Reviews and network meta-analysis.
Shi C, Dumville JC, Cullum N, Rhodes S, McInnes E, Goh EL, Norman G
Cochrane Database Syst Rev 2021 Aug 16;8(8):CD013761. doi: 10.1002/14651858.CD013761.pub2. PMID: 34398473Free PMC Article
Comparing alternating pressure mattresses and high-specification foam mattresses to prevent pressure ulcers in high-risk patients: the PRESSURE 2 RCT.
Nixon J, Brown S, Smith IL, McGinnis E, Vargas-Palacios A, Nelson EA, Brown J, Coleman S, Collier H, Fernandez C, Gilberts R, Henderson V, McCabe C, Muir D, Rutherford C, Stubbs N, Thorpe B, Wallner K, Walker K, Wilson L, Hulme C
Health Technol Assess 2019 Sep;23(52):1-176. doi: 10.3310/hta23520. PMID: 31559948Free PMC Article
Effectiveness on hospital-acquired pressure ulcers prevention: a systematic review.
Gaspar S, Peralta M, Marques A, Budri A, Gaspar de Matos M
Int Wound J 2019 Oct;16(5):1087-1102. Epub 2019 Jul 1 doi: 10.1111/iwj.13147. PMID: 31264345Free PMC Article
Support surfaces for pressure ulcer prevention.
McInnes E, Jammali-Blasi A, Bell-Syer SE, Dumville JC, Middleton V, Cullum N
Cochrane Database Syst Rev 2015 Sep 3;2015(9):CD001735. doi: 10.1002/14651858.CD001735.pub5. PMID: 26333288Free PMC Article
Pressure ulcer risk assessment and prevention: a systematic comparative effectiveness review.
Chou R, Dana T, Bougatsos C, Blazina I, Starmer AJ, Reitel K, Buckley DI
Ann Intern Med 2013 Jul 2;159(1):28-38. doi: 10.7326/0003-4819-159-1-201307020-00006. PMID: 23817702

Prognosis

Beds, overlays and mattresses for preventing and treating pressure ulcers: an overview of Cochrane Reviews and network meta-analysis.
Shi C, Dumville JC, Cullum N, Rhodes S, McInnes E, Goh EL, Norman G
Cochrane Database Syst Rev 2021 Aug 16;8(8):CD013761. doi: 10.1002/14651858.CD013761.pub2. PMID: 34398473Free PMC Article
Global prevalence and incidence of pressure injuries in hospitalised adult patients: A systematic review and meta-analysis.
Li Z, Lin F, Thalib L, Chaboyer W
Int J Nurs Stud 2020 May;105:103546. Epub 2020 Jan 31 doi: 10.1016/j.ijnurstu.2020.103546. PMID: 32113142
Pressure Injury.
Hajhosseini B, Longaker MT, Gurtner GC
Ann Surg 2020 Apr;271(4):671-679. doi: 10.1097/SLA.0000000000003567. PMID: 31460882
Medical device-related pressure ulcers: A systematic review and meta-analysis.
Jackson D, Sarki AM, Betteridge R, Brooke J
Int J Nurs Stud 2019 Apr;92:109-120. Epub 2019 Feb 10 doi: 10.1016/j.ijnurstu.2019.02.006. PMID: 30782513
Education of healthcare professionals for preventing pressure ulcers.
Porter-Armstrong AP, Moore ZE, Bradbury I, McDonough S
Cochrane Database Syst Rev 2018 May 25;5(5):CD011620. doi: 10.1002/14651858.CD011620.pub2. PMID: 29800486Free PMC Article

Clinical prediction guides

Nurses' knowledge on pressure ulcer prevention: An updated systematic review and meta-analysis based on the Pressure Ulcer Knowledge Assessment Tool.
Wu J, Wang B, Zhu L, Jia X
Front Public Health 2022;10:964680. Epub 2022 Sep 8 doi: 10.3389/fpubh.2022.964680. PMID: 36159260Free PMC Article
Braden Scale in pressure ulcer risk assessment.
Jansen RCS, Silva KBA, Moura MES
Rev Bras Enferm 2020;73(6):e20190413. Epub 2020 Aug 10 doi: 10.1590/0034-7167-2019-0413. PMID: 32785503
Australian Nurses' Knowledge of Pressure Injury Prevention and Management: A Cross-sectional Survey.
Fulbrook P, Lawrence P, Miles S
J Wound Ostomy Continence Nurs 2019 Mar/Apr;46(2):106-112. doi: 10.1097/WON.0000000000000508. PMID: 30801563Free PMC Article
A prediction tool for hospital-acquired pressure ulcers among surgical patients: Surgical pressure ulcer risk score.
Aloweni F, Ang SY, Fook-Chong S, Agus N, Yong P, Goh MM, Tucker-Kellogg L, Soh RC
Int Wound J 2019 Feb;16(1):164-175. Epub 2018 Oct 5 doi: 10.1111/iwj.13007. PMID: 30289624Free PMC Article
Predicting Pressure Injury in Critical Care Patients: A Machine-Learning Model.
Alderden J, Pepper GA, Wilson A, Whitney JD, Richardson S, Butcher R, Jo Y, Cummins MR
Am J Crit Care 2018 Nov;27(6):461-468. doi: 10.4037/ajcc2018525. PMID: 30385537Free PMC Article

Recent systematic reviews

Nursing interventions for pressure injury prevention among critically ill patients: A systematic review.
Alshahrani B, Sim J, Middleton R
J Clin Nurs 2021 Aug;30(15-16):2151-2168. Epub 2021 Feb 27 doi: 10.1111/jocn.15709. PMID: 33590917
Repositioning for preventing pressure ulcers: a systematic review and meta-analysis.
Avsar P, Moore Z, Patton D, O'Connor T, Budri AM, Nugent L
J Wound Care 2020 Sep 2;29(9):496-508. doi: 10.12968/jowc.2020.29.9.496. PMID: 32924821
Global prevalence and incidence of pressure injuries in hospitalised adult patients: A systematic review and meta-analysis.
Li Z, Lin F, Thalib L, Chaboyer W
Int J Nurs Stud 2020 May;105:103546. Epub 2020 Jan 31 doi: 10.1016/j.ijnurstu.2020.103546. PMID: 32113142
Effectiveness on hospital-acquired pressure ulcers prevention: a systematic review.
Gaspar S, Peralta M, Marques A, Budri A, Gaspar de Matos M
Int Wound J 2019 Oct;16(5):1087-1102. Epub 2019 Jul 1 doi: 10.1111/iwj.13147. PMID: 31264345Free PMC Article
Support surfaces for pressure ulcer prevention.
McInnes E, Jammali-Blasi A, Bell-Syer SE, Dumville JC, Middleton V, Cullum N
Cochrane Database Syst Rev 2015 Sep 3;2015(9):CD001735. doi: 10.1002/14651858.CD001735.pub5. PMID: 26333288Free PMC Article

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