- Decubitus ulcers are common in debilitated patients, particularly the aged who have thinner skin and subcutaneous tissue that is more susceptible to compression injury.
- Patients with limited mobility (from injury, sickness, or neurologic disorders, etc.), poor nutritional intake, conditions affecting perfusion and oxygenation of tissues (like diabetes, cardiovascular disease, heart failure, etc.), skin moisture due to incontinence, and advanced age are particularly vulnerable.
- These ulcers are often multifactorial, making them difficult to prevent and even more difficult to heal in at-risk patients.
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- Pressure ulcers are a localized injury to the skin and/or underlying tissue, usually over a bony prominence, that occur as a result of pressure, shear, and/or friction.
- Stage I decubitus ulcers manifest as a non-blanchable area of skin redness, which then progresses to a partial thickness wound in Stage II, and further to full thickness skin loss in Stage III. Stage IV decubiti involve full thickness tissue loss with exposed bone, tendon, or muscle with sloughing, undermining, and tunneling. These ulcers can extend into muscle and/or supporting structures making osteomyelitis and sepsis a concern.
- Decubitus ulcers are associated with an increased morbidity and mortality, and healing can be difficult as debilitated patients who form them usually have widespread vascular disease, nutritional de cits, and/or oxygenation/perfusion difficulties.
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- Deep tissue injuries can have the same outward appearance as decubitus ulcers, but the underlying etiology is different. These injuries happen and progress quickly.
- The mechanism of this injury is pressure to the skin and soft tissue, within a short period of time, that compromises tissue perfusion and results in ischemia and damage to the deeper subcutaneous tissues.
- The initial injury is not visible on the surface of the skin and only manifests later as the underlying tissue starts to necrose, first forming what appears to be a bruise before progressing to an external/visible skin wound.
- This type of wound evolves upward towards the skin as well as deeper, so once the external wound becomes apparent, it is frequently already a deep injury often with the appearance of a Stage 3–4 decubitus ulcer.
