Pressure ulcers, also known as bed sores, pressure sores, pressure injuries and decubitus ulcers, are areas of localised damage to the skin, which can extend
to underlying structures such as muscle and bone.
Pressure ulcers are formed by a combination of factors including pressure, shear forces, friction and moisture. In extreme cases, pressure ulcers can
become life threatening.
The European Pressure Ulcer Advisory Panel defines a pressure ulcer as "an area of localised damage to the skin and underlying tissue caused by
pressure, shear, friction and/or a combination of these".
Most pressure ulcers occur over a bony prominence, the toes, the heel, the buttocks, the base of the spine, the shoulder or the back of the head.
There are four different grades of pressure ulcer:
- grade 1 pressure ulcers are characterised by non-blanchable erythema (superficial inflammation) of intact skin, discolouration of the skin, warmth,
oedema, induration or hardness may also be used as indicators, particularly on individuals with darker skin;
- grade 2 pressure ulcers are characterised by partial thickness skin loss involving the inner or outer layers of skin or both. The ulcer is superficial
and presents clinically as an abrasion or blister;
- grade 3 pressure ulcers are characterised by full thickness skin loss involving damage to or necrosis (death) of subcutaneous tissue that may extend down
to, but not through, underlying fascia (tissue);
- grade 4 pressure ulcers are characterised by extensive destruction, tissue necrosis, or damage to muscle, bone, or supporting structures with
or without full thickness skin loss.
