pressure ulcers

a preventable injury!

Etiology pressure over area of bony protrusion - heels, sacrum, greater trochanters.
Waterlow score not validated in critical care.
Epidemiology M>F. Other risk factors: smoker, low BMI, impaired mobility (so, like ICU patients), fever, incontinence
Clinical presentation
Pathogenesis ↓ perfusion → tissue necrosis
Diagnostic investigations Only to exclude alternative causes.
Management Poor evidence for many interventions.
Good skin care - clean and dry
Padding
Minimise sedation
Promote healing
Exudate management
Debridement

Risk factors

  1. pressure/shear
  2. poor padding/protrusions
  3. poor perfusion
  4. poor healing