Pressure Ulcers (Decubitus)

Decubitus is the localized damage to the skin and/ or the underlying tissue. As a rule, it arises over bony protrusions (predilection points), as a result of pressure or in combination with shear forces (shifting of the skin layers).

A pressure ulcer often develops because of serious illnesses, especially in connection with pronounced immobility. It often arises in places where the soft body tissue between hard bone protrusions and external structures, such as a mattress or chair seat is compressed.

For the development of a pressure ulcer, these are preferably body regions with convex bone protrusions under thin subcutaneous fat tissue. Whether a pressure ulcer can develop at these points depends, among other things, on the position of the patient. When sitting, for example, shoulder blades, spinous processes of the spine, elbows, ischial bones and heels are particularly at risk.

There are several factors that can contribute to the development of pressure ulcers. First and foremost is the restricted ability to move (immobility). But also a reduced perception of pressure, a bad nutritional condition, incontinence, a bad skin condition (depressed tissue tolerance), a generally poor physical condition, a restricted willingness or ability to cooperate and many other individual factors can promote the development of a pressure ulcer.

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The measures to avoid a pressure ulcer are also an essential part of pressure ulcer therapy. These include measures to relieve and reduce pressure by encouraging and supporting the individual’s own movement, measures to distribute pressure through the use of aids such as soft pillows and mattresses, skin care and the reduction of other risk factors. In the case of an existing pressure ulcer, besides the preventive measures described above, an individual, specialized wound treatment should be carried out. The assessment of the individual pressure ulcer risk, measures to promote physical activity and treatment of other risk factors, the selection of suitable aids and adequate wound treatment, considering the needs of those affected, requires a high level of specialist expertise on the part of the practitioner and can only be done in team with the person concerned, relatives and in cooperation with medical and non-medical partners.