decubiti

Decubitus ulcers, also known as pressure ulcers or bedsores, are injuries to skin and underlying tissue. They typically occur in areas where skin is pressed between a hard surface, such as a bed or wheelchair, and a bony prominence of the body. These bony prominences are areas where there is little fat padding between the bone and the skin, making them more susceptible to damage from prolonged pressure. Common sites for decubiti include the sacrum (tailbone), heels, hips, ankles, shoulders, and elbows.

The development of decubiti is often attributed to a combination of factors. Sustained pressure is the primary cause, restricting blood flow to the affected area. When blood flow is limited, the skin and underlying tissues do not receive enough oxygen and nutrients, leading to cell damage and eventual tissue death. Other contributing factors include friction, which is the rubbing of skin against a surface, and shear, which occurs when skin layers move over each other, such as when a patient slides down in bed. Moisture from incontinence or perspiration can also weaken the skin, making it more vulnerable.

The severity of decubitus ulcers is categorized into stages. Stage I involves non-blanchable redness of intact skin. Stage II ulcers are superficial and involve partial-thickness skin loss. Stage III ulcers extend through the full thickness of the skin and into the subcutaneous tissue. Stage IV ulcers are the most severe, involving deep tissue loss that may extend to muscle, bone, or tendon. Prevention is key and involves frequent repositioning of individuals at risk, keeping the skin clean and dry, and using supportive surfaces that redistribute pressure. Treatment varies depending on the stage and may include wound care, debridement, and nutritional support.