View source for Pressure ulcer

==Background==
[[File:Schema stades escarres.png|100px|thumb|Decubitus ulcer stages I to IV.]]
[[File:Pressure ulcer points.png|thumb|Common pressure ulcer points. Red: in supine position. Blue: in lateral-lying position.]]
*Classified into stages based on thickness
*External compression of skin causes ischemic tissue damage, necrosis which is common in
*Bedridden patients
*Nursing home patients

==Clinical Features==
[[File:Imagen Bob 108.jpg|thumb|Stage IV decubitus ulcer.]]
*Stage 1 - Skin intact, nonblanchable erythema
*Stage 2 - Erosion into epidermis only (dermis is intact)
**Adipose tissue is not visible
*Stage 3 - Deep necrosis/ulceration with full-thickness skin loss
**Adipose tissue is visible
**Fascia, muscles, ligaments/tendons, cartilage/bone not visible
*Stage 4 - Full thickness ulceration revealing muscle and bone
*Unstageable - Full-thickness skin involvement with devitalized tissue/eschar obscuring view

==Differential Diagnosis==
===Skin breakdown===
*[[Cellulitis]]
*[[Diabetic ulcer]]
*[[Pressure ulcer]]
*[[Pyoderma gangrenosum]]
*[[Osteomyelitis]]
*[[Venous ulcer]]

==Evaluation==
*The most important piece of the evaluation is early identification and classification especially for patients being admitted.
*For deep wounds and in patients with signs of [[sepsis]], evaluate for hematogenous spread (blood cultures) or [[osteomyelitis]] (imaging or deep culture)

==Management==
*Stage 1 and 2 ulcers
**Wound care and dressing changes in addition to padding to relief pressure
*Stage 2 and 3 ulcers
**Surgical debridement and ongoing intensive wound care and pressure relief

==Disposition==
*Disposition is not dependent on the degree of ulcer but rather depends on the patient's clincal condition

==See Also==
*[[General Approach to EM Geriatrics]]

==External Links==


==References==
<references/>
[[Category:Dermatology]]