A pressure ulcer is defined as localised damage to the skin and underlying soft tissue usually over a bony prominence or related to a medical or other device

It can present as intact skin or an open ulcer and occurs as a result of intense and/or prolonged pressure, or pressure in combination with shear. Pressure ulcers most commonly occur over bony prominences but can develop on any part of the body, including mucosal surfaces.

They may be small, superficial wounds or blisters involving only epidermal elements or extensive, deep wounds, covered or filled with necrotic tissue and involving fascia, muscle, and bone.

Risk factors:

• Immobility
• sensory impairment
• older age
• surgery
• ICU stay
• malnourishment
• Hx of previous pressure ulcers
• environmental factors - Nature of the surface on which the patient has been lying (innappropriate mattress)

Waterlow score - used to identify patients at risk of pressure sores

Features

*Presence of risk factors

• Use of non-pressure-relieving support surface
• Localised skin changes in areas subject to pressure
  • shallow open wound
  • full thickness wound
  • full thickness wound with involvement of major tissues (exposed bone, tendon or muscle)