Pressure ulcers--prophylaxis and treatment.

BACKGROUND Pressure sores are common and affect 10-20% of all institutionalized patients. Health personnel should have sufficient knowledge of prevention, evaluation and treatment. MATERIAL AND METHODS This article is based on a non-systematic search in Medline and EMBASE, and the authors' own clinical experience. RESULTS The causes of pressure sores are mechanical pressure, shear and frictional forces on the skin and underlying tissue. Neuropathy, nutrition deficiency, moist skin, and infection are risk factors for development and persistence of the wound. Preventive measures and treatment must to be directed towards both causes and risk factors. Pressure sores are graded on a scale from 0 to 4, based on depth of wound penetration into underlying tissue. Superficial wounds are treated conservatively while deeper pressure sores, which affect muscle and bone, must be evaluated for surgical treatment. INTERPRETATION Alleviation of pressure and reduction of risk factors are important for prevention and treatment of pressure sores. Depending on the depth of wound penetration into underlying tissue, additional treatment may be conservative wound treatment or surgery.