Materiały źródłowe

• #1 Pressure Ulcer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553107/

  Pressure injuries are localized skin and soft tissue injuries that develop due to prolonged pressure exerted over specific areas of the body, typically bony prominences. […] Evaluation and treatment options must consider the latest guidelines and classifications by the National Pressure Injury Advisory Panel and the International Statistical Classification of Diseases and Related Health Problems (ICD-11). […] Pressure injuries, also termed bedsores, decubitus ulcers, or pressure ulcers, are localized skin and soft tissue injuries that form as a result of prolonged pressure and shear, usually exerted over bony prominences. […] The 2 latest and most acceptable classifications were defined by the NPIAP and the International Statistical Classification of Diseases and Related Health Problems (ICD-11), released in 2019 and 2018, respectively.

• #2 Bedsores (Pressure Ulcers): Symptoms, Staging & Treatment

  https://my.clevelandclinic.org/health/diseases/17823-bedsores-pressure-injuries

  Bedsores are wounds that occur from prolonged pressure on your skin. […] Healthcare providers diagnose and stage bedsores based on their appearance. Your provider will photograph the sore to monitor wound healing. […] You may see a wound specialist for diagnosis and treatment. […] Stages of bedsores or pressure ulcers include: […] Healthcare providers use a staging system to determine the severity of a pressure ulcer. […] Depending on the severity of the pressure ulcer, it may take weeks or months for the sore to heal. […] Stages 3 or 4 pressure sores that are deep or affect a large area of skin may require surgery. You may need a skin graft to close the wound and promote healing.

• #3 Pressure Injuries (Pressure Ulcers) and Wound Care: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/190115-overview

  Although the terms decubitus ulcer, pressure sore, and pressure ulcer have often been used interchangeably, the National Pressure Injury Advisory Panel (NPIAP; formerly the National Pressure Ulcer Advisory Panel [NPUAP]) has stated that pressure injury the best term to use, given that open ulceration does not always occur. According to the NPIAP, a pressure injury is localized 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 may be painful. It occurs as a result of intense or prolonged pressure or pressure in combination with shear. […] For the purposes of workup and treatment, it is helpful to stage the pressure injury according to the system promulgated by the NPIAP, as follows: Stage 1 pressure injury – Nonblanchable erythema of intact skin; Stage 2 pressure injury – Partial-thickness skin loss with exposed dermis; Stage 3 pressure injury – Full-thickness skin loss; Stage 4 pressure injury – Full-thickness skin and tissue loss; Unstageable pressure injury – Obscured full-thickness skin and tissue loss; Deep pressure injury – Persistent nonblanchable deep red, maroon or purple discoloration.

• #4 Pressure Sores – Skin Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/skin-disorders/pressure-sores/pressure-sores

  Pressure sores are areas of skin damage resulting from a lack of blood flow due to prolonged pressure. […] The diagnosis is usually based on a physical examination. […] Doctors can usually diagnose pressure sores by doing a physical examination and noting the appearance and location of the sores. […] Because the depth and severity of pressure sores are difficult to determine, doctors or specially trained health care professionals stage and photograph pressure sores to monitor how they progress or heal. […] Doctors use specific criteria to determine how a pressure sore is healing. […] When pressure sores do not heal, doctors often suspect a complication such as an infection. If osteomyelitis is suspected, doctors do blood tests and often the imaging test magnetic resonance imaging (MRI). To confirm osteomyelitis, doctors may need to take a small sample (biopsy) of bone to see if bacteria grow from it (culture).

• #5 Bed Sores or Pressure Sores & Their Four Stages.

  https://www.webmd.com/skin-problems-and-treatments/pressure-sores-4-stages

  Your doctor may talk about the „stage” of your pressure sores. The stages are based on how deep the sores are, which can affect how they’re treated. […] To diagnose a pressure sore, your doctor will examine your skin. They might ask questions like: When did the sore appear? Does it hurt? How often do you change positions? Have you ever had a pressure sore before? […] Your doctor will consider your symptoms. Then they’ll determine whether you have a pressure sore, and if so, what stage it’s in. They might take a picture to record its healing progress.

• #6 Pressure Ulcers: Prevention, Evaluation, and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2008/1115/p1186.html/1000

  The physician should note the number, location, and size (length, width, and depth) of ulcers and assess for the presence of exudate, odor, sinus tracts, necrosis or eschar formation, tunneling, undermining, infection, healing (granulation and epithelialization), and wound margins. […] The stage of an ulcer cannot be determined until enough slough or eschar is removed to expose the base of the wound. […] Ulcers are difficult to resolve. Although more than 70 percent of stage II ulcers heal after six months of appropriate treatment, only 50 percent of stage III ulcers and 30 percent of stage IV ulcers heal within this period. […] Surgical consultation should be obtained for patients with clean stage III or IV ulcers that do not respond to optimal patient care or when quality of life would be improved with rapid wound closure.

• #7 Pressure Ulcers: Treatment and Management | Doctor

  https://patient.info/doctor/pressure-ulcers-pro

  Pressure ulcers occur when skin and underlying tissues are placed under pressure that impairs blood supply, leading to tissue damage. […] The use of pressure ulcer risk assessment tools or scales is a component of the assessment process used to identify individuals at risk of developing a pressure ulcer. […] Pressure ulcers can develop in any area of the body. In adults, damage usually occurs over bony prominences, such as the sacrum. Patients with pressure ulcers should receive an initial and ongoing assessment which should include: […] Ulcer assessment: should be supported by photography (calibrated with a ruler) and tracings. Ulcer assessment should include: […] The National Institute for Health and Care Excellence (NICE) has produced a quality standard which covers the prevention, assessment and management of pressure ulcers in all settings, including hospitals, care homes (with and without nursing) and people’s own homes.

• #8 Pressure ulcers (pressure sores)

  https://www.nhs.uk/conditions/pressure-sores/

  Pressure ulcers (pressure sores or bed sores) are areas of damage to your skin and the tissue underneath. You have a higher chance of getting them if you have difficulty moving. […] Symptoms of a pressure ulcer include: discoloured patches of skin that do not change colour when pressed the patches are usually red on white skin, or purple or blue on black or brown skin; a patch of skin that feels warm, spongy or hard; pain or itchiness in the affected area of skin. […] They can become a blister or open wound. If left untreated, they can get worse and eventually reach deeper layers of skin or muscle and bone. […] You or someone you care for have symptoms of a pressure ulcer and: hot, swollen or red skin it can look blue or purple on brown or black skin; pus coming out of the ulcer; a high temperature; severe pain or pain that’s getting worse.

• #9 Pressure ulcers and skin tone – Wounds International

  https://woundsinternational.com/made-easy/pressure-ulcers-and-skin-tone/

  Pressure ulcers are a global threat and present a significant health challenge worldwide (Li et al, 2020). Evidence shows that it is difficult to accurately identify the early stages of pressure ulceration in patients with dark skin tones (Black, 2018); for example, patients with dark skin are more likely to be diagnosed with higher-category pressure ulcers than patients with light skin (Bates-Jensen et al, 2021; Cox and Hawkins, 2023). This is the result of a lack of early identification e.g. redness can be easy to spot among people with light skin tones, but can be difficult to spot in dark skin tones (Chansky et al, 2017). Unrecognised damage arising from pressure ulcers in people with dark skin can lead to worsening stages; prolonged periods of hospital stay; deterioration in patients physical and psychological wellbeing; increased risk of sepsis and death; and elevated costs for healthcare services (Andersson et al, 2023). Therefore, there is a need to improve skin assessment skills among clinicians, as well as guidance on integrating pressure ulcer prevention best practice into all care settings where patients present with diverse skin tones.

• #10 Pressure ulcers and skin tone – Wounds International

  https://woundsinternational.com/made-easy/pressure-ulcers-and-skin-tone/

  While pressure ulcers in patients with dark skin tones is an under-researched area that is limited by poor methodological quality, there is evidence to show that people with dark skin tones are at a greater risk of developing higher category pressure ulcers (Harms et al, 2014; Ahn et al, 2016). This variation may be associated with inadequate skin assessment protocols for individuals with dark skin tones. In addition, there is a significant lack of knowledge and guidance to support clinicians to identify and manage pressure ulcers in people with dark skin tones. […] It has been acknowledged that skin tone variance may affect early detection of pressure ulcers (Dhoonmoon et al, 2021). Many of the signs and symptoms that clinicians have been educated to look for may present differently depending on the patients skin tone; for example, it has been found that dark skin rarely shows the blanching response that clinicians are trained to look out for, and erythema may also be hard to detect (Grimes, 2009).

• #11 Pressure Ulcer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553107/

  The development of pressure injuries is complex and multifactorial. […] Prolonged pressure on tissues can cause capillary bed occlusion, reducing oxygen levels in the area. […] Patients with the following conditions exhibit a predisposition to decubitus ulcers: Neurologic disease, Cardiovascular disease, Prolonged anesthesia, Dehydration, Malnutrition, Hypotension, Surgical patients. […] Pressure ulcers are a significant healthcare problem worldwide, which affects several thousands of people each year. […] Pressure injury management is a significant source of economic burden. […] The stages are as follows: Stage 1: The skin is intact with nonblanchable erythema. Stage 2: There is partial-thickness skin loss involving the epidermis and dermis. Stage 3: A full-thickness loss of skin extends to the subcutaneous tissue but does not cross the fascia beneath it. Stage 4: Full-thickness skin loss extends through the fascia with considerable tissue loss.

• #12 Pressure Ulcers: Nursing Diagnoses, Care Plans, Assessment & Interventions | NurseTogether

  https://www.nursetogether.com/pressure-ulcers-nursing-diagnosis-care-plan/

  Pressure ulcers, also known as decubitus ulcers, pressure injuries, or bedsores, are a type of skin breakdown that occurs due to continuous pressure disrupting blood flow and oxygenation to the tissues. This leads to poor tissue perfusion, tissue death, ulcerations, and necrosis. […] The National Pressure Injury Advisory Panel offers a widely recognized staging classification system for pressure ulcers based on the level of tissue involvement: Stage 1: Intact skin with non-blanchable redness. Stage 2: Partial-thickness skin loss involving the epidermis or dermis (blister or abrasion). Stage 3: Full-thickness skin loss exposing subcutaneous tissue (fat) but not underlying muscle. Stage 4: Full-thickness skin loss that may expose muscle, tendon, or bones. Unstageable: Unknown tissue loss due to slough or eschar covering the wound.

• #13 Pressure Injuries (Pressure Ulcers) and Wound Care: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/190115-overview

  Although the terms decubitus ulcer, pressure sore, and pressure ulcer have often been used interchangeably, the National Pressure Injury Advisory Panel (NPIAP; formerly the National Pressure Ulcer Advisory Panel [NPUAP]) has stated that pressure injury the best term to use, given that open ulceration does not always occur. According to the NPIAP, a pressure injury is localized 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 may be painful. It occurs as a result of intense or prolonged pressure or pressure in combination with shear. […] For the purposes of workup and treatment, it is helpful to stage the pressure injury according to the system promulgated by the NPIAP, as follows: Stage 1 pressure injury – Nonblanchable erythema of intact skin; Stage 2 pressure injury – Partial-thickness skin loss with exposed dermis; Stage 3 pressure injury – Full-thickness skin loss; Stage 4 pressure injury – Full-thickness skin and tissue loss; Unstageable pressure injury – Obscured full-thickness skin and tissue loss; Deep pressure injury – Persistent nonblanchable deep red, maroon or purple discoloration.

• #14 Pressure Ulcers: Prevention, Evaluation, and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2008/1115/p1186.html/1000

  The physician should note the number, location, and size (length, width, and depth) of ulcers and assess for the presence of exudate, odor, sinus tracts, necrosis or eschar formation, tunneling, undermining, infection, healing (granulation and epithelialization), and wound margins. […] The stage of an ulcer cannot be determined until enough slough or eschar is removed to expose the base of the wound. […] Ulcers are difficult to resolve. Although more than 70 percent of stage II ulcers heal after six months of appropriate treatment, only 50 percent of stage III ulcers and 30 percent of stage IV ulcers heal within this period. […] Surgical consultation should be obtained for patients with clean stage III or IV ulcers that do not respond to optimal patient care or when quality of life would be improved with rapid wound closure.

• #15 Reporting Pressure Ulcers

  https://hiacode.com/blog/education/icd-10-coding-tip-reporting-pressure-ulcers

  The coding of pressure ulcers has seen many changes over the past several years. Coders have seen that ICD-10-CM also came with changes on reporting of these ulcers. […] With ICD-10-CM, the code for reporting pressure ulcers now identifies the site and the stage of the ulcer. […] If a patient has more than one pressure ulcer a code for each should be reported. […] Unstageable pressure ulcers are diagnosed when the physician or clinician is not able to stage due to the ulcer being covered by eschar or possibly even a skin graft. If a patient with an unstageable pressure ulcer has a debridement and the stage of the ulcer is then revealed and documented, only code the stage revealed and not unstageable. […] Unspecified pressure ulcers are reported when there is a lack of documentation regarding the pressure ulcer stage.

• #16 Pressure Injuries – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/pressure-injury/pressure-injuries

  Pressure injuries are areas of necrosis and often ulceration (also called pressure ulcers) where soft tissues are compressed between bony prominences and external hard surfaces. […] Diagnosis is clinical. […] Diagnosis of pressure injury is based on clinical evaluation. A pressure injury is typically identified by its characteristic appearance and by its location over a bony prominence. […] Depth and extent of pressure injuries can be difficult to determine. Serial staging and photography of wounds is essential for monitoring injury progression or healing. […] Routine wound culture is not recommended because all pressure injuries are heavily colonized by bacteria. […] Tenderness, erythema of surrounding skin, exudate, or foul odor suggests an underlying infection. […] If osteomyelitis is suspected, complete blood count, blood cultures, and erythrocyte sedimentation rate or C-reactive protein is recommended.

• #17 Pressure Sores – Skin Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/skin-disorders/pressure-sores/pressure-sores

  Pressure sores are areas of skin damage resulting from a lack of blood flow due to prolonged pressure. […] The diagnosis is usually based on a physical examination. […] Doctors can usually diagnose pressure sores by doing a physical examination and noting the appearance and location of the sores. […] Because the depth and severity of pressure sores are difficult to determine, doctors or specially trained health care professionals stage and photograph pressure sores to monitor how they progress or heal. […] Doctors use specific criteria to determine how a pressure sore is healing. […] When pressure sores do not heal, doctors often suspect a complication such as an infection. If osteomyelitis is suspected, doctors do blood tests and often the imaging test magnetic resonance imaging (MRI). To confirm osteomyelitis, doctors may need to take a small sample (biopsy) of bone to see if bacteria grow from it (culture).

• #18 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Diagnosis-of-pressure-ulcers-(bedsores).aspx

  In patients presenting with pressure ulcers the ulcer is documented using photographic evidence. Patients general health and nutritional status is assessed. […] The patient undergoes a routine blood test to detect infections, high blood sugar (diabetes), high blood cholesterol) and sometimes blood cultures to determine presence of infections. […] Nutritional assessment is made by testing for serum albumin and haemoglobin (to detect anemia). A routine chest X ray is performed before any surgical treatment is chosen. […] The ulcer is evaluated by looking at: Cause of the ulcer diseases like diabetes, kidney disease anemia etc. are diagnosed. […] The ulcer is staged as per its depth. Staging does not depend on the total area of the ulcer. A stage I or II pressure ulcer may have a large surface area, but a stage III or IV is usually of relatively smaller diameter but of greater depth. […] Stages are progressive and need regular assessment and early management.

• #19 Pressure Ulcers: Treatment and Management | Doctor

  https://patient.info/doctor/pressure-ulcers-pro

  Pressure ulcers occur when skin and underlying tissues are placed under pressure that impairs blood supply, leading to tissue damage. […] The use of pressure ulcer risk assessment tools or scales is a component of the assessment process used to identify individuals at risk of developing a pressure ulcer. […] Pressure ulcers can develop in any area of the body. In adults, damage usually occurs over bony prominences, such as the sacrum. Patients with pressure ulcers should receive an initial and ongoing assessment which should include: […] Ulcer assessment: should be supported by photography (calibrated with a ruler) and tracings. Ulcer assessment should include: […] The National Institute for Health and Care Excellence (NICE) has produced a quality standard which covers the prevention, assessment and management of pressure ulcers in all settings, including hospitals, care homes (with and without nursing) and people’s own homes.

• #20 Pressure Ulcers: Nursing Diagnoses, Care Plans, Assessment & Interventions | NurseTogether

  https://www.nursetogether.com/pressure-ulcers-nursing-diagnosis-care-plan/

  A Deep Tissue Injury (DTI) is another pressure injury causing non-blanchable discoloration to intact or non-intact skin from damage to underlying tissues. […] Pressure ulcers are preventable through thorough assessment and intervention. This is the priority goal, as they can be difficult to heal once they form. […] Stage 3 and 4 pressure ulcers increase the risk of complications like osteomyelitis or sepsis. […] The first step of nursing care is the nursing assessment, during which the nurse will gather physical, psychosocial, emotional, and diagnostic data. […] The nurse should document the stage of the pressure injury using the classification system mentioned above. Staging the pressure ulcer accurately is vital to monitor progress or deterioration. […] Certain lab values may offer insight into the causes of pressure ulcers or the risk for poor healing: Increased white blood cell (WBC) counts indicate inflammation or infection. Low hemoglobin levels indicate less oxygen traveling to tissues. Low platelet counts may complicate wound proliferation and angiogenesis. Low albumin levels indicate decreased protein, which inhibits wound healing. Elevated glucose levels may impact wound healing.

• #21 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Diagnosis-of-pressure-ulcers-(bedsores).aspx

  Pressure ulcers or pressure sores are commonly seen among the sick and debilitated individuals admitted to nursing homes with prolonged immobility. […] Evaluation of the patients skin for signs of pressure sores is vital. Pressure sores are notoriously recurrent and difficult to treat. Their most important management is by prevention of occurrence in the first place. […] On admission to the acute or chronic care hospital all patients need a thorough skin assessment to determine if they may develop pressure ulcers or if they have symptoms of early pressure ulcers. […] Evaluation involves presence of previous ulcers, assessment of risk of pressure ulcer development. […] The highest possible Braden score is 23. Patients with scores of 18 or less are considered to be at risk of pressure sores.

• #22 5 Pressure Injuries (Bedsores) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/pressure-ulcer-nursing-care-plans/

  It is helpful to stage the pressure injury according to the system promulgated by the NPIAP. […] Staging is essential because it determines the treatment plan. Staging should be assessed at each dressing stage. It reflects whether the epidermis, dermis, fat, muscle, bone, or joint is exposed. […] The Braden scale is the most widely used risk assessment. […] The Norton scale includes the following items: physical condition, mental state, activity, mobility, and incontinence. Lower scores indicate a greater risk of pressure injuries. […] Therapeutic interventions and nursing actions for patients with pressure injury may include: Assessing and Staging Pressure Injuries. […] The incidence of skin breakdown is directly related to the number of risk factor present. Prevention is the key to managing pressure injuries, and it begins with a complete medical and nursing history, a risk assessment, and a skin examination when the client is admitted (Kirman Geibel, 2022).

• #23 Pressure Injuries (Pressure Ulcers) and Wound Care Workup: Laboratory Studies, Imaging Studies, Biopsy

  https://emedicine.medscape.com/article/190115-workup

  A complete blood count (CBC) with differential may show an elevated white blood cell (WBC) count indicative of inflammation or invasive infection. The erythrocyte sedimentation rate (ESR) should be determined. An ESR higher than 120 mm/hr and a WBC count greater than 15,000/L suggest osteomyelitis. […] A diagnosis of underlying osteomyelitis can be evaluated first with plain films. Osteomyelitis may also be suggested by positive bone scan findings. A negative bone scan finding generally excludes osteomyelitis; however, patients with an open wound, such as a pressure injury, can often have a falsely positive bone scan. A positive bone scan finding can be evaluated further by means of magnetic resonance imaging (MRI) or bone biopsy. […] A tissue biopsy should be performed for wounds that do not demonstrate clinical improvement despite adequate care and for wounds in which tissue invasion by bacteria is suggested. This allows quantification and identification of bacterial species and their antibiotic susceptibilities. Biopsy also enables the clinician to distinguish between simple contamination and tissue invasion, an important distinction that is not revealed by the common practice of swabbing the wound surface for culture.

• #24 Pressure Ulcers: Nursing Diagnoses, Care Plans, Assessment & Interventions | NurseTogether

  https://www.nursetogether.com/pressure-ulcers-nursing-diagnosis-care-plan/

  A Deep Tissue Injury (DTI) is another pressure injury causing non-blanchable discoloration to intact or non-intact skin from damage to underlying tissues. […] Pressure ulcers are preventable through thorough assessment and intervention. This is the priority goal, as they can be difficult to heal once they form. […] Stage 3 and 4 pressure ulcers increase the risk of complications like osteomyelitis or sepsis. […] The first step of nursing care is the nursing assessment, during which the nurse will gather physical, psychosocial, emotional, and diagnostic data. […] The nurse should document the stage of the pressure injury using the classification system mentioned above. Staging the pressure ulcer accurately is vital to monitor progress or deterioration. […] Certain lab values may offer insight into the causes of pressure ulcers or the risk for poor healing: Increased white blood cell (WBC) counts indicate inflammation or infection. Low hemoglobin levels indicate less oxygen traveling to tissues. Low platelet counts may complicate wound proliferation and angiogenesis. Low albumin levels indicate decreased protein, which inhibits wound healing. Elevated glucose levels may impact wound healing.

• #25 Pressure Injuries (Pressure Ulcers) and Wound Care: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/190115-overview

  Laboratory studies that may be helpful include the following: Complete blood count (CBC) with differential; Erythrocyte sedimentation rate (ESR); Albumin and prealbumin; Transferrin; Serum protein. When indicated by the specific clinical situation, the following should be obtained: Urinalysis and culture in the presence of urinary incontinence; Stool examination for fecal WBCs and Clostridium difficile toxin when pseudomembranous colitis may be the cause of fecal incontinence; Blood cultures if bacteremia or sepsis is suggested. […] Osteomyelitis should be considered whenever an ulcer does not heal, especially if the ulcer is over a bony prominence. Clinicians also should rule out other conditions associated with nonhealing ulcers, such as heterotopic calcification or ossification. Most findings indicate that antibiotic treatment for osteomyelitis should last 6-8 weeks. Surgery is needed for some cases of chronic osteomyelitis.

• #26 Pressure Injuries (Pressure Ulcers) and Wound Care: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/190115-overview

  Laboratory studies that may be helpful include the following: Complete blood count (CBC) with differential; Erythrocyte sedimentation rate (ESR); Albumin and prealbumin; Transferrin; Serum protein. When indicated by the specific clinical situation, the following should be obtained: Urinalysis and culture in the presence of urinary incontinence; Stool examination for fecal WBCs and Clostridium difficile toxin when pseudomembranous colitis may be the cause of fecal incontinence; Blood cultures if bacteremia or sepsis is suggested. […] Osteomyelitis should be considered whenever an ulcer does not heal, especially if the ulcer is over a bony prominence. Clinicians also should rule out other conditions associated with nonhealing ulcers, such as heterotopic calcification or ossification. Most findings indicate that antibiotic treatment for osteomyelitis should last 6-8 weeks. Surgery is needed for some cases of chronic osteomyelitis.

• #27 Decubitus ulcers – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/decubitus-ulcers/

  Decubitus ulcers or pressure ulcers are preventable injuries frequently encountered in older, malnourished, and immobilized individuals, especially those with multiple comorbidities. […] Diagnosis is primarily clinical but laboratory studies and imaging are required to evaluate for complications or risk factors that may delay healing (e.g., uncontrolled blood sugars, hypoalbuminemia). […] Confirm that the injury is secondary to prolonged focal pressure. […] Document the stage of the decubitus ulcer. […] Evaluate for predisposing factors, such as: Blood glucose and HbA1C to assess for diabetes, Serum albumin to assess for malnutrition. […] Screen for complications: CBC, CRP: Leukocytosis and CRP suggest an infectious complication. […] Imaging (e.g., x-ray, CT, or MRI): Consider if osteomyelitis or an underlying bony involvement is suspected.

• #28 Pressure Injuries – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/pressure-injury/pressure-injuries

  Pressure injuries are areas of necrosis and often ulceration (also called pressure ulcers) where soft tissues are compressed between bony prominences and external hard surfaces. […] Diagnosis is clinical. […] Diagnosis of pressure injury is based on clinical evaluation. A pressure injury is typically identified by its characteristic appearance and by its location over a bony prominence. […] Depth and extent of pressure injuries can be difficult to determine. Serial staging and photography of wounds is essential for monitoring injury progression or healing. […] Routine wound culture is not recommended because all pressure injuries are heavily colonized by bacteria. […] Tenderness, erythema of surrounding skin, exudate, or foul odor suggests an underlying infection. […] If osteomyelitis is suspected, complete blood count, blood cultures, and erythrocyte sedimentation rate or C-reactive protein is recommended.

• #29 Pressure Injuries (Pressure Ulcers) and Wound Care Workup: Laboratory Studies, Imaging Studies, Biopsy

  https://emedicine.medscape.com/article/190115-workup

  A complete blood count (CBC) with differential may show an elevated white blood cell (WBC) count indicative of inflammation or invasive infection. The erythrocyte sedimentation rate (ESR) should be determined. An ESR higher than 120 mm/hr and a WBC count greater than 15,000/L suggest osteomyelitis. […] A diagnosis of underlying osteomyelitis can be evaluated first with plain films. Osteomyelitis may also be suggested by positive bone scan findings. A negative bone scan finding generally excludes osteomyelitis; however, patients with an open wound, such as a pressure injury, can often have a falsely positive bone scan. A positive bone scan finding can be evaluated further by means of magnetic resonance imaging (MRI) or bone biopsy. […] A tissue biopsy should be performed for wounds that do not demonstrate clinical improvement despite adequate care and for wounds in which tissue invasion by bacteria is suggested. This allows quantification and identification of bacterial species and their antibiotic susceptibilities. Biopsy also enables the clinician to distinguish between simple contamination and tissue invasion, an important distinction that is not revealed by the common practice of swabbing the wound surface for culture.

• #30 Pressure Injuries (Pressure Ulcers) and Wound Care Workup: Laboratory Studies, Imaging Studies, Biopsy

  https://emedicine.medscape.com/article/190115-workup

  A complete blood count (CBC) with differential may show an elevated white blood cell (WBC) count indicative of inflammation or invasive infection. The erythrocyte sedimentation rate (ESR) should be determined. An ESR higher than 120 mm/hr and a WBC count greater than 15,000/L suggest osteomyelitis. […] A diagnosis of underlying osteomyelitis can be evaluated first with plain films. Osteomyelitis may also be suggested by positive bone scan findings. A negative bone scan finding generally excludes osteomyelitis; however, patients with an open wound, such as a pressure injury, can often have a falsely positive bone scan. A positive bone scan finding can be evaluated further by means of magnetic resonance imaging (MRI) or bone biopsy. […] A tissue biopsy should be performed for wounds that do not demonstrate clinical improvement despite adequate care and for wounds in which tissue invasion by bacteria is suggested. This allows quantification and identification of bacterial species and their antibiotic susceptibilities. Biopsy also enables the clinician to distinguish between simple contamination and tissue invasion, an important distinction that is not revealed by the common practice of swabbing the wound surface for culture.

• #31 5 Pressure Injuries (Bedsores) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/pressure-ulcer-nursing-care-plans/

  Poor nutritional status can weaken a clients immune system and reduce their ability to fight off infections, making them more susceptible to infections in open pressure ulcers. […] Open pressure ulcers create a direct entryway for bacteria and other pathogens to enter the body, increasing the risk of infection. […] Clients who seriously lack nutrition (serum albumin 2.5 mg/dl) are at risk of developing an infection produced by a pressure ulcer. […] Infection is present when there is copious, foul-smelling, purulent drainage and the client has other signs of infection (fever, increased pain) and bacteria count greater than 105. […] In clients who present with sepsis and pressure injuries, the sepsis is usually caused by a urinary tract infection (Kirman Geibel, 2022). […] A tissue biopsy should be performed for wounds that do not demonstrate clinical improvement despite adequate care and for wounds in which tissue invasion by bacteria is suggested.

• #32 5 Pressure Injuries (Bedsores) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/pressure-ulcer-nursing-care-plans/

  Poor nutritional status can weaken a clients immune system and reduce their ability to fight off infections, making them more susceptible to infections in open pressure ulcers. […] Open pressure ulcers create a direct entryway for bacteria and other pathogens to enter the body, increasing the risk of infection. […] Clients who seriously lack nutrition (serum albumin 2.5 mg/dl) are at risk of developing an infection produced by a pressure ulcer. […] Infection is present when there is copious, foul-smelling, purulent drainage and the client has other signs of infection (fever, increased pain) and bacteria count greater than 105. […] In clients who present with sepsis and pressure injuries, the sepsis is usually caused by a urinary tract infection (Kirman Geibel, 2022). […] A tissue biopsy should be performed for wounds that do not demonstrate clinical improvement despite adequate care and for wounds in which tissue invasion by bacteria is suggested.

• #33 Pressure Injuries (Pressure Ulcers) and Wound Care Workup: Laboratory Studies, Imaging Studies, Biopsy

  https://emedicine.medscape.com/article/190115-workup

  A complete blood count (CBC) with differential may show an elevated white blood cell (WBC) count indicative of inflammation or invasive infection. The erythrocyte sedimentation rate (ESR) should be determined. An ESR higher than 120 mm/hr and a WBC count greater than 15,000/L suggest osteomyelitis. […] A diagnosis of underlying osteomyelitis can be evaluated first with plain films. Osteomyelitis may also be suggested by positive bone scan findings. A negative bone scan finding generally excludes osteomyelitis; however, patients with an open wound, such as a pressure injury, can often have a falsely positive bone scan. A positive bone scan finding can be evaluated further by means of magnetic resonance imaging (MRI) or bone biopsy. […] A tissue biopsy should be performed for wounds that do not demonstrate clinical improvement despite adequate care and for wounds in which tissue invasion by bacteria is suggested. This allows quantification and identification of bacterial species and their antibiotic susceptibilities. Biopsy also enables the clinician to distinguish between simple contamination and tissue invasion, an important distinction that is not revealed by the common practice of swabbing the wound surface for culture.

• #34 Chronic Osteomyelitis in Sacral Pressure Ulcers Management Review in QA Format – Private Practice Infectious Disease

  https://www.ppidjournal.com/doi-full-10-35995-ppid1010002/

  The most common tests include erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and alpha-1 acid glycoprotein. They are usually elevated but have low sensitivity and specificity. […] Most of the studies have shown histologically confirmed chronic osteomyelitis as typically being superficial or focal without deep or diffuse involvement. […] It can be difficult to distinguish chronic osteomyelitis from reactive bone formation or healed osteomyelitis. […] There has been much discussion regarding the role of imaging in the diagnosis of osteomyelitis including radiographs, computed tomography (CT), magnetic resonance imaging (MRI), and scintigraphy. The challenge is differentiating via imaging the reactive bony changes from true infection. […] Most of the data regarding true sensitivity and specificity of imaging techniques are poor with small sample sizes and comparison to bone culture rather than histopathology.

• #35 Chronic Osteomyelitis in Sacral Pressure Ulcers Management Review in QA Format – Private Practice Infectious Disease

  https://www.ppidjournal.com/doi-full-10-35995-ppid1010002/

  The most common tests include erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and alpha-1 acid glycoprotein. They are usually elevated but have low sensitivity and specificity. […] Most of the studies have shown histologically confirmed chronic osteomyelitis as typically being superficial or focal without deep or diffuse involvement. […] It can be difficult to distinguish chronic osteomyelitis from reactive bone formation or healed osteomyelitis. […] There has been much discussion regarding the role of imaging in the diagnosis of osteomyelitis including radiographs, computed tomography (CT), magnetic resonance imaging (MRI), and scintigraphy. The challenge is differentiating via imaging the reactive bony changes from true infection. […] Most of the data regarding true sensitivity and specificity of imaging techniques are poor with small sample sizes and comparison to bone culture rather than histopathology.

• #36 Pressure Injuries (Pressure Ulcers) and Wound Care Workup: Laboratory Studies, Imaging Studies, Biopsy

  https://emedicine.medscape.com/article/190115-workup

  Bone biopsy is the criterion standard for the diagnosis of osteomyelitis within a pressure injury. It should be considered in patients with an elevated ESR, an elevated WBC count, and or abnormal pelvic films suggestive of osteomyelitis, as well as in cases of stage 4 pressure injury with exposed bone. If osteomyelitis is confirmed, treatment with a prolonged course of antibiotic therapy may be indicated.

• #37 Diagnosis and management of pressure ulcers – PubMed

  https://pubmed.ncbi.nlm.nih.gov/17967627/

  Pressure ulcers represent a significant health issue and cost for the growing number of elderly and debilitated patients. […] Simultaneously, the surgeon should order an MRI and erythrocyte sedimentation rate and take a bone biopsy to diagnose the extent of the wound and the bacteria present. […] If more than 10(5) bacteria are present, surgical debridement should be performed, followed by 6 weeks of intravenous antibiotics. […] Once the bacterial load has been lessened, a 6-week course of Regranex should be applied. […] Finally, after the wound bed has been prepared adequately, definitive surgical closure should be planned and performed.

• #38 Diagnostic and Therapeutic Value of Surgical Biopsy of Grade IV Sacral Pressure Ulcer

  https://orthojournalhms.org/18/article42_45.html

  OBJECTIVE Surgical bone biopsy is the gold standard to diagnose osteomyelitis in pressure sores; however the true utility of this procedure is debated, as it may not offer any additional culture information beyond a swab culture taken from the surface of the exposed bone. The purpose of this retrospective study is to evaluate the diagnostic and therapeutic role of bone biopsy in patients with stage IV sacral decubitus/pressure ulcers. […] Surgical bone biopsy from a stage IV sacral pressure ulcer provided additional information useful in diagnosing osteomyelitis and identifying bacteria involved. In this patient cohort, biopsy changed antibiotic management in over 90% of patients. […] Therefore, medical clinicians and infectious disease physicians often request an open biopsy of a sacral pressure ulcer that often probes to bone (stage IV) for definitive diagnosis of osteomyelitis and also to obtain culture data to guide antibiotic treatment.

• #39 A Guide on Detecting and Treating Pressure Sores | MSKTC

  https://msktc.org/sci/factsheets/recognizing-and-treating-pressure-sores

  One of the first signs of a possible skin sore is a reddened, discolored or darkened area (an African Americans skin may look purple, bluish or shiny). It may feel hard and warm to the touch. […] A pressure sore has begun if you remove pressure from the reddened area for 10 to 30 minutes and the skin color does not return to normal after that time. […] Test your skin with the blanching test: Press on the red, pink or darkened area with your finger. The area should go white; remove the pressure and the area should return to red, pink or darkened color within a few seconds, indicating good blood flow. If the area stays white, then blood flow has been impaired and damage has begun. […] Warning: What you see at the skins surface is often the smallest part of the sore, and this can fool you into thinking you only have a little problem. But skin damage from pressure doesn’t start at the skin surface. Pressure usually results from the blood vessels being squeezed between the skin surface and bone, so the muscles and the tissues under the skin near the bone suffer the greatest damage. Every pressure sore seen on the skin, no matter how small, should be regarded as serious because of the probable damage below the skin surface.

• #40 Pressure ulcers and skin tone – Wounds International

  https://woundsinternational.com/made-easy/pressure-ulcers-and-skin-tone/

  While pressure ulcers in patients with dark skin tones is an under-researched area that is limited by poor methodological quality, there is evidence to show that people with dark skin tones are at a greater risk of developing higher category pressure ulcers (Harms et al, 2014; Ahn et al, 2016). This variation may be associated with inadequate skin assessment protocols for individuals with dark skin tones. In addition, there is a significant lack of knowledge and guidance to support clinicians to identify and manage pressure ulcers in people with dark skin tones. […] It has been acknowledged that skin tone variance may affect early detection of pressure ulcers (Dhoonmoon et al, 2021). Many of the signs and symptoms that clinicians have been educated to look for may present differently depending on the patients skin tone; for example, it has been found that dark skin rarely shows the blanching response that clinicians are trained to look out for, and erythema may also be hard to detect (Grimes, 2009).

• #41 Pressure ulcers and skin tone – Wounds International

  https://woundsinternational.com/made-easy/pressure-ulcers-and-skin-tone/

  In dark skin tones, it can be difficult to predict exactly what erythema will look like (Dhoonmoon et al, 2023), and this is due to high melanin concentration in the skin (Baker, 2016). In addition, it is not uncommon for dark skin to present with age-related hyperpigmentation, which can mask the visual identification of erythema. It can be suggested that people with dark skin tones face a disadvantage, as category 1 pressure ulcers are more likely to go undetected and deteriorate to full thickness pressure ulcers e.g. category 3 and 4 (Bennet, 1995; Springle et al, 2009). Moreover, research has shown a pattern of underdiagnosis of category 1 pressure ulcers in dark skin tones (Oozageer Gunowa et al, 2018). […] Risk assessment is an important component of clinical practice that enables quick and efficient identification of patients at risk (Fletcher, 2023). It is important to note that standard risk assessment tools for pressure ulcers often rely on visual inspection and categorisation of skin tone; however, these tools may not adequately capture the specific risk factors and characteristics of dark skin. As a result, the accuracy of risk assessment may be compromised, leading to insufficient preventative measures in patients with dark skin tones.

• #42 Bedsores (Pressure Ulcers) — DermNet

  https://dermnetnz.org/topics/pressure-ulcer

  Pressure ulcers remain a clinical diagnosis. The patients skin should be examined thoroughly from scalp to toe. Special attention must be given to skin in common pressure sites, under medical devices, and skin folds in patients with larger body habitus. […] Temperature sensing technologies such as infrared thermography (IRT) have been developed to aid early prediction and early diagnosis of pressure ulcers. In a blinded prospective study of 70 patients in an ICU, IRT was found to detect skin changes 518 days before the visible appearance of pressure ulcers.

• #43 Diagnosis of Pressure Ulcer Stage Using On-Device AI

  https://www.mdpi.com/2076-3417/14/16/7124

  This study proposes a light-weight deep learning-based mobile healthcare platform for boundary detection and classification of pressure ulcers in general camera images, simultaneously. […] The YOLOv8 models, which perform with low computational cost and high accuracy, are employed to distinguish the affected area of pressure ulcers and sort them into six classes according to the NPUAP staging criterion. […] The YOLOv8m model recorded the highest values except for the precision metric. The YOLOv8m model showed strong performance in terms of the overall accuracy of 0.846, recall of 0.891, and mAP@50 of 0.908 on the test dataset. This implies that the YOLOv8m model can classify and detect pressure ulcers with high confidence. Accordingly, the YOLOv8m model was chosen as the best option for diagnosing pressure ulcer stage and it was deployed in mobile devices.

• #44 Diagnosis of Pressure Ulcer Stage Using On-Device AI

  https://www.mdpi.com/2076-3417/14/16/7124

  This study proposes a light-weight deep learning-based mobile healthcare platform for boundary detection and classification of pressure ulcers in general camera images, simultaneously. […] The YOLOv8 models, which perform with low computational cost and high accuracy, are employed to distinguish the affected area of pressure ulcers and sort them into six classes according to the NPUAP staging criterion. […] The YOLOv8m model recorded the highest values except for the precision metric. The YOLOv8m model showed strong performance in terms of the overall accuracy of 0.846, recall of 0.891, and mAP@50 of 0.908 on the test dataset. This implies that the YOLOv8m model can classify and detect pressure ulcers with high confidence. Accordingly, the YOLOv8m model was chosen as the best option for diagnosing pressure ulcer stage and it was deployed in mobile devices.

• #45 Diagnosis of Pressure Ulcer Stage Using On-Device AI

  https://www.mdpi.com/2076-3417/14/16/7124

  The trained YOLOv8m model successfully generated a set of bounding boxes along with pressure ulcer classes and confidence scores under both the desktop and the smartphone settings. […] The ‘Pressure Ulcer Checker’ mobile app was developed. The main components of this mobile app are registration, home, detection results, and instruction pages. […] Consequently, the on-device AI mobile app is able to precisely determine the pressure ulcer areas and stages with taking about 3 s. The proposed system would be useful for early diagnosis of and recovery from pressure ulcers.

• #46 Pressure ulcer | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/pressure-ulcer?lang=us

  A pressure ulcer, also known as pressure sore, is a cutaneous and subcutaneous local injury, following long-term pressure of soft tissues under bony prominences. […] Pressure ulcers evolve through time and present in the early stages as non-blanching skin erythema. Conscious patients may complain of pain or paresthesia. In later stages, a wound will develop, skin and soft tissue erosions will expose subcutaneous fat with possible muscular or bone exposure. […] Pressure ulcer results from sustained hypoperfusion and ischemia, associated with a local inflammatory reaction and bacterial colonization of the upper layers of the skin, extending progressively to the deeper layers leading to skin erosions, loss of all skin layers, necrosis of the subcutaneous tissue, and eventually necrosis of muscles, tendons, and bone. […] Pressure ulcer differentials include all causes of cutaneous erythema and chronic wounds such as venous or diabetic ulcers. Still, the site and clinical presentation of the lesion usually make it easy to diagnose.

• #47 Pressure ulcer | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/pressure-ulcer?lang=us

  A pressure ulcer, also known as pressure sore, is a cutaneous and subcutaneous local injury, following long-term pressure of soft tissues under bony prominences. […] Pressure ulcers evolve through time and present in the early stages as non-blanching skin erythema. Conscious patients may complain of pain or paresthesia. In later stages, a wound will develop, skin and soft tissue erosions will expose subcutaneous fat with possible muscular or bone exposure. […] Pressure ulcer results from sustained hypoperfusion and ischemia, associated with a local inflammatory reaction and bacterial colonization of the upper layers of the skin, extending progressively to the deeper layers leading to skin erosions, loss of all skin layers, necrosis of the subcutaneous tissue, and eventually necrosis of muscles, tendons, and bone. […] Pressure ulcer differentials include all causes of cutaneous erythema and chronic wounds such as venous or diabetic ulcers. Still, the site and clinical presentation of the lesion usually make it easy to diagnose.

• #48 Bedsores (pressure ulcers) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bed-sores/symptoms-causes/syc-20355893

  Complications of pressure ulcers include: Cellulitis. Cellulitis is an infection of the skin and connected soft tissues. […] Some complications can be life-threatening. […] You can help stop bedsores with these steps: Frequently change your position to avoid stress on the skin. […] Inspect the skin daily. Look closely at your skin daily for warning signs of a bedsore.

• #49 Bedsores (pressure ulcers): Treatments, stages, causes, and pictures

  https://www.medicalnewstoday.com/articles/173972

  Without treatment, pressure sores can lead to complications. One example is cellulitis, a potentially life-threatening bacterial infection from the surface of the skin to its deepest layer. Cellulitis can also travel to other parts of the body and cause further complications, such as sepsis, a life-threatening infection that can lead to organ failure. […] It is often possible to reduce the risk of pressure sores. When a sore is at an early stage, a person can treat it at home, but more advanced pressure ulcers require professional care.

• #50 Pressure Ulcer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553107/

  The prognosis for patients with pressure ulcers varies depending on the anatomic location, stage of injury, and treatment regimen. […] Most study results compare treatment efficacy by measuring the reduction in the incidence of pressure ulcers in a determined facility as a preventive measurement instead of the healing rate after treatment initiation. […] However, after 6 months of treatment, stage 2 pressure injuries have been documented to heal over 70% of the time, stage 3 about 50%, and stage 4 approximately 30%. […] Factors that affect prognosis include advancing age, the size and stage of PI, nutritional status, and chronic comorbidities. […] Complications often develop with decubitus ulcers. […] The most common problem is infection. […] Chronic decubitus ulcers can cause chronic anemia or secondary amyloidosis. […] The treatment of decubitus ulcers has its basis in the following: Prevention of additional ulcers, Decreasing pressure on the wound, Wound management, Surgical intervention, Improving the nutritional status.

• #51 Bedsores (pressure ulcers): Treatments, stages, causes, and pictures

  https://www.medicalnewstoday.com/articles/173972

  Without treatment, pressure sores can lead to complications. One example is cellulitis, a potentially life-threatening bacterial infection from the surface of the skin to its deepest layer. Cellulitis can also travel to other parts of the body and cause further complications, such as sepsis, a life-threatening infection that can lead to organ failure. […] It is often possible to reduce the risk of pressure sores. When a sore is at an early stage, a person can treat it at home, but more advanced pressure ulcers require professional care.

• #52 Pressure Ulcer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553107/

  The prognosis for patients with pressure ulcers varies depending on the anatomic location, stage of injury, and treatment regimen. […] Most study results compare treatment efficacy by measuring the reduction in the incidence of pressure ulcers in a determined facility as a preventive measurement instead of the healing rate after treatment initiation. […] However, after 6 months of treatment, stage 2 pressure injuries have been documented to heal over 70% of the time, stage 3 about 50%, and stage 4 approximately 30%. […] Factors that affect prognosis include advancing age, the size and stage of PI, nutritional status, and chronic comorbidities. […] Complications often develop with decubitus ulcers. […] The most common problem is infection. […] Chronic decubitus ulcers can cause chronic anemia or secondary amyloidosis. […] The treatment of decubitus ulcers has its basis in the following: Prevention of additional ulcers, Decreasing pressure on the wound, Wound management, Surgical intervention, Improving the nutritional status.

• #53 Pressure Ulcers: Prevention, Evaluation, and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2008/1115/p1186.html/1000

  The physician should note the number, location, and size (length, width, and depth) of ulcers and assess for the presence of exudate, odor, sinus tracts, necrosis or eschar formation, tunneling, undermining, infection, healing (granulation and epithelialization), and wound margins. […] The stage of an ulcer cannot be determined until enough slough or eschar is removed to expose the base of the wound. […] Ulcers are difficult to resolve. Although more than 70 percent of stage II ulcers heal after six months of appropriate treatment, only 50 percent of stage III ulcers and 30 percent of stage IV ulcers heal within this period. […] Surgical consultation should be obtained for patients with clean stage III or IV ulcers that do not respond to optimal patient care or when quality of life would be improved with rapid wound closure.

• #54 Pressure Ulcer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553107/

  The prognosis for patients with pressure ulcers varies depending on the anatomic location, stage of injury, and treatment regimen. […] Most study results compare treatment efficacy by measuring the reduction in the incidence of pressure ulcers in a determined facility as a preventive measurement instead of the healing rate after treatment initiation. […] However, after 6 months of treatment, stage 2 pressure injuries have been documented to heal over 70% of the time, stage 3 about 50%, and stage 4 approximately 30%. […] Factors that affect prognosis include advancing age, the size and stage of PI, nutritional status, and chronic comorbidities. […] Complications often develop with decubitus ulcers. […] The most common problem is infection. […] Chronic decubitus ulcers can cause chronic anemia or secondary amyloidosis. […] The treatment of decubitus ulcers has its basis in the following: Prevention of additional ulcers, Decreasing pressure on the wound, Wound management, Surgical intervention, Improving the nutritional status.

• #55 Bedsores (pressure ulcers) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bed-sores/diagnosis-treatment/drc-20355899

  Your healthcare professional likely will look closely at your skin to decide if you have a pressure ulcer. If a pressure ulcer is found, your healthcare professional will assign a stage to the wound. Staging helps determine what treatment is best for you. You might need blood tests to learn about your general health. […] Care for pressure ulcers depends on how deep the wound is. Generally, tending to a wound includes these steps: […] To heal properly, wounds need to be free of damaged, dead or infected tissue. The healthcare professional may remove damaged tissue, also known as debriding, by gently flushing the wound with water or cutting out damaged tissue. […] A large bedsore that fails to heal might require surgery. One method of surgical repair is to use padding from your muscle, skin or other tissue to cover the wound and cushion the affected bone. This is called flap surgery.

• #56 Pressure Ulcer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553107/

  The prognosis for patients with pressure ulcers varies depending on the anatomic location, stage of injury, and treatment regimen. […] Most study results compare treatment efficacy by measuring the reduction in the incidence of pressure ulcers in a determined facility as a preventive measurement instead of the healing rate after treatment initiation. […] However, after 6 months of treatment, stage 2 pressure injuries have been documented to heal over 70% of the time, stage 3 about 50%, and stage 4 approximately 30%. […] Factors that affect prognosis include advancing age, the size and stage of PI, nutritional status, and chronic comorbidities. […] Complications often develop with decubitus ulcers. […] The most common problem is infection. […] Chronic decubitus ulcers can cause chronic anemia or secondary amyloidosis. […] The treatment of decubitus ulcers has its basis in the following: Prevention of additional ulcers, Decreasing pressure on the wound, Wound management, Surgical intervention, Improving the nutritional status.

• #57 Diagnosis of Pressure Ulcer Stage Using On-Device AI

  https://www.mdpi.com/2076-3417/14/16/7124

  Pressure ulcers are serious healthcare concerns, especially for the elderly with reduced mobility. Severe pressure ulcers are accompanied by pain, degrading patients’ quality of life. Thus, speedy and accurate detection and classification of pressure ulcers are vital for timely treatment. The conventional visual examination method requires professional expertise for diagnosing pressure ulcer severity but it is difficult for the lay carer in domiciliary settings. […] The National Pressure Ulcer Advisory Panel (NPUAP) staging criterion is widely used for consistent assessment of the severity of pressure ulcers. Pressure ulcers can be classified into six categories such as stage 1, 2, 3, 4, deep tissue pressure injury (DTPI), and unstageable based on wound size, redness, tissue loss, inflammation degree, etc. The severity of pressure ulcers should be correctly identified for the effective care. Traditionally, the severity of pressure ulcers including the degree of tissue damage and infection is diagnosed through visual examination and manual palpation by medical professionals. However, the typical diagnostics is labor-intensive, time consuming, and observer-dependent.

• #58 Diagnosis of Pressure Ulcer Stage Using On-Device AI

  https://www.mdpi.com/2076-3417/14/16/7124

  The trained YOLOv8m model successfully generated a set of bounding boxes along with pressure ulcer classes and confidence scores under both the desktop and the smartphone settings. […] The ‘Pressure Ulcer Checker’ mobile app was developed. The main components of this mobile app are registration, home, detection results, and instruction pages. […] Consequently, the on-device AI mobile app is able to precisely determine the pressure ulcer areas and stages with taking about 3 s. The proposed system would be useful for early diagnosis of and recovery from pressure ulcers.

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