Over the centuries, pressure ulcers have been referred to as decubitus ulcers, bedsores, and pressure sores. The term pressure ulcer has become the preferred name of choice because it most closely describes the etiology and resultant ulcer. The National Pressure Ulcer Advisory Panel (NPUAP) revised its definition of pressure ulcers at its 2007 consensus conference to read: “localized injury to the skin and/or underlying tissue over a bony prominence, as a result of pressure, or pressure in combination with shear and/or friction.”
Pressure ulcers are usually located over bony prominences, such as the sacrum, coccyx, hips, and heels, and are staged according to the extent of observable tissue damage. Pressure ulcers can occur even with the best preventive measures. Effective treatment depends on a thorough assessment of the developing wound. Meaningful ulcer assessment requires a systematic and objective approach. Clinical assessment should include:
* ulcer history, including etiology, duration, and prior treatment
* anatomic location
* size (length, width, depth in centimeters)
* sinus tracts, undermining, and tunneling
* necrotic tissue (slough and eschar)
* granulation tissue (newly formed tissue within a healing wound)
epithelialization (regenerated tissue within a healing wound).
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