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Neurorehabilitation and Neural Repair
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Review: Pathogenesis and Management of Pressure Ulcers

Pete Tiernan

Departments of Surgery, VA Medical Center, Castle Point, New York Medical College, Valhalla New Rochelle Hospital Medical Center, New Rochelle, NY, U.S.A.

Bok Y. Lee

Departments of Surgery, VA Medical Center, Castle Point, New York Medical College, Valhalla New Rochelle Hospital Medical Center, New Rochelle, NY, U.S.A.

Pressure ulcers are a major problem in spinal cord injury patients and nursing home patients. The etiology is most probably pressure-induced ischemia. The first histopathologic changes are likely to occur either in muscle or subepidermally. Prevention of the problem is the best management, and the hallmark of prevention is identifying patients at risk and turning them frequently. When pressure sores occur, they heal with conservative measurements 80% of the time. With large, ulcerated, or infected lesions, surgical management is indicated. With sepsis, surgery should be performed immediately. Surgeons have made great progress filling huge defects with innovative grafts. Nevertheless, recurrence is a continuous problem. The use of an air-fluidized bed is beneficial in relieving pressure on the operated area during the postoperative period and in the measurement of pressure sores in general. Key Words: Pressure ulcers—Spinal cord injury-Pressure-Shearing forces-Friction-Moisture.

Neurorehabilitation and Neural Repair, Vol. 4, No. 3, 129-136 (1990)
DOI: 10.1177/136140969000400302
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