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A pressure ulcer or decubital ulcer is localized injury to theskin and/or underlying tissue usually over a bony prominence,as a result of pressure, or pressure in combination with shear

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Etiology and pathogenesis

Pressure or force per unit area is considered to be the most important factor in pressureulcer formation. ormal tissue pressure is between !" to #" mm$g. Pressure higherthan this upper limit can compromise tissue circulation and o%ygenation. &hen patienlies immobile on a hospital bed, pressures as high as !'( mm$g can be generated.

Especially over bony prominence. )onstant pressure can lead to tissue death *hear force results from the motion of bone and subcutaneous tissue relative to the

skin when the skin is +%ed. *hearing forces are parallel to the tissue surface, and thesubseuent sliding pressure is transmitted to deeper tissues, which can becomeangulated and occlude the blood vessels

-riction can cause damage to the super+cial layers of the skin

A moist environtment from urinary incontinence, perspiration, or e%cessive wounddrainage can cause maceration of the skin, which increases the risk of pressure ulcerformation

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