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Pressure ulcer (pressure injury)

This is an educational overview summarizing the causes, characteristics, diagnosis, and management principles of pressure ulcers, along with the scope of evidence.

decubitus ulcer · decubitus ulcer · decubitus ulcer, elbow · decubitus ulcer, lower back · decubitus ulcer, other site · decubitus ulcer, upper back · pressure sores · pressure ulcer

MONDO:0004646Public QA completeSource-bound · 4

Disease at a glance

Start with the essentials, then explore the patient and research views.

Public revision · cb820063b8e4

Disease category
Pressure ulcers (pressure sores) are localized lesions in which the skin and underlying tissues are damaged when a single posture is maintained for an extended period, commonly occurring in areas where bones are close to the skin.
Core mechanism
The primary contributing factor is sustained or repetitive pressure; friction, shear forces, moisture, and restricted mobility can exacerbate the damage.
Main causes · related factors
Pressure reduces blood flow and oxygen supply to the tissues, and if pressure persists, it can lead to ischemic damage of the skin and deeper tissues.
Representative patterns
Common sites include the ankles, back, elbows, heels, and buttocks, presenting as skin discoloration, pain, warmth, edema, or skin defects.
Individual differences
Risk is increased by being bedridden, using a wheelchair, or having difficulty changing positions independently; individual differences are significant depending on nutrition, sensation, blood circulation, and comorbidities.
Diagnosis
In the early stages, the skin may remain persistently red or discolored with tenderness; as it progresses, blisters, open wounds, and deep tissue damage may appear, potentially delaying recovery.
Management
Diagnosis is centered on clinical evaluation that comprehensively integrates the location of the lesion, skin/tissue status, pressure exposure, mobility, and systemic status.
Treatment/Research Status
It is difficult to determine depth or the presence of infection based on skin color alone, and assessment of stage and severity may require repeated observation and clinical judgment by wound experts.
Read Evidence
The fundamentals of management are repositioning and the use of support devices to reduce pressure, keeping the skin clean and dry, and continuous assessment of wound status and systemic risk factors.
Key Precautions
Treatment is based on pressure relief and wound cleansing/protection, and depending on the depth of the lesion and the presence of infection or necrosis, dressing, debridement, nutritional support, or surgical treatment may be considered.

For patients and families

A structured guide for understanding the disease and preparing for clinical conversations.

At a Glance

Pressure ulcers (pressure sores) are localized lesions in which the skin and underlying tissues are damaged when a single posture is maintained for an extended period, commonly occurring in areas where bones are close to the skin.

Common sites include the ankles, back, elbows, heels, and buttocks, presenting as skin discoloration, pain, warmth, edema, or skin defects.

How the disease works

The primary contributing factor is sustained or repetitive pressure; friction, shear forces, moisture, and restricted mobility can exacerbate the damage.

Pressure reduces blood flow and oxygen supply to the tissues, and if pressure persists, it can lead to ischemic damage of the skin and deeper tissues.

Variations in presentation among individuals

Risk is increased by being bedridden, using a wheelchair, or having difficulty changing positions independently; individual differences are significant depending on nutrition, sensation, blood circulation, and comorbidities.

The broad framework of diagnosis and management

In the early stages, the skin may remain persistently red or discolored with tenderness; as it progresses, blisters, open wounds, and deep tissue damage may appear, potentially delaying recovery.

Diagnosis is centered on clinical evaluation that comprehensively integrates the location of the lesion, skin/tissue status, pressure exposure, mobility, and systemic status.

Current status of treatment

It is difficult to determine depth or the presence of infection based on skin color alone, and assessment of stage and severity may require repeated observation and clinical judgment by wound experts.

The fundamentals of management are repositioning and the use of support devices to reduce pressure, keeping the skin clean and dry, and continuous assessment of wound status and systemic risk factors.

Treatment is based on pressure relief and wound cleansing/protection, and depending on the depth of the lesion and the presence of infection or necrosis, dressing, debridement, nutritional support, or surgical treatment may be considered.

How to read clinical trials

In follow-up, wound size, depth, exudate, pain, and signs of systemic infection must be checked, and registered trials only demonstrate the existence of research and do not prove efficacy, approval, or standard of care.

Points to verify during clinical consultations

In clinical practice, it is important to assess the timing of onset and changes, pressure/positioning/mobility, pain and sensation, nutritional/urinary/bowel status, signs of infection such as fever, odor, or discharge, and the prevention/wound management methods currently in use.

Medical Guidance

This material is for educational purposes only and does not constitute individual diagnostic or treatment guidelines. If you have symptoms or wounds, please seek evaluation from a healthcare professional.

Evidence and sources

A trial registry status does not establish efficacy or regulatory approval.