OVERVIEW OF PRESSURE ULCERS: PATHOPHYSIOLOGY, EPIDEMIOLOGY, RISK FACTORS, PRESENTATION AND TREATMENT

Abstract

Introduction: Skin alterations or lesions called pressure ulcers (PUs) encompass localized areas of ischemia with subsequent tissue necrosis, which are generated by prolonged compression, shear or friction of soft tissues between bony prominences and the external surface. Objective: to detail current information related to pressure ulcers pathophysiology, epidemiology, risk factors, presentation and treatment. Methodology: a total of 24 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 17 bibliographies were used because the other articles were not relevant to this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: pressure ulcers, skin lesions, decubitus ulcers. Results: The creation of pressure ulcers is multifactorial. The prevalence of pressure ulcers reported globally according to WHO is around 5 to 12%. Despite increased attention to prevention over the last 20 years, the prevalence of pressure ulcers has remained virtually unchanged, yet the related values of care continue to increase. Two-thirds of ulcers occur in people over 70 years of age. Conclusions: due to the high prevalence worldwide, especially in patients over 70 years of age, the recognition, presentation and pathophysiology of pressure ulcers should be clearly understood, with the aim of preventing their occurrence. Prevention consists of maintaining and improving tissue tolerance and adequate offloading. Both internal and external factors have to be evaluated because they play a major role in pressure ulcer formation. Special attention should be paid to epidemiological risk groups. Proper hydration, together with adequate nutrition are essential in the treatment of this condition, in addition to close monitoring and corresponding wound management. Key words: ulcers, pressure, lesions, skin, decubitus.