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Infectious complications of pressure ulcers

Imad M Tleyjeh, MD, MSc, FACP, FIDSA
Dan Berlowitz, MD, MPH
Larry M Baddour, MD, FIDSA, FAHA
Section Editor
Daniel J Sexton, MD
Deputy Editor
Allyson Bloom, MD


Pressure ulcers are localized areas of tissue necrosis that tend to develop when soft tissue is compressed between a bony prominence and an external surface for a prolonged period of time [1]. They are a significant problem in critically ill patients, the elderly, and in persons with spinal cord injury (SCI).

Pressure ulcers cause pain, decrease quality of life, and lead to significant morbidity and prolonged hospital stays, in part due to complicating infection. Infected pressure ulcers are a common problem, occurring in 4 to 6 percent of nursing home patients in two series [1,2].

The infectious complications of pressure ulcers are reviewed in this topic. The epidemiology, pathogenesis, clinical manifestations, staging, prevention, and treatment of noninfected pressure skin and soft tissue injuries are discussed separately. (See "Epidemiology, pathogenesis, and risk assessment of pressure-induced skin and soft tissue injury" and "Prevention of pressure-induced skin and soft tissue injury" and "Clinical staging and management of pressure-induced skin and soft tissue injury".)

Pressure ulcers that occur in the feet of patients with severe neuropathy and/or vascular insufficiency, often due to diabetes mellitus, are discussed separately. (See "Clinical manifestations, diagnosis, and management of diabetic infections of the lower extremities".)


The National Pressure Ulcer Advisory Panel (NPUAP) made changes to its classification in April 2016 and suggested using the terminology "pressure injury" instead of "pressure ulcer" to describe these wounds. (See "Clinical staging and management of pressure-induced skin and soft tissue injury", section on 'NPUAP staging'.)

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Literature review current through: Nov 2017. | This topic last updated: Dec 04, 2017.
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