Infectious complications of pressure ulcers
- Imad M Tleyjeh, MD, MSc, FACP, FIDSA
Imad M Tleyjeh, MD, MSc, FACP, FIDSA
- Consultant, Infectious Diseases
- King Fahd Medical City, Riyadh
- Professor of Medicine and Epidemiology
- College of Medicine
- Alfaisal University, Riyadh
- Dan Berlowitz, MD, MPH
Dan Berlowitz, MD, MPH
- Boston University Schools of Public Health and Medicine
- Larry M Baddour, MD, FIDSA, FAHA
Larry M Baddour, MD, FIDSA, FAHA
- Professor of Medicine
- Mayo Clinic College of Medicine
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 . 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".)
CLASSIFICATION AND TERMINOLOGY
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'.)To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- CLASSIFICATION AND TERMINOLOGY
- Microbiologic evaluation
- CLINICAL FEATURES
- SUPERFICIAL INFECTION
- DEEP INFECTION
- - Cellulitis
- - Osteomyelitis
- - Bacteremia
- - Other complications
- - Antibiotic therapy
- INFECTION CONTROL