Pressure ulcers--prevention of pressure related damage.

Pressure ulcers (or pressure sores, bedsores, decubiti or decubitis ulcers) are areas of localised damage or trauma to the skin and underlying tissue, caused by pressure, friction or shear. They generally occur over bony prominences such as the base of the spine, heels and hips and are most common in people with impaired mobility, spinal cord injuries, severe acute illness (patients in ICU) and the elderly. Prevention is generally considered the most effective way to confront the issue, and the quality of nursing care is considered the key factor in managing pressure ulcers, however the actual extent to which they are preventable is unclear. Prevention measures are commonly divided into several areas: identification of those individuals deemed to be most at risk of developing pressure ulcers, repositioning and use of pressure-reducing support surfaces, and nutrition. The systematic reviews included in this information sheet reviewed the effectiveness of risk assessment scales, repositioning, support surfaces and nutritional supplements for pressure ulcer prevention. Management (including treatment) of pressure ulcers is discussed in another information sheet.