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Difference between revisions of "Pressure ulcer"
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'''Pressure ulcer''', also known as '''decubitus ulcer''' (as it often arises from lying down, i.e. being decubitus, a long time), is a relatively common [[ditzel]]. | '''Pressure ulcer''', also known as '''decubitus ulcer''' (as it often arises from lying down, i.e. being decubitus, a long time), is a relatively common [[ditzel]]. | ||
Ulcers overlying the ischial tuberosity (ischial ulcers) are pressure ulcers. | |||
==General== | ==General== | ||
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*Mechanical injury.<ref name=pmid20299616>{{Cite journal | last1 = Olesen | first1 = CG. | last2 = de Zee | first2 = M. | last3 = Rasmussen | first3 = J. | title = Missing links in pressure ulcer research--an interdisciplinary overview. | journal = J Appl Physiol | volume = 108 | issue = 6 | pages = 1458-64 | month = Jun | year = 2010 | doi = 10.1152/japplphysiol.01006.2009 | PMID = 20299616 }}</ref><ref name=pmid15157010>{{Cite journal | last1 = Hamanami | first1 = K. | last2 = Tokuhiro | first2 = A. | last3 = Inoue | first3 = H. | title = Finding the optimal setting of inflated air pressure for a multi-cell air cushion for wheelchair patients with spinal cord injury. | journal = Acta Med Okayama | volume = 58 | issue = 1 | pages = 37-44 | month = Feb | year = 2004 | doi = | PMID = 15157010 }}</ref> | *Mechanical injury.<ref name=pmid20299616>{{Cite journal | last1 = Olesen | first1 = CG. | last2 = de Zee | first2 = M. | last3 = Rasmussen | first3 = J. | title = Missing links in pressure ulcer research--an interdisciplinary overview. | journal = J Appl Physiol | volume = 108 | issue = 6 | pages = 1458-64 | month = Jun | year = 2010 | doi = 10.1152/japplphysiol.01006.2009 | PMID = 20299616 }}</ref><ref name=pmid15157010>{{Cite journal | last1 = Hamanami | first1 = K. | last2 = Tokuhiro | first2 = A. | last3 = Inoue | first3 = H. | title = Finding the optimal setting of inflated air pressure for a multi-cell air cushion for wheelchair patients with spinal cord injury. | journal = Acta Med Okayama | volume = 58 | issue = 1 | pages = 37-44 | month = Feb | year = 2004 | doi = | PMID = 15157010 }}</ref> | ||
==Gross== | |||
Typical locations: | |||
*Ischial tuberosity. | |||
*Sacrum.<ref name=pmid19060829>{{Cite journal | last1 = Beldon | first1 = P. | title = Problems encountered managing pressure ulceration of the sacrum. | journal = Br J Community Nurs | volume = 13 | issue = 12 | pages = S6, S8, 10 passim | month = Dec | year = 2008 | doi = | PMID = 19060829 }}</ref> | |||
==Microscopic== | ==Microscopic== | ||
Features: | Features: | ||
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<pre> | <pre> | ||
SKIN LESION ("DECUBITUS ULCER"), EXCISION: | SKIN LESION ("DECUBITUS ULCER"), EXCISION: | ||
- ULCERATED SKIN WITH ACANTHOSIS, HYPERKERATOSIS, PARAKERATOSIS, AND CHRONIC ACTIVE INFLAMMATION -- CONSISTENT WITH A PRESSURE ULCER. | - ULCERATED SKIN WITH ACANTHOSIS, HYPERKERATOSIS, PARAKERATOSIS, AND CHRONIC | ||
ACTIVE INFLAMMATION -- CONSISTENT WITH A PRESSURE ULCER. | |||
- NEGATIVE FOR MALIGNANCY. | - NEGATIVE FOR MALIGNANCY. | ||
</pre> | </pre> | ||
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<pre> | <pre> | ||
SKIN LESION ("DECUBITUS ULCER"), EXCISION: | SKIN LESION ("DECUBITUS ULCER"), EXCISION: | ||
- ULCERATED SKIN WITH PSEUDOEPITHELIOMATOUS HYPERPLASIA AND CHRONIC ACTIVE INFLAMMATION -- CONSISTENT WITH A PRESSURE ULCER. | - ULCERATED SKIN WITH PSEUDOEPITHELIOMATOUS HYPERPLASIA AND CHRONIC ACTIVE | ||
INFLAMMATION -- CONSISTENT WITH A PRESSURE ULCER. | |||
- NEGATIVE FOR MALIGNANCY. | |||
</pre> | |||
<pre> | |||
LESION ("LEFT ISCHIAL ULCER"), EXCISION: | |||
- ULCERATED SKIN AND SUBCUTANEOUS TISSUE WITH REACTIVE CHANGES. | |||
- NEGATIVE FOR MALIGNANCY. | - NEGATIVE FOR MALIGNANCY. | ||
</pre> | |||
<pre> | |||
LESION ("RIGHT ISCHIAL ULCER"), EXCISION: | |||
- ULCERATED SKIN WITH EPIDERMAL HYPERPLASIA, AND DERMAL AND SUBCUTANEOUS TISSUE WITH | |||
CHRONIC INFLAMMATION. | |||
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY. | |||
</pre> | |||
<pre> | |||
LESION ("SACRAL ULCER"), EXCISION: | |||
- ULCERATED SKIN AND SUBCUTANEOUS TISSUE WITH REACTIVE CHANGES, MICROABSCESS | |||
AND GRANULATION TISSUE. | |||
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY. | |||
</pre> | </pre> | ||