Pressure ulcer

(Redirected from Decubitus ulcers)


Decubitus ulcer stages I to IV.
Common pressure ulcer points. Red: in supine position. Blue: in lateral-lying position.
  • Classified into stages based on thickness
  • External compression of skin causes ischemic tissue damage, necrosis which is common in
  • Bedridden patients
  • Nursing home patients

Clinical Features

Stage IV decubitus ulcer.
  • Stage 1 - Skin intact, nonblanchable erythema
  • Stage 2 - Erosion into epidermis only (dermis is intact)
    • Adipose tissue is not visible
  • Stage 3 - Deep necrosis/ulceration with full-thickness skin loss
    • Adipose tissue is visible
    • Fascia, muscles, ligaments/tendons, cartilage/bone not visible
  • Stage 4 - Full thickness ulceration revealing muscle and bone
  • Unstageable - Full-thickness skin involvement with devitalized tissue/eschar obscuring view

Differential Diagnosis

Skin breakdown


  • The most important piece of the evaluation is early identification and classification especially for patients being admitted.
  • For deep wounds and in patients with signs of sepsis, evaluate for hematogenous spread (blood cultures) or osteomyelitis (imaging or deep culture)


  • Stage 1 and 2 ulcers
    • Wound care and dressing changes in addition to padding to relief pressure
  • Stage 2 and 3 ulcers
    • Surgical debridement and ongoing intensive wound care and pressure relief


  • Disposition is not dependent on the degree of ulcer but rather depends on the patient's clincal condition

See Also

External Links