Decubitus Ulcers Workup

  • Author: Don R Revis Jr, MD; Chief Editor: John Geibel, MD, DSc, MA   more...
 
Updated: Apr 9, 2010
 

Diagnostic Procedures

  • Differentiation of bacterial infection from simple contamination is best made with a tissue biopsy, which allows quantitative wound culture techniques. This will indicate whether antibiotics should be administered.
Proceed to Treatment & Management
 
 
Contributor Information and Disclosures
Author

Don R Revis Jr, MD  Consulting Staff, Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Florida College of Medicine

Don R Revis Jr, MD is a member of the following medical societies: American College of Surgeons, American Medical Association, American Society for Aesthetic Plastic Surgery, and American Society of Plastic Surgeons

Disclosure: Nothing to disclose.

Specialty Editor Board

Alex Jacocks, MD  Program Director, Professor, Department of Surgery, University of Oklahoma School of Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Michael A Grosso, MD  Consulting Staff, Department of Cardiothoracic Surgery, St Francis Hospital

Michael A Grosso, MD is a member of the following medical societies: American College of Surgeons, Society of Thoracic Surgeons, and Society of University Surgeons

Disclosure: Nothing to disclose.

Paolo Zamboni, MD  Professor of Surgery, Chief of Day Surgery Unit, Chair of Vascular Diseases Center, University of Ferrara, Italy

Paolo Zamboni, MD is a member of the following medical societies: American Venous Forum and New York Academy of Sciences

Disclosure: Nothing to disclose.

Chief Editor

John Geibel, MD, DSc, MA  Vice Chairman, Professor, Department of Surgery, Section of Gastrointestinal Medicine and Department of Cellular and Molecular Physiology, Yale University School of Medicine; Director of Surgical Research, Department of Surgery, Yale-New Haven Hospital

John Geibel, MD, DSc, MA is a member of the following medical societies: American Gastroenterological Association, American Physiological Society, American Society of Nephrology, Association for Academic Surgery, International Society of Nephrology, New York Academy of Sciences, and Society for Surgery of the Alimentary Tract

Disclosure: AMGEN Royalty Other

References

  1. Howard DL, Taylor YJ. Racial and gender differences in pressure ulcer development among nursing home residents in the Southeastern United States. J Women Aging. Oct 2009;21(4):266-78. [Medline].

  2. Schweinberger MH, Roukis TS. Effectiveness of Instituting a Specific Bed Protocol in Reducing Complications Associated with Bed Rest. J Foot Ankle Surg. Apr 1 2010;[Medline].

  3. Zhao G, Hiltabidel E, Liu Y, et al. A Cross-sectional Descriptive Study of Pressure Ulcer Prevalence in a Teaching Hospital in China. Ostomy Wound Manage. Feb 2010;56(2):38-42. [Medline].

  4. Fogerty M, Guy J, Barbul A, et al. African Americans show increased risk for pressure ulcers: A retrospective analysis of acute care hospitals in America. Wound Repair Regen. Aug 11 2009;[Medline].

  5. Baumgarten M, Margolis DJ, Orwig DL, et al. Pressure ulcers in elderly patients with hip fracture across the continuum of care. J Am Geriatr Soc. May 2009;57(5):863-70. [Medline].

  6. Gefen A. Reswick and Rogers pressure-time curve for pressure ulcer risk. Part 1. Nurs Stand. Jul 15-21 2009;23(45):64, 66, 68 passim. [Medline].

  7. Gefen A. Reswick and Rogers pressure-time curve for pressure ulcer risk. Part 2. Nurs Stand. Jul 22-28 2009;23(46):40-4. [Medline].

  8. Stausberg J, Kiefer E. Classification of pressure ulcers: a systematic literature review. Stud Health Technol Inform. 2009;146:511-5. [Medline].

  9. Barbenel JC, Jordan MM, Nicol SM, Clark MO. Incidence of pressure-sores in the Greater Glasgow Health Board area. Lancet. Sep 10 1977;2(8037):548-50. [Medline].

  10. Conway H, Griffith BH. Plastic surgery for closure of decubitus ulcers in patients with paraplegia; based on experience with 1,000 cases. Am J Surg. Jun 1956;91(6):946-75. [Medline].

  11. Crenshaw RP, Vistnes LM. A decade of pressure sore research: 1977-1987. J Rehabil Res Dev. Winter 1989;26(1):63-74. [Medline].

  12. Dansereau JG, Conway H. Closure of decubiti in paraplegics Report of 2000 Cases. Plast Reconstr Surg. May 1964;33:474-80. [Medline].

  13. Dinsdale SM. Decubitus ulcers: role of pressure and friction in causation. Arch Phys Med Rehabil. Apr 1974;55(4):147-52. [Medline].

  14. El-Toraei I, Chung B. The management of pressure sores. J Dermatol Surg Oncol. Sep-Oct 1977;3(5):507-11. [Medline].

  15. Klitzman B, Kalinowski C, Glasofer SL, Rugani L. Pressure ulcers and pressure relief surfaces. Clin Plast Surg. Jul 1998;25(3):443-50. [Medline].

  16. Koch-Bitsch K, Woiwoda R. [Decubitus ulcer prevention expert standard--excerpts from implementation: on the path to continuous improvements]. Pflege Z. Mar 2007;60(3):158-61. [Medline].

  17. Maklebust J. An update on horizontal patient support surfaces. Ostomy Wound Manage. Jan 1999;45(1A Suppl):70S-77S; quiz 78S-79S. [Medline].

  18. Marjolin JN. Ulcere. Dictionnaire de Medicine. 1828;21.

  19. Mustoe T, Upton J, Marcellino V, Tun CJ, Rossier AB, Hachend HJ. Carcinoma in chronic pressure sores: a fulminant disease process. Plast Reconstr Surg. Jan 1986;77(1):116-21. [Medline].

  20. Parish LC, Lowthian P, Witkowski JA. The decubitus ulcer: many questions but few definitive answers. Clin Dermatol. Jan-Feb 2007;25(1):101-8. [Medline].

  21. Piascik P. Use of Regranex gel for diabetic foot ulcers. J Am Pharm Assoc (Wash). Sep-Oct 1998;38(5):628-30. [Medline].

  22. Redfern SJ, Jeneid PA, Gillingham ME, et al. Local pressures with ten types of patient-support system. Lancet. Aug 11 1973;2(7824):277-80. [Medline].

  23. Relander M, Palmer B. Recurrence of surgically treated pressure sores. Scand J Plast Reconstr Surg Hand Surg. 1988;22(1):89-92. [Medline].

  24. Reuler JB, Cooney TG. The pressure sore: pathophysiology and principles of management. Ann Intern Med. May 1981;94(5):661-6. [Medline].

  25. Rogers J, Wilson LF. Preventing recurrent tissue breakdowns after "pressure sore" closures. Plast Reconstr Surg. Oct 1975;56(4):419-22. [Medline].

  26. Siegler EL, Lavizzo-Mourey R. Management of stage III pressure ulcers in moderately demented nursing home residents. J Gen Intern Med. Nov-Dec 1991;6(6):507-13. [Medline].

  27. Staas WE Jr, LaMantia JG. Decubitus ulcers and rehabilitation medicine. Int J Dermatol. Oct 1982;21(8):437-44. [Medline].

  28. Stal S, Serure A, Donovan W, Spira M. The perioperative management of the patient with pressure sores. Ann Plast Surg. Oct 1983;11(4):347-56. [Medline].

  29. Thompson RJ. Pathological changes in mummies. Proc R Soc Med. 1961;54:409.

 
Previous
Next
 
Advanced sacral pressure ulcer shows the effects of pressure, shearing, and moisture.
Heel pressure ulcer.
Small sacral pressure sores can be reconstructed with the inferior-based skin rotation flap, with or without the superior gluteus maximus myocutaneous flap.
Sacral pressure ulcer before and after flap closure.
Heaps of verrucous white tissue around the ulcer suggest malignant transformation, as observed with Marjolin ulcers.
Close-up view of area with heaps of verrucous white tissue around the ulcer, the presence of which suggests malignant transformation (as observed with Marjolin ulcers).
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.